Appendicitis By Rnpedia.Com

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Appendicitis By Rnpedia.Com - Quiz

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Questions and Answers
  • 1. 

    Which condition is most likely to have a nursing diagnosis of fluid volume deficit?  

    • A.

      Appendicitis

    • B.

      Pancreatitis

    • C.

      Cholecystitis

    • D.

      Gastric ulcer

    Correct Answer
    B. Pancreatitis
    Explanation
    Hypovolemic shock from fluid shifts is a major factor in acute pancreatitis. The other conditions are less likely to exhibit fluid volume deficit.

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  • 2. 

    When preparing a male client, age 51, for surgery to treat appendicitis, the nurse formulates a nursing diagnosis of Risk for infection related to inflammation, perforation, and surgery. What is the rationale for choosing this nursing diagnosis?  

    • A.

      Obstruction of the appendix may increase venous drainage and cause the appendix to rupture.

    • B.

      Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix.

    • C.

      The appendix may develop gangrene and rupture, especially in a middle-aged client.

    • D.

      Infection of the appendix diminishes necrotic arterial blood flow and increases venous drainage.

    Correct Answer
    B. Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix.
    Explanation
    A client with appendicitis is at risk for infection related to inflammation, perforation, and surgery because obstruction of the appendix causes mucus fluid to build up, increasing pressure in the appendix and compressing venous outflow drainage. The pressure continues to rise with venous obstruction; arterial blood flow then decreases, leading to ischemia from lack of perfusion. Inflammation and bacterial growth follow, and swelling continues to raise pressure within the appendix, resulting in gangrene and rupture. Geriatric, not middle-aged, clients are especially susceptible to appendix rupture.

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  • 3. 

    Situation : Mr. Gerald Liu, 19 y/o, is being admitted to a hospital unit complaining of severe pain in the lower abdomen. Admission vital signs reveal an oral temperature of 101.2 0F.  Which of the following would confirm a diagnosis of appendicitis?   

    • A.

      The pain is localized at a position halfway between the umbilicus and the right iliac crest.

    • B.

      Mr. Liu describes the pain as occurring 2 hours after eating

    • C.

      The pain subsides after eating

    • D.

      The pain is in the left lower quadrant

    Correct Answer
    A. The pain is localized at a position halfway between the umbilicus and the right iliac crest.
    Explanation
    Pain over McBurney’s point, the point halfway between the umbilicus and the iliac crest, is diagnosis for appendicitis. Options b and c are common with ulcers; option d may suggest ulcerative colitis or diverticulitis.

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  • 4. 

    Situation : Mr. Gerald Liu, 19 y/o, is being admitted to a hospital unit complaining of severe pain in the lower abdomen. Admission vital signs reveal an oral temperature of 101.2 0F. Which of the following complications is thought to be the most common cause of appendicitis?   

    • A.

      A fecalith

    • B.

      Internal bowel occlusion

    • C.

      Bowel kinking

    • D.

      Abdominal wall swelling

    Correct Answer
    A. A fecalith
    Explanation
    A fecalith is a hard piece of stool which is stone like that commonly obstructs the lumen. Due to obstruction, inflammation and bacterial invasion can occur. Tumors or foreign bodies may also cause obstruction.

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  • 5. 

    Situation : Mr. Gerald Liu, 19 y/o, is being admitted to a hospital unit complaining of severe pain in the lower abdomen. Admission vital signs reveal an oral temperature of 101.2 0F. The doctor ordered for a complete blood count. After the test, Nurse Ray received the result from the laboratory. Which laboratory values will confirm the diagnosis of appendicitis?   

    • A.

      RBC 5.5 x 106/mm3

    • B.

      Hct 44 %

    • C.

      WBC 13, 000/mm3

    • D.

      Hgb 15 g/dL

    Correct Answer
    C. WBC 13, 000/mm3
    Explanation
    Increase in WBC counts is suggestive of appendicitis because of bacterial invasion and inflammation. Normal WBC count is 5, 000 – 10, 000/mm3. Other options are normal values.

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  • 6. 

    Situation: Mr. Gerald Liu, 19 y/o, is being admitted to a hospital unit complaining of severe pain in the lower abdomen. Admission vital signs reveal an oral temperature of 101.2 0F. Signs and symptoms include pain in the RLQ of the abdomen that may be localize at McBurney’s point. To relieve pain, Mr. Liu should assume which  position? 

