A nurse is caring for a client who has appendicitis. Which of the following findings should the nurse identify as a manifestation of this condition? (Select all that apply.)

WBC count 22,000/mm2 (5,000 to 10,000/mm3)

Diarrhea

Rebound tenderness

Low-grade fever

Hyperactive bowel sounds

Answer and Explanation

Correct Answer : A,C,D

A. WBC count 22,000/mm³ (5,000 to 10,000/mm³): Leukocytosis is a common finding in appendicitis due to the inflammatory and infectious process. A significantly elevated WBC count supports the diagnosis and indicates the body’s response to infection.

B. Diarrhea: Diarrhea is not a typical manifestation of appendicitis. Clients more commonly present with constipation or localized abdominal pain rather than frequent loose stools, so this finding is not characteristic.

C. Rebound tenderness: Rebound tenderness, especially in the right lower quadrant, is a classic sign of peritoneal irritation associated with appendicitis. Pain that increases when pressure is released is a key physical examination finding.

D. Low-grade fever: A low-grade fever often accompanies appendicitis due to the body’s inflammatory response. Fever typically develops as the condition progresses and can help differentiate appendicitis from other causes of abdominal pain.

E. Hyperactive bowel sounds: Hyperactive bowel sounds are more commonly associated with gastroenteritis or early intestinal obstruction. In appendicitis, bowel sounds are often normal or decreased, particularly if peritoneal irritation is present.

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Correct Answer is A

Explanation

A. "You seem like you're feeling hopeless.": This response acknowledges the client’s emotional state and invites further discussion, which is essential in managing suicidal ideation. It validates the client’s feelings while opening a therapeutic dialogue that helps the nurse assess risk, provide support, and ensure safety.

B. "Suicide is not the answer to your problems.": This response can feel dismissive and may shut down communication. It offers a directive rather than exploring the client’s feelings, which may increase the client’s sense of isolation. Effective therapeutic communication focuses on understanding before offering guidance.

C. "Did you take your medications today?": Asking about medication adherence shifts the focus away from the client's emotional distress. While medication compliance is important, it does not address the immediate expression of suicidal thoughts or support emotional exploration.

D. "Don't worry. Everything will be just fine.": Offering false reassurance minimizes the client's feelings and can worsen distress. It closes communication and prevents the nurse from gathering important information about the client’s level of suicidal risk, which is critical in this situation.

A. Take this medication at the same time each day. B. Take ginger for constipation while on this medication. C. Eat foods high in vitamin K. D. Shave with disposable razors.

Correct Answer is A

Explanation

A. Take this medication at the same time each day: Consistent timing helps maintain stable anticoagulation levels and reduces the risk of under- or over-anticoagulation. Warfarin’s effectiveness and safety depend on steady dosing and adherence to a regular schedule.

B. Take ginger for constipation while on this medication: Ginger can increase the risk of bleeding when taken with warfarin due to its antiplatelet properties. Clients should avoid supplements or herbal remedies that may interact with anticoagulants unless approved by the healthcare provider.

C. Eat foods high in vitamin K: Foods high in vitamin K, such as leafy greens, can decrease the effectiveness of warfarin by promoting clotting. Clients should maintain a consistent intake rather than increasing consumption to avoid fluctuations in anticoagulation levels.

D. Shave with disposable razors: Clients on warfarin are advised to use electric razors instead of disposable or manual razors to reduce the risk of cuts and bleeding. Using disposable razors increases the likelihood of minor injuries that can lead to excessive bleeding.

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A nurse is caring for a client who has appendicitis. Which of the following findings should the nurse identify as a manifestation of this condition? (Select all that apply.)

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