AACN Exam CCRN-Adult Topic 1 Question 4 Discussion

Actual exam question for AACN's CCRN-Adult exam

Question #: 4
Topic #: 1

A patient is experiencing lower left quadrant pain with guarding, as well as abdominal distention and rigidity. KUB reveals free air in the abdominal

cavity. Vital signs are:

BP 76/40

HR 130

RR 32

T 101.7 F (38.7C)

A nurse would suspect

Aperforated bowel.

Bparalytic ileus.

Cappendicitis.

Dacute pancreatitis.

Show Suggested Answer

Suggested Answer: A

The clinical presentation of lower left quadrant pain with guarding, abdominal distention, rigidity, and free air in the abdominal cavity on a KUB (kidney, ureter, and bladder) radiograph strongly suggests a perforated bowel. The presence of free air indicates that there is a breach in the gastrointestinal tract, allowing air to escape into the peritoneal cavity. The patient's vital signs, including hypotension (BP 76/40), tachycardia (HR 130), tachypnea (RR 32), and fever (T 101.7F), are consistent with sepsis and shock, which are common complications of bowel perforation. Reference: CCRN Exam Handbook, AACN, page 30, section on Gastrointestinal.

by Bulah at Mar 08, 2025, 05:15 AM

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Lacresha

15 days ago

I don't think so, the free air in the abdominal cavity suggests perforated bowel.

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Minna

17 days ago

I'm just going to go with option A and hope for the best. Perforated bowel sounds dramatic, but at least it's not something boring like appendicitis. Who wants to be the nurse that misses a major abdominal catastrophe, am I right?

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Adolph

6 days ago

User 2: Yeah, that sounds serious.

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Charlie

12 days ago

User 1: I think it's perforated bowel.

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Anglea

18 days ago

But could it also be acute pancreatitis?

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Nakita

23 days ago

This is a tough one, but I'm leaning towards paralytic ileus. The distention and rigidity could be due to a blockage in the intestines. Plus, the nurse would definitely suspect this, right? It's the most obscure answer, so it must be correct.

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Shelia

25 days ago

Hmm, I'm not so sure. The combination of symptoms makes me think it could be acute pancreatitis. The fever and low blood pressure are concerning, though. I'll go with that just to be different.

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Laila

1 days ago

I believe it might be appendicitis.

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Cecilia

10 days ago

I'm leaning towards paralytic ileus.

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Santos

16 days ago

I think it's a perforated bowel.

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Azzie

26 days ago

I agree, the symptoms and vital signs point towards that.

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Irma

29 days ago

I'm going with appendicitis. The lower left quadrant pain and guarding are classic signs. Maybe the patient just had a big meal and that's why there's distention and rigidity.

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Pamella

1 months ago

Definitely a perforated bowel. The free air in the abdomen and the patient's vital signs point to a serious abdominal emergency. This is a no-brainer.

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Chauncey

22 days ago

Definitely a perforated bowel. The free air in the abdomen and the patient's vital signs point to a serious abdominal emergency. This is a no-brainer.

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Lashon

25 days ago

A) perforated bowel.

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Filiberto

1 months ago

I think the patient might have a perforated bowel.

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