    • A.

      Prone

    • B.

      Supine, stretched out

    • C.

      Sitting

    • D.

      Lying with legs drawn up

    Correct Answer
    D. Lying with legs drawn up
    Explanation
    Posturing by lying with legs drawn up can relax the abdominal muscle thus relieve pain.

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  • 7. 

    Situation: Mr. Gerald Liu, 19 y/o, is being admitted to a hospital unit complaining of severe pain in the lower abdomen. Admission vital signs reveal an oral temperature of 101.2 0F. After a few minutes, the pain suddenly stops without any intervention. Nurse Ray might suspect that:   

    • A.

      The appendix is still distended

    • B.

      The appendix may have ruptured

    • C.

      An increased in intrathoracic pressure will occur

    • D.

      Signs and symptoms of peritonitis occur

    Correct Answer
    B. The appendix may have ruptured
    Explanation
    If a confirmed diagnosis is made and the pain suddenly without any intervention, the appendix may have ruptured; the pain is lessened because the appendix is no longer distended thus surgery is still needed.

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  • 8. 

    Roxy is admitted to the hospital with a possible diagnosis of appendicitis. On physical examination, the nurse should be looking for tenderness on palpation at McBurney’s point, which is located in the   

    • A.

      Left lower quadrant

    • B.

      Left upper quadrant

    • C.

      right lower quadrant

    • D.

      right upper quadrant

    Correct Answer
    C. right lower quadrant
    Explanation
    To be exact, the appendix is anatomically located at the Mc Burney’s point at the right iliac area of the right lower quadrant.

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  • 9. 

    Typical signs and symptoms of appendicitis include:

    • A.

      Nausea

    • B.

      Left lower quadrant pain

    • C.

      Pain when pressure is applied to the right lower quadrant of the abdomen.

    • D.

      High fever

    Correct Answer
    A. Nausea
    Explanation
    Nausea is typically associated with appendicitis with or without vomiting. Pain is generally felt in the right lower quadrant. Rebound tenderness, or pain felt with release of pressure applied to the abdomen, may be present with appendicitis. Low-grade fever is associated with appendicitis.

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  • 10. 

    When preparing a male client, age 51, for surgery to treat appendicitis, the nurse formulates a nursing diagnosis of Risk for infection related to inflammation, perforation, and surgery. What is the rationale for choosing this nursing diagnosis?  

    • A.

      Obstruction of the appendix may increase venous drainage and cause the appendix to rupture.

    • B.

      Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix.

    • C.

      The appendix may develop gangrene and rupture, especially in a middle-aged client.

    • D.

      Infection of the appendix diminishes necrotic arterial blood flow and increases venous drainage.

    Correct Answer
    B. Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix.
    Explanation
    A client with appendicitis is at risk for infection related to inflammation, perforation, and surgery because obstruction of the appendix causes mucus fluid to build up, increasing pressure in the appendix and compressing venous outflow drainage. The pressure continues to rise with venous obstruction; arterial blood flow then decreases, leading to ischemia from lack of perfusion. Inflammation and bacterial growth follow, and swelling continues to raise pressure within the appendix, resulting in gangrene and rupture. Geriatric, not middle-aged, clients are especially susceptible to appendix rupture.

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  • 11. 

     Jerry has diagnosed with appendicitis. He develops a fever, hypotension and tachycardia. The nurse suspects which of the following complications?

    • A.

      Intestinal obstruction

    • B.

      Peritonitis

    • C.

      Bowel ischemia

    • D.

      Deficient fluid volume

    Correct Answer
    B. Peritonitis
    Explanation
    Complications of acute appendicitis are peritonitis, perforation and abscess development.

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  • 12. 

    Situation: A 20 year old college student was rushed to the ER of PGH after he fainted during their ROTC drill. Complained of severe right iliac pain. Upon palpation of his abdomen, Ernie jerks even on slight pressure. Blood test was ordered. Diagnosis is acute appendicitis. Which result of the lab test will be significant to the diagnosis?   

    • A.

      RBC : 4.5 TO 5 Million / cu. mm.

    • B.

      Hgb : 13 to 14 gm/dl.

