APPENDICITIS EXAM QUESTIONS AND
ANSWERS
A client with severe right lower quadrant abdominal pain says that the pain has
suddenly stopped. Which nursing interventions are appropriate for this client? - Answer-
A sudden reduction in abdominal pain in appendicitis could indicate that the appendix
has ruptured. The nurse needs to anticipate care for a ruptured appendix and potential
peritonitis by notifying the physician, preparing the client for surgery to remove the
appendix, expecting intravenous antibiotics to be prescribed, and expect intravenous
fluids to be prescribed for fluid resuscitation.
the appendix - Answer-a pouch that is attached to the cecum below the ileocecal valve.
It is located in the right iliac region in the area called McBurney's point.
simple appendicitis - Answer-The appendix is inflamed but intact.
gangrenous - Answer-The appendix has areas of tissue necrosis and microscopic
perforations.
perforated - Answer-The appendix has ruptured, and the peritoneal cavity is
contaminated with gastrointestinal contents.
fecalith - Answer-a hard mass of feces
-obstruction that can cause appendicitis
risk factors for fecaliths - Answer-adolescent males
diet low in fiber, hi in carbs
gi infections
first manifestation - Answer-continuous, mild, generalized pain or upper abdominal pain.
The pain intensifies over the next 4 hours and localizes in the right lower abdominal
quadrant. The pain is aggravated by moving, walking, or coughing.
pregnant client - Answer-periumbilical or right subcostal pain can occur because the
appendix is displaced by the expanding uterus.
young female - Answer-the symptoms of appendicitis must be differentiated from the
pain of ovulation (mittelschmerz), possible ruptured ectopic pregnancy, and pelvic
inflammatory disease.
mittelschmerz - Answer-pain of ovulation
chronic appendicitis - Answer-chronic abdominal pain with acute attacks occurring every
several months.
, children under 4 - Answer-seldom develop it, but risk of rupture INCREASES because
unable to verbalize extent and location of pain
older adult - Answer-leading manifestation is confusion
test to dx - Answer-abd ultrasound
WBC with diff - Answer-the total white blood cell count will be elevated, with an increase
in immature white blood cells.
goals of pharma therapy - Answer-maintain fluid balance
prevent infection
control pain
abx - Answer-3rd generation cephalosporins
things to avoid while appi suspect - Answer-laxatives or enemas
-may cause perforation
How is appendicitis classified? - Answer-simple, gangrenous, perforated
Which nursing diagnoses are appropriate for acute appendicitis? - Answer-•Potential for
deficient fluid volume
•Increased risk for impaired gas exchange
•Potential for infection
•Increased risk for acute pain
•Potential for anxiety
•Potential for fear.
While caring for a client recovering from an appendectomy, the nurse monitors urine
output, intravenous fluid intake, and the amount of nasogastric drainage. Which nursing
diagnosis is the nurse using to guide this
client's
care? - Answer-risk for deficient fluid volume
A client telephones the health clinic with complaints of vague abdominal pain. The client
has not been able to eat for a day and is nauseated. What advice should the nurse
provide to this client? - Answer-Seek immediate medical attention
-Manifestations of appendicitis begin with vague abdominal pain. Nausea and anorexia
are additional manifestations. If medical attention is not provided, gangrene can develop
within 24 to 36 hours. The client should be instructed to seek immediate medical
attention. Resting in bed and drinking warm fluids is not going to prevent the appendix
from developing gangrene. When appendicitis is suspected, the client should be
instructed to avoid laxatives and not to apply heat to the abdomen because heat could
encourage the appendix to rupture.
ANSWERS
A client with severe right lower quadrant abdominal pain says that the pain has
suddenly stopped. Which nursing interventions are appropriate for this client? - Answer-
A sudden reduction in abdominal pain in appendicitis could indicate that the appendix
has ruptured. The nurse needs to anticipate care for a ruptured appendix and potential
peritonitis by notifying the physician, preparing the client for surgery to remove the
appendix, expecting intravenous antibiotics to be prescribed, and expect intravenous
fluids to be prescribed for fluid resuscitation.
the appendix - Answer-a pouch that is attached to the cecum below the ileocecal valve.
It is located in the right iliac region in the area called McBurney's point.
simple appendicitis - Answer-The appendix is inflamed but intact.
gangrenous - Answer-The appendix has areas of tissue necrosis and microscopic
perforations.
perforated - Answer-The appendix has ruptured, and the peritoneal cavity is
contaminated with gastrointestinal contents.
fecalith - Answer-a hard mass of feces
-obstruction that can cause appendicitis
risk factors for fecaliths - Answer-adolescent males
diet low in fiber, hi in carbs
gi infections
first manifestation - Answer-continuous, mild, generalized pain or upper abdominal pain.
The pain intensifies over the next 4 hours and localizes in the right lower abdominal
quadrant. The pain is aggravated by moving, walking, or coughing.
pregnant client - Answer-periumbilical or right subcostal pain can occur because the
appendix is displaced by the expanding uterus.
young female - Answer-the symptoms of appendicitis must be differentiated from the
pain of ovulation (mittelschmerz), possible ruptured ectopic pregnancy, and pelvic
inflammatory disease.
mittelschmerz - Answer-pain of ovulation
chronic appendicitis - Answer-chronic abdominal pain with acute attacks occurring every
several months.
, children under 4 - Answer-seldom develop it, but risk of rupture INCREASES because
unable to verbalize extent and location of pain
older adult - Answer-leading manifestation is confusion
test to dx - Answer-abd ultrasound
WBC with diff - Answer-the total white blood cell count will be elevated, with an increase
in immature white blood cells.
goals of pharma therapy - Answer-maintain fluid balance
prevent infection
control pain
abx - Answer-3rd generation cephalosporins
things to avoid while appi suspect - Answer-laxatives or enemas
-may cause perforation
How is appendicitis classified? - Answer-simple, gangrenous, perforated
Which nursing diagnoses are appropriate for acute appendicitis? - Answer-•Potential for
deficient fluid volume
•Increased risk for impaired gas exchange
•Potential for infection
•Increased risk for acute pain
•Potential for anxiety
•Potential for fear.
While caring for a client recovering from an appendectomy, the nurse monitors urine
output, intravenous fluid intake, and the amount of nasogastric drainage. Which nursing
diagnosis is the nurse using to guide this
client's
care? - Answer-risk for deficient fluid volume
A client telephones the health clinic with complaints of vague abdominal pain. The client
has not been able to eat for a day and is nauseated. What advice should the nurse
provide to this client? - Answer-Seek immediate medical attention
-Manifestations of appendicitis begin with vague abdominal pain. Nausea and anorexia
are additional manifestations. If medical attention is not provided, gangrene can develop
within 24 to 36 hours. The client should be instructed to seek immediate medical
attention. Resting in bed and drinking warm fluids is not going to prevent the appendix
from developing gangrene. When appendicitis is suspected, the client should be
instructed to avoid laxatives and not to apply heat to the abdomen because heat could
encourage the appendix to rupture.
