Situation 9: Mr. Gerald Liu, 19 y/o, is being admitted to ahospital unit complaining of severe pain in the lower abdomen.Admission vital signs reveal an oral temperature of 101.2 0F.
41. Which of the following would confirm a diagnosis ofappendicitis?
a. The pain is localized at a position halfway between theumbilicus and the right iliac crest.
b. Mr. Liu describes the pain as occurring 2 hours after eating
c. The pain subsides after eating
d. The pain is in the left lower quadrant
42. Which of the following complications is thought to be the mostcommon cause of appendicitis?
a. A fecalith
b. Internal bowel occlusion
c. Bowel kinking
d. Abdominal wall swelling
43. The doctor ordered for a complete blood count. After the test,Nurse Ray received the result from the laboratory. Which laboratoryvalues will confirm the diagnosis of appendicitis?
a. RBC 5.5 x 106/mm3
b. Hct 44 %
c. WBC 13, 000/mm3
d. Hgb 15 g/dL
44. Signs and symptoms include pain in the RLQ of the abdomen thatmay be localize at McBurney’s point. To relieve pain, Mr. Liushould assume which position?
a. Prone
b. Supine, stretched out
c. Sitting
d. Lying with legs drawn up
45. After a few minutes, the pain suddenly stops without anyintervention. Nurse Ray might suspect that:
a. the appendix is still distended
b. the appendix may have ruptured
c. an increased in intrathoracic pressure will occur
d. signs and symptoms of peritonitis occur
Situation 10: Nurse Nico is caring to a 38-year-old female, G3P3client who has been diagnosed with hemorrhoids.
46. Which of the following factors would most likely be a primarycause of her hemorrhoids?
a. Her age
b. Three vaginal delivery pregnancies
c. Her job as a school teacher
d. Varicosities in the legs
47. Client education should include minimizing client discomfortdue to hemorrhoids. Nursing management should include:
a. Suggest to eat low roughage diet
b. Advise to wear silk undergarments
c. Avoid straining during defecation
d. Use of sitz bath for 30 minutes
48. The doctor orders for Witch Hazel 5 %. Nurse Nico knows thatthe action of this astringent is:
a. temporarily relieves pain, burning, and itching by numbing thenerve endings
b. causes coagulation (clumping) of proteins in the cells of theperianal skin or the lining of the anal canal
c. inhibits the growth of bacteria and other organisms
d. causes the outer layers of skin or other tissues todisintegrate
49. Which position would be ideal for the client in the earlypostoperative period after hemorrhoidectomy?
a. High Fowler’s
b. Supine
c. Side – lying
d. Trendelenburg’s
50. Nurse Nico instructs her client who has had a hemorrhoidectomynot to used sitz bath until at least 12 hours postoperatively toavoid which of the following complications?
a. Hemorrhage
b. Rectal Spasm
c. Urinary retention
d. Constipation
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