WEEK 6 [ADN260] APPENDICITIS,
GALLBLADDER DISEASE,
INFLAMMATION, NEPHRITIS EXAM
QUESTIONS AND ANSWERS
The nurse is caring for Shanelle Hamilton, a 35-year-old African American female being
treated for exacerbation of systemic lupus erythematosus. What should the nurse teach
Ms. Hamilton about the prescribed medication dexamethasone? - Answer-Do not stop
taking this medication.
Alicia Meritt, a 22-year-old woman with complaints of fatigue and persistent diarrhea, is
suspected of having Crohn disease and is scheduled to have a colonoscopy. Which
finding would Alicia's nurse expect to see from the colonoscopy if Alicia has Crohn
disease? - Answer-Cobblestone appearance of bowel
Danae Jacobs is a 35-year-old woman with a history of Crohn disease, which
manifested itself when she was 21 years old. For the last 2 years, she has been on
numerous antibiotics and steroids with less than desirable effects. After a recent
colonoscopy, the surgeon has told Danae that strictures have formed in her bowel and
he suggested surgery. What surgery does Danae's nurse anticipate Danae needing? -
Answer-Strictureplasty
Eli Schwartz is a 15-year-old boy who was recently diagnosed with ulcerative colitis and
is admitted to the hospital with severe diarrhea. Which nursing intervention would Eli's
nurse provide for Eli? - Answer-Infuse intravenous fluids as prescribed
A nurse is caring for Taraj Singh, a 5-year-old child who was recently diagnosed with
strep throat and treated. However, a week after Taraj's strep throat diagnosis, Taraj
began complaining of a severe headache and Taraj's mother noticed Taraj had a
swollen face. Taraj's healthcare provider has diagnosed Taraj with acute postinfection
glomerulonephritis. Which additional manifestation will Taraj's nurse expect to find upon
physical assessment? - Answer-Hematuria
A nurse is caring for Samuel McMurray, a 68-year-old man with rapidly progressive
glomerulonephritis (RPGN). Mr. McMurray's past medical history includes diabetes
mellitus and hypertension. His current blood pressure is 142/92 and his nurse notes 3+
pedal edema to both of Mr. McMurray's legs. Mr. McMurray's healthcare provider has
ordered antihypertensive and immunosuppressive medications, as well as
plasmapheresis. Mr. McMurray asks his nurse, "What is plasmapheresis?" Which
response by the nurse is the most appropriate? - Answer-"This therapy removes
damaging antibodies from your blood."
,A nurse is caring for Maria Lopez, a 68-year-old female who presents to the hospital in
a hypertensive crisis. Ms. Lopez's healthcare provider has ruled out a neurological
cause for her symptoms and now suspects that Ms. Lopez may be suffering from
nephritis. Ms. Lopez's nurse is performing a focused exam and is now performing Ms.
Lopez's health history intake. Which factor would the nurse suspect as being related to
the possible diagnosis of nephritis? - Answer-History of a nonhealing skin infection
A nurse is caring for William Sanders, a 65-year-old male with a history of peptic ulcer
disease (PUD), who presents to the emergency department via ambulance gurney. Mr.
Sanders called first responders to his house when he developed severe upper
abdominal pain that radiated to his right shoulder. Mr. Sanders's heart rate is 114 and
blood pressure is 90/55. Mr. Sanders's nurse notes that his skin is cool and clammy, his
abdomen is hard, and no bowel sounds can be auscultated. What complication
associated with PUD does the nurse suspect that Mr. Sanders has? - Answer-
Perforation
A nurse is caring for Mohammed Hassad, a 34-year-old man who has a 20-pack-year
history of smoking and works as an construction worker. Recently, Mohammed has
been complaining of hungerlike pain in his upper abdomen that occurs in the middle of
the night but seems to subside once he eats. Mr. Hassad's healthcare provider has
ordered an upper GI series to aid in diagnosing his condition. What instruction will Mr.
Hassad's nurse provide to Mohammed regarding this diagnostic test? - Answer-"This
procedure is a type of x-ray that uses contrast."
A nurse is planning care for Peter Carroll, a 55-year-old man who was recently
diagnosed with peptic ulcer disease (PUD). Peter is hospitalized after several days of
nausea and vomiting in addition to complaining of epigastric pain. When planning care
for Mr. Carroll, which nursing diagnosis takes priority? - Answer-risk of deficient fluid
volume
Case Study: Appendicitis
The nurse, caring for an 11-year-old child recovering from an appendectomy, is
preparing to help the family ambulate the child for the first time after surgery. Which
non-pharmacological nursing strategies would be appropriate for this child? - Answer-A
splint pillow against the abdomen when moving or coughing
The nurse is conducting an assessment on a client who is 36 hours postoperative
following an appendectomy. During the assessment, the nurse is unable to hear any
bowel sounds. The client denies passing flatus. Which action is most appropriate by the
nurse? - Answer-Withholding food and fluid intake until intestinal motility has returned
List the pathophysiology processes involved in appendicitis in sequential order. -
Answer-1---obstruction of the proximal lumen of the appendix is apparent.