    • C.

      Platelets : 250,000 to 500,000 cu.mm.

    • D.

      WBC : 12,000 to 13,000/cu.mm

    Correct Answer
    D. WBC : 12,000 to 13,000/cu.mm
    Explanation
    WBC increases with inflammation and infection.

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  • 13. 

    Situation: A 20 year old college student was rushed to the ER of PGH after he fainted during their ROTC drill. Complained of severe right iliac pain. Upon palpation of his abdomen, Ernie jerks even on slight pressure. Blood test was ordered. Diagnosis is acute appendicitis. Stat appendectomy was indicated. Pre op care would include all of the following except? [1]  

    • A.

      Consent signed by the father

    • B.

      Enema STAT

    • C.

      Skin prep of the area including the pubis

    • D.

      Remove the jewelries

    Correct Answer
    B. Enema STAT
    Explanation
    Pre-op care for acute appendicitis typically includes obtaining consent from the patient or their legal guardian, preparing the skin in the area of the surgery, and removing any jewelry that the patient may be wearing. However, an enema is not typically performed as part of the pre-op care for appendectomy. Therefore, the correct answer is "Enema STAT."

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  • 14. 

    Situation: A 20 year old college student was rushed to the ER of PGH after he fainted during their ROTC drill. Complained of severe right iliac pain. Upon palpation of his abdomen, Ernie jerks even on slight pressure. Blood test was ordered. Diagnosis is acute appendicitis. Pre-anesthetic med of Demerol and atrophine sulfate were ordered to :

    • A.

      Allay anxiety and apprehension

    • B.

      Reduce pain

    • C.

      Prevent vomiting

    • D.

      Relax abdominal muscle

    Correct Answer
    A. Allay anxiety and apprehension
    Explanation
    Pain is not reduced in appendicits. Clients are not given pain medication as to assess whether the appendix ruptured. A sudden relief of pain indicates the the appendix has ruptured and client will have an emergency appendectomy and prevent peritonitis. Demerol and Atropine are used to allay client's anxiety pre operatively.

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  • 15. 

    Common anesthesia for appendectomy is   

    • A.

      Spinal

    • B.

      General

    • C.

      Caudal

    • D.

      Hypnosis

    Correct Answer
    A. Spinal
    Explanation
    Spinal anesthesia is the most common method used in appendectomy. Using this method, Only the area affected is anesthetized preventing systemic side effects of anesthetics like dizziness, hypotension and RR depression.

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  • 16. 

    Post op care for appendectomy include the following except   

    • A.

      Early ambulation

    • B.

      Diet as tolerated after fully conscious

    • C.

      Nasogastric tube connect to suction

    • D.

      Deep breathing and leg exercise

    Correct Answer
    B. Diet as tolerated after fully conscious
    Explanation
    Client's peristalsis will return in 48 to 72 hours post-op therefore, Fluid and food are witheld until the bowel sounds returns. Remember that ALL PROCUDURES requiring GENERAL and SPINAL anesthesia above the nerves that supply the intestines will cause temporary paralysis of the bowel. Specially when the bowels are traumatized during the procedure, it may take longer for the intestinal peristalsis to resume.

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  • 17. 

    Peritonitis may occur in ruptured appendix and may cause serious problems which are  1. Hypovolemia, electrolyte imbalance 2. Elevated temperature, weakness and diaphoresis 3. Nausea and vomiting, rigidity of the abdominal wall 4. Pallor and eventually shock  

    • A.

      1 and 2

    • B.

      2 and 3

    • C.

      1,2,3

    • D.

      All of the above

    Correct Answer
    D. All of the above
    Explanation
    Peritonitis will cause all of the above symptoms. The peritoneum has a natural tendency to GUARD and become RIGID as to limit the infective exudate exchange inside the abdominal cavity. Hypovolemia and F&E imbalance are caused by severe nausea and vomiting in patients with peritonitis because of acute pain. As inflammation and infection spreads, fever and chills will become more apparent causing elevation in temperature, weakness and sweating. If peritonitis is left untreated, Client will become severely hypotensive leading to shock and death.

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  • 18. 

     If after surgery the patient’s abdomen becomes distended and no bowel sounds appreciated, what would be the most suspected complication? [1]  

    • A.

