Daily Nursing Exam Questions #0057-60

Rationale: In appendicitis, pain typically starts in the epigastrium or periumbilical region and then shifts to the right iliac fossa as inflammation spreads. This classical migration of pain is known as Kocher’s sign, and it is a key clinical feature that helps distinguish appendicitis from other abdominal conditions.

Rationale: If appendicitis is not treated promptly, the inflamed appendix can rupture, leading to perforation and peritonitis. This is a serious, life-threatening complication that requires immediate surgical intervention. Early diagnosis and appendectomy prevent these dangerous outcomes.

Rationale: Before surgery for acute appendicitis, it is essential to keep the patient NPO (nothing by mouth) to reduce the risk of aspiration during anesthesia. Administering prescribed IV fluids maintains hydration and electrolyte balance. Oral intake and abdominal heat or massage are contraindicated as they may worsen inflammation or precipitate rupture.

Rationale: Sudden severe abdominal pain, generalized tenderness, rigidity, fever, and tachycardia indicate a surgical emergency. These signs suggest that the inflamed appendix has perforated, leading to generalized peritonitis. Prompt recognition and immediate surgical intervention are critical to prevent sepsis and other life-threatening complications.