Internet Citation: Research Protocol: Diagnosis of Right Lower Quadrant Pain and Suspected Acute Appendicitis. Content last reviewed December 2019. Effective Health Care Program, Agency for Healthcare Research and Quality, Rockville, MD.
//effectivehealthcare.ahrq.gov/products/appendicitis/research-protocol
This is a quiz that contains NCLEX review questions for appendicitis. As a nurse providing care to a patient with appendicitis, it is important to know the classic signs and symptoms of appendicitis, the complications (peritonitis, perforation etc.), pre-opt and post-opt nursing care.
In the previous NCLEX review series, I explained about other GI disorders you may be asked about on the NCLEX exam, so be sure to check out those reviews and quizzes as well.
(NOTE: When you hit submit, it will refresh this same page. Scroll down to see your results.)
Appendicitis NCLEX Questions
1. True or False: The appendix is found on the left lower side of the abdomen and is connected to the cecum of the large intestine.
2. Select all the following options that are NOT causes of appendicitis:
A. Fecalith
B. Routine usage of NSAIDs
C. Infection due to Helicobacter pylori
D. Lymph node enlargement due to viral or bacterial infection
E. Diet low in fiber
3. A 23 year old patient is admitted with suspected appendicitis. The patient states he is having pain around the umbilicus that extends into the lower part of his abdomen. In addition, he says that the pain is worst on the right lower quadrant. The patient points to his abdomen at a location which is about a one-third distance between the anterior superior iliac spine and umbilicus. This area is known as what?
A. Rovsing’s Point
B. Hamman’s Point
C. McBurney’s Point
D. Murphy’s Point
4. Thinking back to the scenario in question 3, what other signs and symptoms are associated with appendicitis. SELECT-ALL-THAT-APPLY:
A. Increased red blood Cells
B. Patient has the desire to be positioned in the prone position to relieve pain
C. Umbilical pain that extends in the right lower quadrant
D. Abdominal rebound tenderness
E. Abdominal Flaccidity
5. An 18 year old patient is admitted with appendicitis. Which statement by the patient requires immediate nursing intervention?
A. “The pain hurts so much it is making me nauseous.”
B. “I have no appetite.”
C. “The pain seems to be gone now.”
D. “If I position myself on my right side, it makes the pain less intense.”
6. You’re providing education to a group of nursing students about the care of a patient with appendicitis. Which statement by a nursing student requires re-education about your teaching?
A. “After an appendectomy the patient may have a nasogastric tube to remove stomach fluids and swallowed air.”
B. “Non-pharmacological techniques for a patient with appendicitis include application of heat to the abdomen and the side-lying position.”
C. “The nurse should monitor the patient for signs and symptoms of peritonitis which includes increased heart rate, respirations, temperature, abdominal distention, and intense abdominal pain.”
D. “It is normal for some patients to have shoulder pain after a laparoscopic appendectomy.”
7. Your patient is 4 days post-opt from an appendectomy. Which assessment finding requires further evaluation?
A. The patient reports their last bowel movement was the day before surgery.
B. The patient reports incisional pain.
C. The patient coughs and deep breathes while splinting the abdominal incision.
D. Options A and C
8. A patient is recovering after having an appendectomy. The patient is 48 hours post-opt from surgery and is tolerating full liquids. The physician orders for the patient to try solid foods. What types of foods should the patient incorporate in their diet?
A. Foods high in fiber
B. Foods low in fiber
C. Foods high in carbohydrates
D. Foods low in protein
9. A patient is scheduled for appendectomy at noon. While performing your morning assessment, you note that the patient has a fever of 103.8 ‘F and rates abdominal pain 9 on 1-10. In addition, the abdomen is distended and the patient states, “I was feeling better last night but it seems the pain has become worst.” The patient is having tachycardia and tachypnea. Based on the scenario, what do you suspect the patient is experiencing?
A. Pulmonary embolism
B. Colon Fistulae
C. Peritonitis
D. Hemorrhage
Answer Key:
1. False 2. B, C, E 3. C 4. C, D 5. C 6. B 7. A 8. A
9. C
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Imaging and diagnosis of acute appendicitis
| Plain radiography | None | No role in diagnosis of acute appendicitis,w6 although in some cases a faecolith may be shown |
| Ultrasonography | Aperistaltic and non-compressible structure with diameter >6 mmw8 | Sensitivity of 86%; specificity of 81%7 |
| Computed tomography scanning | Abnormal appendix identified or calcified appendicolith seen in association with periappendiceal inflammation or diameter >6 mmw8 | Sensitivity of 94% and specificity of 95% in diagnosis of acute appendicitis7 |
| Magnetic resonance imaging | Not confirmed | Restricted to cases in which radiation and diagnostic difficulties preclude use of other modalities (for example, pregnancy)8w9 |