      Intussusception

    • B.

      Paralytic Ileus

    • C.

      Hemorrhage

    • D.

      Ruptured colon

    Correct Answer
    B. Paralytic Ileus
    Explanation
    Paralytic Ileus is a mechanical bowel obstruction where in, the patients intestine fails to regain its motility. It is usually caused by surgery and anesthesia. Intusussusception, Appendicitis and Peritonitis also causes paralytic ileus.

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  • 19. 

    During defecation, movement of feces into the rectum initiates (click all that apply)

    • A.

      Rectoanal inhibitory reflex

    • B.

      Voluntary relaxation of the pelvic floor and external sphincter mechanism

    • C.

      Voluntary increase in intra-abdominal pressure

    • D.

      Voluntary contraction of external sphincter

    Correct Answer(s)
    B. Voluntary relaxation of the pelvic floor and external sphincter mechanism
    C. Voluntary increase in intra-abdominal pressure
    Explanation
    During defecation, the movement of feces into the rectum triggers the voluntary relaxation of the pelvic floor and external sphincter mechanism. This allows for the passage of feces through the anus. Additionally, there is a voluntary increase in intra-abdominal pressure, which aids in the expulsion of feces. The rectoanal inhibitory reflex, on the other hand, is not involved in the initiation of defecation but rather helps to prevent the involuntary release of feces. Voluntary contraction of the external sphincter is also not part of the initiation process, as it would impede the passage of feces.

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  • 20. 

    What percentage of people have appendicitis in their lifetime?

    • A.

      10%

    • B.

      20%

    • C.

      30%

    • D.

      50%

    Correct Answer
    A. 10%
    Explanation
    In the given question, the correct answer is 10%. This means that approximately 10% of people will experience appendicitis at some point in their lifetime. Appendicitis is a condition characterized by inflammation of the appendix, which is a small organ located in the lower right abdomen. While the exact percentage may vary, studies suggest that around 10% of the population will develop appendicitis, requiring surgical removal of the appendix.

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  • 21. 

    What are diagnostic features of acute appendicitis? click all that apply

    • A.

      Low grade fever less than 100.4F/38C

    • B.

      Moderate leukocytosis (10,000-20,000)

    • C.

      Ultrasound

    • D.

      CT (with contrast depending on body habitus)

    • E.

      CT (helpful if perforation is suspected to diagnose periappendiceal abscess)

    Correct Answer(s)
    A. Low grade fever less than 100.4F/38C
    B. Moderate leukocytosis (10,000-20,000)
    C. Ultrasound
    D. CT (with contrast depending on body habitus)
    E. CT (helpful if perforation is suspected to diagnose periappendiceal abscess)
    Explanation
    The diagnostic features of acute appendicitis include low grade fever less than 100.4F/38C, moderate leukocytosis (10,000-20,000), ultrasound, and CT (with contrast depending on body habitus). CT is also helpful if perforation is suspected to diagnose periappendiceal abscess.

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  • 22. 

    What best explains what happens to the appendix when it is obstructed?

    • A.

      The inflamed tissue becomes infected and dies from lack of blood supply and eventually bursts

    • B.

      The inflamed tissue dies from lack of blood supply causing the appendix to burst

    • C.

      The obstruction causes pressure to build up and eventually causes the appendix to burst

    • D.

      The obstruction hardens the appendix eventually causing it to burst

    Correct Answer
    A. The inflamed tissue becomes infected and dies from lack of blood supply and eventually bursts
    Explanation
    When the appendix is obstructed, the inflamed tissue becomes infected and dies due to the lack of blood supply. As a result, the appendix eventually bursts. The obstruction prevents proper blood flow to the appendix, leading to tissue death and subsequent infection. The pressure buildup caused by the obstruction further contributes to the bursting of the appendix.

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  • 23. 

    What is the primary cause of appendicitis?

    • A.

      Obstruction of the lumen between the cecum and appendix

    • B.

      Inflammation due to an immune response

    • C.

      Constipation

    • D.

      Overuse of antibiotics

    Correct Answer
    A. Obstruction of the lumen between the cecum and appendix
    Explanation
    Appendicitis is primarily caused by the obstruction of the lumen, which is the opening, between the cecum and appendix. When this opening gets blocked, it can lead to the inflammation and infection of the appendix, resulting in appendicitis. Inflammation due to an immune response, constipation, and overuse of antibiotics are not the primary causes of appendicitis.

