A female patient presents to the emergency department with severe abdominal pain localized to the right lower quadrant, nausea, and a low-grade fever. After performing a physical examination and diagnostic imaging, the patient is diagnosed with acute appendicitis. What is the most appropriate initial intervention?

Administer intravenous antibiotics and observe the patient for 24 hours.

Provide the patient with oral pain medications and discharge them with a follow-up appointment.

Recommend a liquid diet and bed rest to reduce inflammation.

Prepare the patient for an appendectomy.

Answer and Explanation

The Correct Answer is D

A. Administer intravenous antibiotics and observe the patient for 24 hours: IV antibiotics may be given preoperatively, but observation without surgery is not the standard treatment for confirmed appendicitis due to the risk of rupture.

B. Provide the patient with oral pain medications and discharge them with a follow-up appointment: Oral pain medications are not appropriate as the patient needs surgical intervention. Discharging the patient without surgery could result in life-threatening complications.

C. Recommend a liquid diet and bed rest to reduce inflammation: A liquid diet and bed rest will not address the underlying issue of appendicitis, which requires surgical removal of the inflamed appendix.

D. Prepare the patient for an appendectomy. The standard treatment for acute appendicitis is an appendectomy. Delaying surgery can lead to complications such as perforation, peritonitis, or abscess formation. This is the most appropriate intervention.

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Free Nursing Study Resources

Correct Answer is ["A","B","E"]

Explanation

A. "I will try not to gain weight." Weight gain can increase pressure on the diaphragm and abdomen, worsening symptoms of hiatal hernia. Maintaining a healthy weight helps reduce this pressure.

B. “I will sleep with the head of my bed elevated." Elevating the head of the bed helps prevent stomach acid from refluxing into the esophagus while lying down, a common issue in both hiatal hernia and GERD.

C. "I will drink less fluid": Reducing fluid intake is not a recommended strategy for managing hiatal hernia symptoms. Fluid is essential for digestion and overall health.

D. "I will lie down for one half hour after meals": Lying down after meals can worsen reflux symptoms because gravity is no longer helping keep stomach contents in place. Patients should remain upright after eating.

E. "I will consume less caffeine and spicy foods." Caffeine and spicy foods can increase acid production and irritate the esophagus, worsening symptoms of hiatal hernia.

A. Encourage the patient to use an alcohol-based mouthwash to clean the oral cavity. B. Advise the patient to avoid all oral intake until the ulcers heal completely. C. Suggest the patient to brush their teeth vigorously to remove any bacteria from the mouth D. Recommend the patient to consume soft, non-irritating foods and avoid acidic or spicy foods.

Correct Answer is D

Explanation

A. Encourage the patient to use an alcohol-based mouthwash to clean the oral cavity:
Alcohol-based mouthwashes can irritate the oral mucosa and worsen the pain of stomatitis. Instead, non-alcoholic, soothing mouth rinses are recommended.

B. Advise the patient to avoid all oral intake until the ulcers heal completely: Patients still need proper nutrition, and complete avoidance of food can lead to malnutrition. Soft, non-irritating foods are encouraged rather than full avoidance.

C. Suggest the patient brush their teeth vigorously to remove any bacteria from the mouth: Vigorous brushing can worsen oral ulcers and lead to further pain and bleeding. A gentle, soft-bristle toothbrush should be recommended.

D. Recommend the patient to consume soft, non-irritating foods and avoid acidic or spicy foods.
Consuming soft, bland, non-irritating foods and avoiding acidic or spicy foods helps reduce discomfort and prevent further irritation of oral ulcers, which is essential in managing stomatitis.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following client statements demonstrates a comprehensive understanding of the dietary and lifestyle modifications necessary for managing symptoms associated with a hiatal hernia? (Select all that apply.)

Correct Answer is ["A","B","E"]

Explanation

A patient undergoing chemotherapy reports painful oral ulcers, difficulty eating, and a metallic taste in the mouth. The nurse suspects stomatitis. Which nursing intervention is most appropriate for this patient?

Correct Answer is D

Explanation

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