2---the appendix becomes distended with fluid secreted by its mucosa.
3---pressure within the lumen of the appendix increases.
, 4---purulent exudante formed causes further distention of the appendix.
5---tissue necrosis and gangrene result.
The 25-year-old female is visiting family from Iran and develops signs and symptoms of
appendicitis during the night. The client is brought to the Emergency Department by the
family. Which nursing intervention is the most culturally sensitive for this client? -
Answer-Explain the assessment procedure and ask the family their preference.
The nurse is caring for a child recovering from surgery for a perforated appendix. Which
nursing diagnosis should the nurse use to guide this client's care during the immediate
postoperative period? - Answer-Risk for Infection
The nurse is caring for a client in the Emergency Department who is suspected of
having appendicitis. What should the nurse expect to be prescribed for this client? -
Answer-A cephalosporin
Complete white blood cell count
Pain medication
A client with appendicitis is highly agitated and states that there is a great deal of pain.
Which intervention will decrease the client's anxiety? - Answer-Assess pain levels every
2 hours and administer ordered medication.
A client was admitted with complaints of an elevated temperature,, nausea, and pain
and tenderness in the lower right quadrant of the abdomen. After receiving pain
medication, the client continues to complain of pain at a level of 8 of 10 on the pain
scale. Pain medications are not due for at least another 2 hours. What should the nurse
say? - Answer-"I will inform the physician about your continued pain."
A client with acute abdominal pain is scheduled for an appendectomy in 3 hours. While
waiting for the surgery, the client reports that the pain has subsided. What should the
nurse do? - Answer-Contact the physician.
An older client with a ruptured appendix and peritonitis wants to know why the abdomen
is swollen. Which explanation by the nurse is the most appropriate? - Answer-"The
contents of the appendix are causing inflammation of the abdominal cavity."
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 thisclient? - Answer-Seek immediate medical attention
GALLBLADDER DISEASE,
INFLAMMATION, NEPHRITIS EXAM
QUESTIONS AND ANSWERS
The nurse is caring for Shanelle Hamilton, a 35-year-old African American female being
treated for exacerbation of systemic lupus erythematosus. What should the nurse teach
Ms. Hamilton about the prescribed medication dexamethasone? - Answer-Do not stop
taking this medication.
Alicia Meritt, a 22-year-old woman with complaints of fatigue and persistent diarrhea, is
suspected of having Crohn disease and is scheduled to have a colonoscopy. Which
finding would Alicia's nurse expect to see from the colonoscopy if Alicia has Crohn
disease? - Answer-Cobblestone appearance of bowel
Danae Jacobs is a 35-year-old woman with a history of Crohn disease, which
manifested itself when she was 21 years old. For the last 2 years, she has been on
numerous antibiotics and steroids with less than desirable effects. After a recent
colonoscopy, the surgeon has told Danae that strictures have formed in her bowel and
he suggested surgery. What surgery does Danae's nurse anticipate Danae needing? -
Answer-Strictureplasty
Eli Schwartz is a 15-year-old boy who was recently diagnosed with ulcerative colitis and
is admitted to the hospital with severe diarrhea. Which nursing intervention would Eli's
nurse provide for Eli? - Answer-Infuse intravenous fluids as prescribed
A nurse is caring for Taraj Singh, a 5-year-old child who was recently diagnosed with
strep throat and treated. However, a week after Taraj's strep throat diagnosis, Taraj
began complaining of a severe headache and Taraj's mother noticed Taraj had a
swollen face. Taraj's healthcare provider has diagnosed Taraj with acute postinfection
glomerulonephritis. Which additional manifestation will Taraj's nurse expect to find upon
physical assessment? - Answer-Hematuria
A nurse is caring for Samuel McMurray, a 68-year-old man with rapidly progressive
glomerulonephritis (RPGN). Mr. McMurray's past medical history includes diabetes
mellitus and hypertension. His current blood pressure is 142/92 and his nurse notes 3+
pedal edema to both of Mr. McMurray's legs. Mr. McMurray's healthcare provider has
ordered antihypertensive and immunosuppressive medications, as well as
plasmapheresis. Mr. McMurray asks his nurse, "What is plasmapheresis?" Which
response by the nurse is the most appropriate? - Answer-"This therapy removes
damaging antibodies from your blood."