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  • 24. 

    During the rectoanal inhibitory reflex, the internal sphincter ________  allowing the contents into the anal canal, then the external sphincter ____________ and contents are pushed back into the rectum. This occurs up to 7 times daily.

    • A.

      Relaxes, relaxes

    • B.

      Contracts, contracts

    • C.

      Relaxes, contracts

    • D.

      Contracts, relaxes

    Correct Answer
    C. Relaxes, contracts
    Explanation
    During the rectoanal inhibitory reflex, the internal sphincter relaxes, allowing the contents into the anal canal, then the external sphincter contracts and contents are pushed back into the rectum. This reflex helps in the process of defecation by coordinating the relaxation and contraction of the sphincters to allow the passage of stool through the anal canal and then prevent leakage back into the rectum. This reflex occurs multiple times daily to facilitate regular bowel movements.

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  • 25. 

    What stimulates the contraction of propulsive waves that move stool distally from the cecum?

    • A.

      Distention of the colonic wall

    • B.

      Distention of the small intestinal wall

    • C.

      The fermenting vat located in the cecum

    • D.

      Distention of the cecum wall

    Correct Answer
    A. Distention of the colonic wall
    Explanation
    The contraction of propulsive waves that move stool distally from the cecum is stimulated by the distention of the colonic wall. When the colonic wall becomes stretched or distended, it triggers a reflex response that initiates the contraction of the smooth muscles in the colon. This contraction helps to propel the stool forward and aids in its movement towards the rectum. Distention of the small intestinal wall, the fermenting vat located in the cecum, or the cecum wall do not directly stimulate the contraction of propulsive waves in the same way as the distention of the colonic wall.

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  • 26. 

    What part of the colon propels retrograde waves of contraction to allow the cecum to retain liquid feces and act as a 'fermenting vat'?

    • A.

      Mid-transverse colon

    • B.

      Entire transverse colon

    • C.

      Ascending colon

    • D.

      Descending colon

    • E.

      Ileum

    Correct Answer
    A. Mid-transverse colon
    Explanation
    The mid-transverse colon is responsible for propelling retrograde waves of contraction that allow the cecum to retain liquid feces and act as a 'fermenting vat'. This means that the mid-transverse colon helps in the process of fermentation and retention of liquid feces in the cecum.

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  • 27. 

    The middle rectal artery supplies blood to which part of the rectum?

    • A.

      The lower rectum

    • B.

      The middle rectum

    • C.

      The anal sphincters

    • D.

      Upper and middle rectum

    Correct Answer
    A. The lower rectum
    Explanation
    The middle rectal artery supplies blood to the lower rectum.

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  • 28. 

    The inferior rectal artery supplies blood to which part of the rectum?

    • A.

      The internal and external anal sphincters

    • B.

      The lower rectum

    • C.

      The uppper, middle, and lower rectum

    • D.

      The external sphincter only

    • E.

      The internal sphincter only

    Correct Answer
    A. The internal and external anal sphincters
    Explanation
    The inferior rectal artery supplies blood to the internal and external anal sphincters. These sphincters are located at the opening of the anus and are responsible for controlling the passage of stool. The blood supply from the inferior rectal artery ensures that these muscles receive the necessary oxygen and nutrients for their proper functioning.

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  • 29. 

    What vein carries venous blood from the intestines to the liver?

    • A.

      Portal vein

    • B.

      Iliac veins

    • C.

      Middle colic vein

    • D.

      Inferior mesenteric vein

    • E.

      Superior mesenteric vein

    Correct Answer
    A. Portal vein
    Explanation
    The portal vein is responsible for carrying venous blood from the intestines to the liver. This vein plays a crucial role in the hepatic portal system, which allows nutrients and other substances absorbed by the intestines to be processed and metabolized by the liver before being distributed to the rest of the body. The other options listed, such as the iliac veins, middle colic vein, inferior mesenteric vein, and superior mesenteric vein, do not perform this specific function of carrying blood from the intestines to the liver.

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  • 30. 

    The inferior mesenteric artery supplies blood to which part of the GI tract?

    • A.

