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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Correct Answer is B

Explanation

A. "Vomiting blood or material that looks like coffee grounds is a serious sign that I need to go to the emergency room." This is a correct understanding. Vomiting blood or coffee-ground material is a sign of gastrointestinal bleeding and requires immediate medical attention.

B. "If I experience severe abdominal pain, I should take an over-the-counter antacid and rest."
Taking an over-the-counter antacid without contacting a healthcare provider for severe pain could mask serious complications, such as recurrent bleeding or perforation, that need immediate medical attention. This statement indicates a need for further teaching.

C. "I should avoid taking NSAIDs like ibuprofen as they can increase my risk of bleeding." This is a correct understanding, as NSAIDs can cause or worsen gastric ulcers and increase the risk of bleeding.

D. "I should immediately report any black, tarry stools to my healthcare provider."This is a correct understanding. Black, tarry stools (melena) indicate upper gastrointestinal bleeding.

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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Naxlex Comprehensive Predictor Exams

A male patient is being discharged after hospitalization for a bleeding peptic ulcer. The nurse is providing discharge teaching on how to monitor for signs of recurrent bleeding. Which of the following statements by the patient indicates a need for further teaching?

Correct Answer is B

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

A nurse practicing population health works for a local hospital's weight-loss program for bariatric patients. After assisting to implement various health-style changes in their care plans, which of the following findings would indicate to the nurse that the interventions are working?

A nurse is assessing an older adult client who has a urinary tract infection (UTI). Which of the following findings should the nurse identify as unique for this age group?

A nurse is providing education to a client who has recently been diagnosed with Crohn's disease. Which of the following explanations by the nurse best simplifies and explains the disorder in non-medical terms?

A patient with Crohn's disease is being discharged from the hospital. The nurse is providing dietary teaching to the patient. Which of the following statements by the patient indicates a correct understanding of the dietary recommendations?

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A patient with acute pancreatitis is being discharged from the hospital. Which statement made by the patient indicates a need for further teaching regarding their discharge instructions?