APPENDICITIS NCLEX QUESTIONS AND ANSWERS WITH 2021/2022
SOLUTIONS
The nurse would increase the comfort of the patient with appendicitis by:
"a. Having the patient lie prone
b. Flexing the patient's right knee
c. Sitting the patient upright in a chair
d. Turning the patient onto his or her left side –
Correct answer: B"
The patient with appendicitis usually prefers to lie still, often with the right leg flexed to decrease pain.
"The nurse is caring for a patient in the emergency department with complaints of acute abdominal
pain, nausea, and vomiting. When the nurse palpates the patient's left lower abdominal quadrant, the
patient complains of pain in the right lower quadrant. The nurse will document this as which of the
following diagnostic signs of appendicitis?
"a. Rovsing sign
b. referred pain
c. Chvostek's sign
d. rebound tenderness
correct answer: A" -Answer A
In patients with suspected appendicitis, Rovsing sign may be elicited by palpation of the left lower
quadrant, causing pain to be felt in the right lower quadrant.
Which of the following position should the client with appendicitis assume to relieve pain ?
A. Prone
B. B. Sitting
C. C. Supine
D. D. Lying with legs drawn up –
Correct Answer: D Lying still with legs drawn up towards chest helps relive tension on the
abdominal muscle, which helps to reduce the amount of discomfort felt. Lying flat or sitting
may increase the amount of pain experienced
"When evaluating a male client for complications of acute pancreatitis, the nurse would observe for:
"a. increased intracranial pressure.
b. decreased urine output.
c. bradycardia.
d. hypertension." –
Correct Answer: B
Rationale: Acute pancreatitis can cause decreased urine output, which results from the renal failure
that sometimes accompanies this condition. Intracranial pressure neither increases nor decreases in
a client with pancreatitis. Tachycardia, not bradycardia, usually is associated with pulmonary or
hypovolemic complications of pancreatitis. Hypotension can be caused by a hypovolemic
complication, but hypertension usually isn't related to acute pancreatitis."
"When preparing a male client, age 51, for surgery to treat appendicitis, the nurse formulates a
nursing diagnosis of Risk for infection related to inflammation, perforation, and surgery. What is the
rationale for choosing this nursing diagnosis?
, "a. Obstruction of the appendix may increase venous drainage and cause the appendix to rupture.
b. Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of
the appendix.
c. The appendix may develop gangrene and rupture, especially in a middle-aged client.
d. Infection of the appendix diminishes necrotic arterial blood flow and increases venous drainage." –
Answer B. A client with appendicitis is at risk for infection related to inflammation, perforation, and
surgery because obstruction of the appendix causes mucus fluid to build up, increasing pressure in
the appendix and compressing venous outflow drainage. The pressure continues to rise with venous
obstruction; arterial blood flow then decreases, leading to ischemia from lack of perfusion.
Inflammation and bacterial growth follow, and swelling continues to raise pressure within the
appendix, resulting in gangrene and rupture. Geriatric, not middle-aged, clients are especially
susceptible to appendix rupture.
"A client is admitted with a diagnosis of acute appendicitis. When assessing the abdomen, the nurse
would expect to find rebound tenderness at which location?
a) Left lower quadrant
b) Left upper quadrant
c) Right upper quadrant
d) Right lower quadrant -Correct answer: d) Right lower quadrant"
Rationale: The pain of acute appendicitis localizes in the right lower quadrant (RLQ) at McBurney's
point, an area midway between the umbilicus and the right iliac crest. Often, the pain is worse when
manual pressure near the region is suddenly released, a condition called rebound tenderness.
The nurse is monitoring a client diagnosed with appendicitis who is scheduled for surgery in 2 hours.
The client begins to complain of increased abdominal pain and begns to vomit. On assessment, the
nurse notes that the abdomen is distended and bowel sounds are diminished. Which is the
appropriate nursing intervention? "1. Notify the Physician
2. Administer the prescribed pain medication
3. Call and ask the operating room team to perform the surgery as soon as possible
4. Reposition the client and apply a heating pad on warm setting to the client's abdomen -CORRECT
ANSWER: 1"
"1. Based on the assessment information the nurse should suspect peritonitis, a complication that is
associated with appendicitis, and notify the physician.
2. Administering pain medication is not an appropriate intervention
3. Scheduling surgical time is not within the scope of practice of an RN.
4. Heat should never be applied to the abdomen of a patient suspected of having peritonitis because
of the risk of rupture."
A client is admitted with right lower quadrant pain, anorexia, nausea, low-grade fever, and elevated
white blood cell count. Which complication is most likely the cause? 1. A. fecalith 2. Bowel Kinking 3.
Internal blowel occlusion 4. Abdominal wall swelling -"
Answer 1
Rational: The client is experiencing appendicitis. A. fecalith is a fecal calculus, or stone, that occludes
the lumen of the appendix and is the most common cause of appendicitis. Bowel wall swelling,
kinking of the appendix, and external occlusion not internal occlusion, of the bowel by adhesions can
also be cause of appendicitis."