      Mid-transverse colon to rectum

    • B.

      Colon and anal canal

    • C.

      Descending colon and rectum

    • D.

      Colon and rectum

    • E.

      Colon, cecum, and rectum

    Correct Answer
    A. Mid-transverse colon to rectum
    Explanation
    The correct answer is "mid-transverse colon to rectum." The inferior mesenteric artery is a branch of the abdominal aorta that supplies blood to the lower part of the gastrointestinal (GI) tract. It specifically provides blood to the mid-transverse colon, descending colon, sigmoid colon, and rectum. Therefore, the correct answer indicates the correct range of the GI tract that is supplied by the inferior mesenteric artery.

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  • 31. 

    The superior rectal artery supplies blood to which part of the GI tract?

    • A.

      The rectum

    • B.

      The upper and middle rectum

    • C.

      Lower rectum

    • D.

      Anal sphincters and rectum

    • E.

      Anal sphincters only

    Correct Answer
    B. The upper and middle rectum
    Explanation
    The superior rectal artery supplies blood to the upper and middle rectum. This artery is a branch of the inferior mesenteric artery and is responsible for providing oxygenated blood to the rectal region. It plays a crucial role in maintaining the blood supply to this area of the gastrointestinal tract, ensuring proper functioning and health of the upper and middle rectum.

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  • 32. 

    What 3 major branches of the aorta supply blood to the intestines?

    • A.

      Celiac artery, superior mesenteric artery, inferior mesenteric artery

    • B.

      Celiac artery, superior mesenteric artery, and right and left gastric artery

    • C.

      Superior mesenteric artery, inferior mesenteric artery, and internal and external iliac arteries

    • D.

      Common iliac artery, superior mesenteric artery, inferior mesenteric arteries

    Correct Answer
    A. Celiac artery, superior mesenteric artery, inferior mesenteric artery
    Explanation
    The correct answer is the celiac artery, superior mesenteric artery, and inferior mesenteric artery. These three major branches of the aorta supply blood to the intestines. The celiac artery supplies blood to the upper part of the intestines, including the stomach, liver, and spleen. The superior mesenteric artery supplies blood to the middle part of the intestines, including the small intestine and the first half of the large intestine. The inferior mesenteric artery supplies blood to the lower part of the intestines, including the second half of the large intestine and the rectum.

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  • 33. 

    The __________ extends from the rectosigmoid junction to the anal canal and is composed of insensitive columnar epithelium.

    • A.

      Anal Canal

    • B.

      Rectum

    • C.

      Colon

    • D.

      Large bowel

    Correct Answer
    B. Rectum
    Explanation
    The rectum is the correct answer because it extends from the rectosigmoid junction to the anal canal and is composed of insensitive columnar epithelium. The anal canal is the terminal part of the large intestine, but it is not composed of insensitive columnar epithelium. The colon and large bowel are also parts of the large intestine, but they do not extend all the way to the anal canal.

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  • 34. 

    While examining a patient with suspected appendicitis, you would expect to find pain (with or without) gaurding, (with or without) rebound tenderness, pain (with or without) passive flexion of R hip, pain (with or without) passive flexion of L hip, and a postitive or negative obturator sign?

    • A.

      Pain: with gaurding, with rebound tenderness, with passive flexion of R hip, without passive flexion of L hip, and a positive obturator sign

    • B.

      Pain: without gaurding, with rebound tenderness, with passive flexion of R hip, without passive flexion of L hip, and a postivie obturator sign

    • C.

      Pain: without gaurding, with rebound tenderness, with passive flexion of R hip, with passive flexion of L hip, and a positive obturator sign

    • D.

      Pain: with gaurding, with rebound tenderness, with passive flexion of R hip, with passive flexion of L hip, and a positive obturator sign

    Correct Answer
    A. Pain: with gaurding, with rebound tenderness, with passive flexion of R hip, without passive flexion of L hip, and a positive obturator sign
    Explanation
    In a patient with suspected appendicitis, the expected findings include pain with guarding and rebound tenderness, along with pain upon passive flexion of the right hip. The absence of pain upon passive flexion of the left hip is also expected. Additionally, a positive obturator sign is likely to be present.

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  • 35. 

