Med Surg Test 4 STUDY Questions and
Answers
Preparation for an appendectomy includes:
An intravenous infusion.
Prophylactic antibiotic therapy.
Salicylates to lower an elevated temperature.
All of the above. - Answer-All of the above
The nurse is seeing clients in the GI clinic. Which client should the nurse see first -
Answer-A 3 week old infant experiencing projectile vomiting and irritability
Symptoms suggestive of acute appendicitis include:
A positive Rovsing's sign.
Increased abdominal pain when coughing.
Tenderness around the umbilicus.
All of the above: - Answer-All of the above: +Rovsings sign, increased pain when
coughing, tenderness around umbilicus
Appendicitis clinical manifestations - Answer-severe periumbilical pain followed by NV,
shifts to RL quadrant and McBurney's point, movement causes pain, feels good to have
R leg flexed
Appendicitis: assessment—"PAINS" - Answer-assessment—"PAINS"
Pain (RLQ)
Anorexia
Increased temperature, WBC (15,000-20,000)
Nausea
Signs (McBurney's, Psoas)
Peritonitis assessment - Answer-severe abdominal pain
abdominal rigidity; decreased bowel sounds
nausea
vomiting
increased temp
leukocytosis
shock: weakness, pallor, diaphoresis
paralytic ileus
symptoms may be masked in elderly persons or those receiving corticosteroids
, The nurse cares for a client diagnoses with cholelithiasis. It is MOST important to
instruct the client to avoid which of the following foods: - Answer-Cabbage, cheese,
chocolate
cause of peritonitis - Answer-Internal and external factors such as injury/trauma,
inflammation, and bacteria
The nurse cares for a client admitted with a diagnosis of acute pancreatitis. An IV is
begun and the nurse inserts a NG tube and attaches it to intermittent low suction. The
nurse gives frequent oral hygiene and administers morphine for reports of pain. Which
client behavior indicates to the nurse the medication is effective: - Answer-The client
sleeps for one hour
Peritonitis - Answer-inflammation of the peritoneum. Usually, it is a result of bacterial
infection; organisms come from diseases of the GI tract, or in women, from the internal
reproductive organs
Peritonitis causes - Answer--ruptured appendix
-perforated ulcer
-bowel perforation
-pelvic inflammatory disease (PID)
-bladder perforation
-traumatic rupture of liver or spleen
Peritonitis occurs in which part of the GI system?
-Peritoneum.
-Appendix.
-Duodenum.
-Sigmoid colon - Answer-Peritoneum.
On physical examination, the nurse should be looking for tenderness on palpation at
McBurney's point, which is located at the:
-Left lower quadrant.
-Left upper quadrant.
-Right lower quadrant.
-Right upper quadrant. - Answer-right lower quadrant
When assessing the abdomen, the nurse should place the patient in which of the
following positions: - Answer-supine with knees flexed
During assessment, the nurse is looking for positive indicators of appendicitis, which
include all of the following except:
-A low-grade fever.
-Abdominal tenderness on palpation.
-Thrombocytopenia.
Answers
Preparation for an appendectomy includes:
An intravenous infusion.
Prophylactic antibiotic therapy.
Salicylates to lower an elevated temperature.
All of the above. - Answer-All of the above
The nurse is seeing clients in the GI clinic. Which client should the nurse see first -
Answer-A 3 week old infant experiencing projectile vomiting and irritability
Symptoms suggestive of acute appendicitis include:
A positive Rovsing's sign.
Increased abdominal pain when coughing.
Tenderness around the umbilicus.
All of the above: - Answer-All of the above: +Rovsings sign, increased pain when
coughing, tenderness around umbilicus
Appendicitis clinical manifestations - Answer-severe periumbilical pain followed by NV,
shifts to RL quadrant and McBurney's point, movement causes pain, feels good to have
R leg flexed
Appendicitis: assessment—"PAINS" - Answer-assessment—"PAINS"
Pain (RLQ)
Anorexia
Increased temperature, WBC (15,000-20,000)
Nausea
Signs (McBurney's, Psoas)
Peritonitis assessment - Answer-severe abdominal pain
abdominal rigidity; decreased bowel sounds
nausea
vomiting
increased temp
leukocytosis
shock: weakness, pallor, diaphoresis
paralytic ileus
symptoms may be masked in elderly persons or those receiving corticosteroids
, The nurse cares for a client diagnoses with cholelithiasis. It is MOST important to
instruct the client to avoid which of the following foods: - Answer-Cabbage, cheese,
chocolate
cause of peritonitis - Answer-Internal and external factors such as injury/trauma,
inflammation, and bacteria
The nurse cares for a client admitted with a diagnosis of acute pancreatitis. An IV is
begun and the nurse inserts a NG tube and attaches it to intermittent low suction. The
nurse gives frequent oral hygiene and administers morphine for reports of pain. Which
client behavior indicates to the nurse the medication is effective: - Answer-The client
sleeps for one hour
Peritonitis - Answer-inflammation of the peritoneum. Usually, it is a result of bacterial
infection; organisms come from diseases of the GI tract, or in women, from the internal
reproductive organs
Peritonitis causes - Answer--ruptured appendix
-perforated ulcer
-bowel perforation
-pelvic inflammatory disease (PID)
-bladder perforation
-traumatic rupture of liver or spleen
Peritonitis occurs in which part of the GI system?
-Peritoneum.
-Appendix.
-Duodenum.
-Sigmoid colon - Answer-Peritoneum.
On physical examination, the nurse should be looking for tenderness on palpation at
McBurney's point, which is located at the:
-Left lower quadrant.
-Left upper quadrant.
-Right lower quadrant.
-Right upper quadrant. - Answer-right lower quadrant
When assessing the abdomen, the nurse should place the patient in which of the
following positions: - Answer-supine with knees flexed
During assessment, the nurse is looking for positive indicators of appendicitis, which
include all of the following except:
-A low-grade fever.
-Abdominal tenderness on palpation.
-Thrombocytopenia.