"When preparing a male client, age 51, for surgery to treat
appendicitis, the nurse formulates a nursing diagnosis of Risk for
SOLUTIONS
The nurse would increase the comfort of the patient with appendicitis by:
"a. Having the patient lie prone
b. Flexing the patient's right knee
c. Sitting the patient upright in a chair
d. Turning the patient onto his or her left side –
Correct answer: B"
The patient with appendicitis usually prefers to lie still, often with the right leg flexed to decrease pain.
"The nurse is caring for a patient in the emergency department with complaints of acute abdominal
pain, nausea, and vomiting. When the nurse palpates the patient's left lower abdominal quadrant, the
patient complains of pain in the right lower quadrant. The nurse will document this as which of the
following diagnostic signs of appendicitis?
"a. Rovsing sign
b. referred pain
c. Chvostek's sign
d. rebound tenderness
correct answer: A" -Answer A
In patients with suspected appendicitis, Rovsing sign may be elicited by palpation of the left lower
quadrant, causing pain to be felt in the right lower quadrant.
Which of the following position should the client with appendicitis assume to relieve pain ?
A. Prone
B. B. Sitting
C. C. Supine
D. D. Lying with legs drawn up –
Correct Answer: D Lying still with legs drawn up towards chest helps relive tension on the
abdominal muscle, which helps to reduce the amount of discomfort felt. Lying flat or sitting
may increase the amount of pain experienced
"When evaluating a male client for complications of acute pancreatitis, the nurse would observe for:
"a. increased intracranial pressure.
b. decreased urine output.
c. bradycardia.
d. hypertension." –
Correct Answer: B
Rationale: Acute pancreatitis can cause decreased urine output, which results from the renal failure
that sometimes accompanies this condition. Intracranial pressure neither increases nor decreases in
a client with pancreatitis. Tachycardia, not bradycardia, usually is associated with pulmonary or
hypovolemic complications of pancreatitis. Hypotension can be caused by a hypovolemic
complication, but hypertension usually isn't related to acute pancreatitis."
"When preparing a male client, age 51, for surgery to treat appendicitis, the nurse formulates a
nursing diagnosis of Risk for infection related to inflammation, perforation, and surgery. What is the
rationale for choosing this nursing diagnosis?
, "a. Obstruction of the appendix may increase venous drainage and cause the appendix to rupture.
b. Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of
the appendix.
c. The appendix may develop gangrene and rupture, especially in a middle-aged client.
d. Infection of the appendix diminishes necrotic arterial blood flow and increases venous drainage." –
Answer B. A client with appendicitis is at risk for infection related to inflammation, perforation, and
surgery because obstruction of the appendix causes mucus fluid to build up, increasing pressure in
the appendix and compressing venous outflow drainage. The pressure continues to rise with venous
obstruction; arterial blood flow then decreases, leading to ischemia from lack of perfusion.
Inflammation and bacterial growth follow, and swelling continues to raise pressure within the
appendix, resulting in gangrene and rupture. Geriatric, not middle-aged, clients are especially
susceptible to appendix rupture.
"A client is admitted with a diagnosis of acute appendicitis. When assessing the abdomen, the nurse
would expect to find rebound tenderness at which location?
a) Left lower quadrant
b) Left upper quadrant
c) Right upper quadrant
d) Right lower quadrant -Correct answer: d) Right lower quadrant"
Rationale: The pain of acute appendicitis localizes in the right lower quadrant (RLQ) at McBurney's
point, an area midway between the umbilicus and the right iliac crest. Often, the pain is worse when
manual pressure near the region is suddenly released, a condition called rebound tenderness.
The nurse is monitoring a client diagnosed with appendicitis who is scheduled for surgery in 2 hours.
The client begins to complain of increased abdominal pain and begns to vomit. On assessment, the
nurse notes that the abdomen is distended and bowel sounds are diminished. Which is the
appropriate nursing intervention? "1. Notify the Physician
2. Administer the prescribed pain medication
3. Call and ask the operating room team to perform the surgery as soon as possible
4. Reposition the client and apply a heating pad on warm setting to the client's abdomen -CORRECT
ANSWER: 1"
"1. Based on the assessment information the nurse should suspect peritonitis, a complication that is
associated with appendicitis, and notify the physician.
2. Administering pain medication is not an appropriate intervention
3. Scheduling surgical time is not within the scope of practice of an RN.
4. Heat should never be applied to the abdomen of a patient suspected of having peritonitis because
of the risk of rupture."
A client is admitted with right lower quadrant pain, anorexia, nausea, low-grade fever, and elevated
white blood cell count. Which complication is most likely the cause? 1. A. fecalith 2. Bowel Kinking 3.
Internal blowel occlusion 4. Abdominal wall swelling -"
Answer 1
Rational: The client is experiencing appendicitis. A. fecalith is a fecal calculus, or stone, that occludes
the lumen of the appendix and is the most common cause of appendicitis. Bowel wall swelling,
kinking of the appendix, and external occlusion not internal occlusion, of the bowel by adhesions can
also be cause of appendicitis."
"When preparing a male client, age 51, for surgery to treat
appendicitis, the nurse formulates a nursing diagnosis of Risk for