    A patient presents with periumbilical pain that moves to the RLQ over 24 hrs. the pain is exacerbated by walking, coughing, or a car ride. The patient presents with nausea, vomiting, and a low grade fever of less than 38C or 100.4. What is the suspected diagnosis?

    • A.

      Acute appendicitis

    • B.

      Ovarian cyst

    • C.

      Volvulus

    • D.

      Acute pancreatitis

    • E.

      Acute cholecystitis

    Correct Answer
    A. Acute appendicitis
    Explanation
    The patient's symptoms of periumbilical pain that migrates to the RLQ, along with nausea, vomiting, and a low-grade fever, are highly suggestive of acute appendicitis. The pain worsening with walking, coughing, or a car ride is a classic symptom known as "McBurney's sign." Acute appendicitis is the inflammation of the appendix and is a common surgical emergency that requires immediate intervention to prevent complications such as perforation or abscess formation. Ovarian cyst, volvulus, acute pancreatitis, and acute cholecystitis do not typically present with the same combination of symptoms as described by the patient.

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  • 36. 

    What are some possible causes of an obstructed appendix?

    • A.

      Inflammatory bowel disease, infection, fecal stasis, calcium salts or undigested fiber- fecaliths, parasites, fb, and neoplasms

    • B.

      Infection, fecal stasis, calcium salts or undigested fiber-fecaliths, parasites, FB, and neoplasms, diarrhea

    • C.

      Fecal stasis, fecaliths, FB, gastric ulcer, infection, calcium salts or undigested fiber- fecaliths, parasites,and neoplasms

    • D.

      Suppositories, FB, neoplams, undigested fiber and calcium salts, calcium salts or undigested fiber-fecaliths, infection, fecal stasis, parasites

    Correct Answer
    A. Inflammatory bowel disease, infection, fecal stasis, calcium salts or undigested fiber- fecaliths, parasites, fb, and neoplasms
    Explanation
    Possible causes of an obstructed appendix include inflammatory bowel disease, infection, fecal stasis, calcium salts or undigested fiber-fecaliths, parasites, foreign bodies (FB), and neoplasms. These factors can lead to a blockage in the appendix, resulting in inflammation and potentially leading to appendicitis.

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  • 37. 

    What type of tissue is the appendix made up of?

    • A.

      Lymphatic

    • B.

      Connective

    • C.

      Fibrinous

    • D.

      Intestinal mucosa

    Correct Answer
    A. Lymphatic
    Explanation
    The appendix is made up of lymphatic tissue. Lymphatic tissue is a type of connective tissue that contains lymphocytes, which are white blood cells involved in the immune response. The appendix is part of the lymphatic system and plays a role in the immune function of the body.

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  • 38. 

    The superior mesenteric artery supplies blood to which part of the GI tract?

    • A.

      Small intestine (other than duodenum) and proximal colon

    • B.

      Mid-transverse colon to rectum

    • C.

      Duodenum

    • D.

      Cecum

    • E.

      Rectum only

    Correct Answer
    A. Small intestine (other than duodenum) and proximal colon
    Explanation
    The superior mesenteric artery supplies blood to the small intestine (other than the duodenum) and the proximal colon. This artery is a major branch of the abdominal aorta and is responsible for providing oxygenated blood to these specific regions of the gastrointestinal (GI) tract. The duodenum, cecum, and rectum are not directly supplied by the superior mesenteric artery.

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  • 39. 

    The celiac artery supplies blood to which part of the GI tract?

    • A.

      Duodenum

    • B.

      Jejunum

    • C.

      Small intestine and proximal colon

    • D.

      Mid-transverse colon to rectum

    • E.

      Cecum

    Correct Answer
    A. Duodenum
    Explanation
    The celiac artery supplies blood to the duodenum, which is the first part of the small intestine. This artery originates from the abdominal aorta and branches off to provide oxygenated blood to various organs in the abdominal region, including the stomach, liver, spleen, and pancreas. The duodenum receives its blood supply from the celiac artery through its branches, ensuring proper oxygenation and nutrient delivery to this important part of the gastrointestinal tract.

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  • 40. 

    The _____________  is 3-4 cm long, starts at the dentate line, is supported by the internal and external anal sphincters, and composed of sensitive squamous epithelium.

    • A.

      Rectum

    • B.

      Anal Canal

    • C.