,A nurse is caring for Maria Lopez, a 68-year-old female who presents to the hospital in
a hypertensive crisis. Ms. Lopez's healthcare provider has ruled out a neurological
cause for her symptoms and now suspects that Ms. Lopez may be suffering from
nephritis. Ms. Lopez's nurse is performing a focused exam and is now performing Ms.
Lopez's health history intake. Which factor would the nurse suspect as being related to
the possible diagnosis of nephritis? - Answer-History of a nonhealing skin infection
A nurse is caring for William Sanders, a 65-year-old male with a history of peptic ulcer
disease (PUD), who presents to the emergency department via ambulance gurney. Mr.
Sanders called first responders to his house when he developed severe upper
abdominal pain that radiated to his right shoulder. Mr. Sanders's heart rate is 114 and
blood pressure is 90/55. Mr. Sanders's nurse notes that his skin is cool and clammy, his
abdomen is hard, and no bowel sounds can be auscultated. What complication
associated with PUD does the nurse suspect that Mr. Sanders has? - Answer-
Perforation
A nurse is caring for Mohammed Hassad, a 34-year-old man who has a 20-pack-year
history of smoking and works as an construction worker. Recently, Mohammed has
been complaining of hungerlike pain in his upper abdomen that occurs in the middle of
the night but seems to subside once he eats. Mr. Hassad's healthcare provider has
ordered an upper GI series to aid in diagnosing his condition. What instruction will Mr.
Hassad's nurse provide to Mohammed regarding this diagnostic test? - Answer-"This
procedure is a type of x-ray that uses contrast."
A nurse is planning care for Peter Carroll, a 55-year-old man who was recently
diagnosed with peptic ulcer disease (PUD). Peter is hospitalized after several days of
nausea and vomiting in addition to complaining of epigastric pain. When planning care
for Mr. Carroll, which nursing diagnosis takes priority? - Answer-risk of deficient fluid
volume
Case Study: Appendicitis
The nurse, caring for an 11-year-old child recovering from an appendectomy, is
preparing to help the family ambulate the child for the first time after surgery. Which
non-pharmacological nursing strategies would be appropriate for this child? - Answer-A
splint pillow against the abdomen when moving or coughing
The nurse is conducting an assessment on a client who is 36 hours postoperative
following an appendectomy. During the assessment, the nurse is unable to hear any
bowel sounds. The client denies passing flatus. Which action is most appropriate by the
nurse? - Answer-Withholding food and fluid intake until intestinal motility has returned
List the pathophysiology processes involved in appendicitis in sequential order. -
Answer-1---obstruction of the proximal lumen of the appendix is apparent.
2---the appendix becomes distended with fluid secreted by its mucosa.
3---pressure within the lumen of the appendix increases.
, 4---purulent exudante formed causes further distention of the appendix.
5---tissue necrosis and gangrene result.
The 25-year-old female is visiting family from Iran and develops signs and symptoms of
appendicitis during the night. The client is brought to the Emergency Department by the
family. Which nursing intervention is the most culturally sensitive for this client? -
Answer-Explain the assessment procedure and ask the family their preference.
The nurse is caring for a child recovering from surgery for a perforated appendix. Which
nursing diagnosis should the nurse use to guide this client's care during the immediate
postoperative period? - Answer-Risk for Infection
The nurse is caring for a client in the Emergency Department who is suspected of
having appendicitis. What should the nurse expect to be prescribed for this client? -
Answer-A cephalosporin
Complete white blood cell count
Pain medication
A client with appendicitis is highly agitated and states that there is a great deal of pain.
Which intervention will decrease the client's anxiety? - Answer-Assess pain levels every
2 hours and administer ordered medication.
A client was admitted with complaints of an elevated temperature,, nausea, and pain
and tenderness in the lower right quadrant of the abdomen. After receiving pain
medication, the client continues to complain of pain at a level of 8 of 10 on the pain
scale. Pain medications are not due for at least another 2 hours. What should the nurse
say? - Answer-"I will inform the physician about your continued pain."
A client with acute abdominal pain is scheduled for an appendectomy in 3 hours. While
waiting for the surgery, the client reports that the pain has subsided. What should the
nurse do? - Answer-Contact the physician.
An older client with a ruptured appendix and peritonitis wants to know why the abdomen
is swollen. Which explanation by the nurse is the most appropriate? - Answer-"The
contents of the appendix are causing inflammation of the abdominal cavity."
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 thisclient? - Answer-Seek immediate medical attention
