The nurse assesses a young adult female who was brought to the emergency department (ED) by her boyfriend because she has not been feeling well all day and he believes she is getting worse. Which finding supports the nurse's suspicion that the client is experiencing appendicitis?

Sudden onset of severe anxiety, fear, and concern.

Periumbilical pain localizing to right lower quadrant.

Diffuse abdominal pain with elevated neutrophil count.

Anorexia progressing to nausea, vomiting, and fever.

Answer and Explanation

The Correct Answer is B

A.   While anxiety and fear can accompany many medical conditions, they are not typically associated with appendicitis. Appendicitis is characterized by physical symptoms like pain and digestive disturbances rather than emotional symptoms.
B.   Periumbilical pain that shifts to the right lower quadrant is the classic presentation of appendicitis. As the inflammation progresses, pain tends to move from the mid-abdomen to the lower right abdomen, which supports a diagnosis of appendicitis.
C.   Diffuse abdominal pain is less specific and could indicate a variety of conditions. While an elevated neutrophil count can suggest infection or inflammation, the localized pain seen in appendicitis is a more distinguishing feature.
D.   These symptoms are also common in appendicitis, as it typically presents with loss of appetite, nausea, and fever. However, the hallmark symptom is localized pain, particularly in the right lower quadrant, making B a stronger indication.

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Correct Answer is C

Explanation

A. Manipulating the testicles upon rising is not a recommended time for TSE and could lead to unnecessary manipulation that doesn't focus on examination.
B. Inspecting the testicles using a mirror is not as effective as feeling for lumps and abnormalities through touch.
C. It is ideal to perform testicular self-examination during bathing, as the warm water relaxes the scrotal skin and makes it easier to detect any lumps or changes in texture.
D. Comparing both testicles concurrently is important, but the technique is not as effective when done without the warmth of a bath or shower.

A. The right pupil constricts and the left consensually responds. B. Both pupils are equal in size and constrict readily to the light source. C. Bilateral pupil size changes as the distance of the light source varies. D. The left iris is "notched" and the pupil size changes minimally.

Correct Answer is D

Explanation

A. This is a normal finding where the right pupil constricts when the light is directed at it, and the left pupil constricts consensually as well. This suggests normal function of the pupillary light reflex pathway, and no further evaluation is needed.
B. This also indicates normal pupillary function. Equal pupil size and appropriate constriction to light are typical findings, suggesting no immediate issues with the nervous system.
C. Pupil size should not change in response to distance unless there is a near response (accommodation). If the pupil size changes to distance of the light source instead of light reflex, this suggests potential abnormality in the pupillary reflex response.
D. This is an abnormal finding. A "notched" iris suggests possible damage or congenital anomalies, and minimal change in pupil size may indicate impaired pupil reflexes, requiring further evaluation to rule out neurological or ophthalmologic issues.

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The nurse assesses a young adult female who was brought to the emergency department (ED) by her boyfriend because she has not been feeling well all day and he believes she is getting worse. Which finding supports the nurse's suspicion that the client is experiencing appendicitis?

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Naxlex Comprehensive Predictor Exams

The college health clinic nurse is preparing a seminar on testicular self-examination (TSE). Which instruction should be included in the content for this seminar?

Correct Answer is C

Explanation

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Correct Answer is D

Explanation

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