      Colon

    • D.

      Anal sphincter canal

    Correct Answer
    B. Anal Canal
    Explanation
    The anal canal is a 3-4 cm long structure that starts at the dentate line. It is supported by the internal and external anal sphincters and is composed of sensitive squamous epithelium.

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  • 41. 

    What is the blind sac that is in the RLQ below the ileocecal valve?

    • A.

      Cecum

    • B.

      Appendix

    • C.

      Transverse colon

    • D.

      Ascending colon

    Correct Answer
    A. Cecum
    Explanation
    The cecum is the blind sac that is located in the right lower quadrant (RLQ) below the ileocecal valve. It is the first part of the large intestine and serves as a site for the fermentation of indigestible materials and the absorption of water and electrolytes. The appendix, transverse colon, and ascending colon are not blind sacs located in the RLQ below the ileocecal valve.

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  • 42. 

    What is the treatment for appendicitis?

    • A.

      Surgical removal of inflamed appendix before it ruptures

    • B.

      Pain control and antibiotics

    • C.

      Pain control

    • D.

      Antibiotics and observation

    Correct Answer
    A. Surgical removal of inflamed appendix before it ruptures
    Explanation
    The correct answer is surgical removal of inflamed appendix before it ruptures. Appendicitis is the inflammation of the appendix, which can lead to rupture if not treated promptly. The most effective treatment for appendicitis is the surgical removal of the inflamed appendix, known as an appendectomy. This procedure is performed to prevent the appendix from bursting and causing a potentially life-threatening infection. Pain control and antibiotics may be used to manage symptoms and prevent infection, but they are not a definitive treatment for appendicitis.

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  • 43. 

    The appendix is located on the _____ lower side of the abdomen.

    • A.

      Right

    • B.

      Left

    Correct Answer
    A. Right
    Explanation
    The appendix is located on the right lower side of the abdomen.

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  • 44. 

    Symptoms of appendicitis include ______

    • A.

      Abdominal pain

    • B.

      Nausea

    • C.

      Constipation

    • D.

      All of the above

    Correct Answer
    D. All of the above
    Explanation
    Symptoms of appendicitis include abdominal pain, nausea, vomiting, loss of appetite, low grade fever, constipation, diarrhea and an inability to pass gas. A swelling may subsequently appear in the abdomen overlying the appendix.

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  • 45. 

    McBurney Point is located ________

    • A.

      Around the umbilicus

    • B.

      In the right lower abdomen

    • C.

      In the left lower abdomen

    • D.

      In the upper abdomen

    Correct Answer
    B. In the right lower abdomen
    Explanation
    Pain in appendicitis normally starts around the umbilicus but later settles in the right lower abdomen near the appendix. This point is called the McBurney Point and is located midway between the umbilicus and the top of the right pelvic bone.

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  • 46. 

    Other condition/s that could produce pain similar to appendicitis include

    • A.

      Inflammation of gall bladder

    • B.

      Stone in ureter

    • C.

      Inflammation of right colon

    • D.

      All of the above

    Correct Answer
    D. All of the above
    Explanation
    Other conditions like gall stones, inflammation of gall bladder, stone in the ureter, ruptured ovarian follicle, a ruptured tubal pregnancy, perforation of stomach or duodenal ulcer, and inflammation of the right colon can produce pain similar to appendicitis.

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  • 47. 

    Worms do not cause appendicitis.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    Worms can block the opening of the appendix resulting in appendicitis. In addition, fecaliths, infection or inflammation can also block the opening of the appendix leading to appendicitis.

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  • 48. 

    Diet does not influence the development of appendicitis.  

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    Diet lacking in fiber is a risk factor for appendicitis.

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  • 49. 

    Surgery is the definitive treatment for appendicitis.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    Surgery is the definitive treatment for appendicitis. It may be performed as an open surgery or through a laparoscope. Antibiotics are also useful in treating appendicitis, but usually require to be followed by surgery due to recurrence.

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  • 50. 

    Perforation is not a complication of appendicitis.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    The inflamed appendix can burst resulting in inflammation of the lining of the abdomen (peritoneum), the condition being called peritonitis.

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  • Current Version
  • Mar 22, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Jan 24, 2013
    Quiz Created by
    RNpedia.com
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