An 18-year-old is admitted with an acute onset of right lower quadrant pain at McBurney's point. Appendicitis is suspected. For which clinical indicator should the nurse assess the client to determine if the pain is secondary to appendicitis?a. Urinary retentionb. Gastric hyperacidityc. bound tendernessd. Increased lower bowel motility

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1. An 18-year-old is admitted with an acute onset of right lower quadrant pain at McBurney's point. Appendicitis is suspected. For which clinical indicator should the nurse assess the client to determine if the pain is secondary to appendicitis?

a. Urinary retention

b. Gastric hyperacidity

c. bound tenderness

d. Increased lower bowel motility

C!

Rebound tenderness is a classic subjective sign of appendicitis. Urinary retention does not cause acute lower right quadrant pain. Hyperacidity causes epigastric, not lower right quadrant pain. There generally is decreased bowel motility distal to an inflamed appendix.
B!

Massaging the legs twice a day is unsafe if a thrombus is present because it may dislodge and cause an embolus. Fluids decrease blood viscosity, reducing the risk for thrombus formation. Elastic stockings physically compress veins, preventing venous stasis and lowering the risk for thrombus formation. Range-of-motion exercises prevent venous stasis and promote muscle tone; they propel venous blood toward the heart, facilitated by venous one-way valves.
A!

Alterations in oxygen saturation can provide information about impending complications, permitting early intervention. Although a low oxygen saturation may be altered in the presence of pain, it is not the most specific way to determine whether a client is experiencing pain. The nurse still should obtain the oxygen saturation level when performing an assessment of a client in the home. Nonprofessionals do not have the expertise to alter ventilator settings. Ventilator settings should be maintained as prescribed by the health care provider.
D!

The nurse should remove and dispose of the patch in a manner that protects self and others from exposure to the fentanyl. Having the family remove and dispose of the patch or having the mortician remove the patch are not the responsibility of nonprofessionals because they do not know how to protect themselves and others from exposure to the fentanyl. It is unnecessary to return a used fentanyl patch.

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