Practice Question
A nurse in the emergency department (ED) is caring for a 13-year-old client who presented with right lower quadrant abdominal pain, nausea, and fever.
Answer Choices:
Correct Answer:
Obtain informed consent for surgery
Rationale:
✅ B. Obtain informed consent for surgery
📝 The client’s worsening right lower quadrant (RLQ) pain, rebound tenderness, guarding, and a WBC count of 22,000/mm³, along with a CRP of 11.8 mg/dL, strongly suggest acute appendicitis, possibly requiring appendectomy.
📝 In pediatric clients, informed consent for surgery must be obtained from a parent or guardian—and assent from the child if developmentally appropriate.
📝 Early surgical consultation and preparation are critical to avoid perforation or peritonitis.
✅ D. Initiate IV antibiotics
💉 IV antibiotics are commonly ordered as preoperative management in suspected appendicitis to prevent or manage infection, especially if perforation is possible.
💉 Initiating broad-spectrum antibiotics helps reduce bacterial load and limit systemic spread, particularly if there's a delay in surgery.
💉 The provider may order ceftriaxone with metronidazole or other combinations as initial empiric therapy.
✅ E. Maintain NPO status
🚫 Clients with suspected appendicitis must remain NPO to prevent aspiration and prepare for possible emergency surgery.
🚫 The client is already nauseated and has vomited, reinforcing the need to withhold oral intake.
🚫 The nurse must also ensure that IV fluids are running at maintenance to support hydration.
✅ F. Obtain abdominal ultrasound
🖥️ Abdominal ultrasound is a first-line imaging test for suspected appendicitis in children due to its non-invasive nature and lack of radiation.
🖥️ It helps visualize the inflamed appendix, free fluid, or other causes of RLQ pain (e.g., ovarian torsion in females, mesenteric adenitis).
🖥️ If ultrasound is inconclusive, CT scan with contrast may be needed, but ultrasound is typically the initial step in pediatrics.
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This question is from RN ATI Paediatrics Nur 223a Section 4 Final Exam which contains 92 questions.
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From Exam
RN ATI Paediatrics Nur 223a Section 4 Final Exam
92 Questions
View Full Exam Start PracticingQuestion Details
- Category: RN Nursing Exam(s)
- Subcategory: ATI Exam(s)
- Domain: RN ATI Pediatrics
- Answer Choices: 7