NCLEX REVIEW: APPENDICITIS TEST QUESTIONS WITH 100%
VERIFIED ANSWERS
1. A nurse is providing wound care to a 4.
client 1 day after the client underwent an The nurse should gently clean
appendectomy. A drain was inserted into the area around the drain by mov-
the incisional site during surgery. Which ing in a circular motion away from
action should the nurse perform when the drain. Doing so prevents the
providing wound care? introduction of microorganisms to
1. Remove the dressing and leave the in- the wound and drain site. The
cision open to air. 2. Remove the drain if incision cannot be left open to
wound drainage is minimal. air as long as the drain is in-
3. Gently irrigate the drain to remove ex- tact. The nurse should note the
udate. amount and character of wound
4. Clean the area around the drain moving drainage, but the surgeon will de-
away from the drain. termine when the drain should be
removed. Surgical wound drains
are not irrigated.
2. The nurse is admitting a client with acute 3.
appendicitis to the emergency depart- The nurse should place the client
ment. The client has abdominal pain of 10 on NPO status in anticipation of
on a pain scale of 1 to 10. The client will surgery. The nurse can initiate
be going to surgery as soon as possible. pain relief strategies, such as re-
The nurse should: laxation techniques, but the sur-
1. Contact the surgeon to request an or- geon will likely not order narcotic
der for a narcotic for the pain. medication prior to surgery. The
2. Maintain the client in a recumbent po- nurse can place the client in a po-
sition. sition that is most comfortable for
3. Place the client on nothing-by-mouth the client. Heat is contraindicated
(NPO) status. because it may lead to perfora-
4. Apply heat to the abdomen in the area tion of the appendix.
of the pain.
3. A client with acute appendicitis devel- 4.
ops a fever, tachycardia, and hypoten- Complications of acute appen-
sion. Based on these assessment find- dicitis are perforation, peritonitis,
ings, the nurse should further assess the and abscess development. Signs
client for which of the following compli- of the development of peritonitis
cations? include abdominal pain and dis-
1. Deficient fluid volume. tention, tachycardia, tachypnea,
2. Intestinal obstruction. nausea, vomiting, and fever. Be-
1/2
VERIFIED ANSWERS
1. A nurse is providing wound care to a 4.
client 1 day after the client underwent an The nurse should gently clean
appendectomy. A drain was inserted into the area around the drain by mov-
the incisional site during surgery. Which ing in a circular motion away from
action should the nurse perform when the drain. Doing so prevents the
providing wound care? introduction of microorganisms to
1. Remove the dressing and leave the in- the wound and drain site. The
cision open to air. 2. Remove the drain if incision cannot be left open to
wound drainage is minimal. air as long as the drain is in-
3. Gently irrigate the drain to remove ex- tact. The nurse should note the
udate. amount and character of wound
4. Clean the area around the drain moving drainage, but the surgeon will de-
away from the drain. termine when the drain should be
removed. Surgical wound drains
are not irrigated.
2. The nurse is admitting a client with acute 3.
appendicitis to the emergency depart- The nurse should place the client
ment. The client has abdominal pain of 10 on NPO status in anticipation of
on a pain scale of 1 to 10. The client will surgery. The nurse can initiate
be going to surgery as soon as possible. pain relief strategies, such as re-
The nurse should: laxation techniques, but the sur-
1. Contact the surgeon to request an or- geon will likely not order narcotic
der for a narcotic for the pain. medication prior to surgery. The
2. Maintain the client in a recumbent po- nurse can place the client in a po-
sition. sition that is most comfortable for
3. Place the client on nothing-by-mouth the client. Heat is contraindicated
(NPO) status. because it may lead to perfora-
4. Apply heat to the abdomen in the area tion of the appendix.
of the pain.
3. A client with acute appendicitis devel- 4.
ops a fever, tachycardia, and hypoten- Complications of acute appen-
sion. Based on these assessment find- dicitis are perforation, peritonitis,
ings, the nurse should further assess the and abscess development. Signs
client for which of the following compli- of the development of peritonitis
cations? include abdominal pain and dis-
1. Deficient fluid volume. tention, tachycardia, tachypnea,
2. Intestinal obstruction. nausea, vomiting, and fever. Be-
1/2
