A nurse is admitting a client who has suspected appendicitis. Which of the following findings is the nurse’s priority to report to the provider?

Distended, board-like abdomen

WBC count 15,000/mm³ (5,000 to 10,000/mm³)

Rebound tenderness over McBurney’s point

Temperature 37.3°C (99.1°F)

Answer and Explanation

The Correct Answer is A

Choice A Reason:

A distended, board-like abdomen is a critical finding that can indicate peritonitis, a severe complication of appendicitis. Peritonitis occurs when the appendix ruptures, leading to infection spreading throughout the abdominal cavity. This condition requires immediate medical intervention to prevent further complications and potential sepsis.

Choice B Reason:

A WBC count of 15,000/mm³ is elevated and suggests an infection, which is common in appendicitis. However, it is not as immediately critical as signs of peritonitis. Elevated WBC counts are expected in cases of appendicitis but do not necessarily indicate a life-threatening emergency.

Choice C Reason:

Rebound tenderness over McBurney’s point is a classic sign of appendicitis and indicates localized inflammation. While it is an important diagnostic sign, it does not require immediate reporting compared to signs of peritonitis.

Choice D Reason:

A temperature of 37.3°C (99.1°F) is only slightly elevated and does not indicate a severe infection or complication. Fever is a common symptom of appendicitis but is not as critical as a distended, board-like abdomen.

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Correct Answer is D

Explanation

Choice A Reason

Increased erythrocyte sedimentation rate (ESR) is a marker of inflammation and is commonly elevated in conditions like rheumatoid arthritis. However, it is not a direct adverse effect of NSAID therapy. NSAIDs are more likely to cause gastrointestinal issues, such as bleeding, which would be detected by a fecal occult blood test.

Choice B Reason

Elevated creatinine clearance is not typically associated with NSAID use. In fact, NSAIDs can potentially reduce kidney function, leading to decreased creatinine clearance. Therefore, this option is incorrect.

Choice C Reason

Increased serum potassium levels can occur with NSAID use, especially in patients with compromised kidney function. However, this is less common compared to gastrointestinal bleeding, which is a more direct and frequent adverse effect of NSAID therapy.

Choice D Reason

Positive fecal occult blood test is the correct answer. NSAIDs can cause gastrointestinal bleeding, which can be detected through a fecal occult blood test. This is a well-documented adverse effect of NSAID therapy and is a significant concern for patients on long-term NSAID treatment.

A. The dressing was changed 7 days ago. B. The circumference of the client’s upper arm has increased by 10%. C. The catheter has not been used in 8 hours. D. The catheter has been flushed with 10 mL of sterile saline after medication use.

Correct Answer is B

Explanation

Choice A Reason:

The dressing for a PICC line should be changed every 7 days or sooner if it becomes wet, soiled, or loose. Therefore, a dressing change 7 days ago is within the recommended guidelines and does not necessarily require immediate notification of the provider.

Choice B Reason:

An increase in the circumference of the client’s upper arm by 10% can indicate swelling, which may be a sign of complications such as infection, thrombosis, or infiltration. This finding should be promptly reported to the provider for further evaluation and intervention.

Choice C Reason:

The catheter not being used for 8 hours is not typically a cause for concern as long as it is properly flushed and maintained. PICC lines can remain in place for extended periods without use, provided they are flushed regularly to prevent occlusion.

Choice D Reason:

Flushing the catheter with 10 mL of sterile saline after medication use is a standard practice to maintain patency and prevent blockage This action does not require notification of the provider unless there are other associated complications.

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A nurse is admitting a client who has suspected appendicitis. Which of the following findings is the nurse’s priority to report to the provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is B

Explanation

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