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Chief complaint: Patient presents with severe abdominal pain and vomiting.

Nursing notes: Upon assessment, the patient appears pale and diaphoretic. The abdomen is distended and tender to palpation in the right lower quadrant. The patient reports a loss of appetite and a fever of 101°F (38.3°C). Bowel sounds are diminished. The patient has a history of appendectomy.

Current medications:
1. Ibuprofen 400 mg every 6 hours as needed for pain
2. Ondansetron 4 mg every 8 hours as needed for nausea/vomiting
3. Metronidazole 500 mg IV every 8 hours for suspected infection
4. Morphine sulfate 2 mg IV every 4 hours as needed for pain

Vital signs on admission:
- Blood pressure: 120/80 mmHg
- Heart rate: 110 beats per minute
- Respiratory rate: 20 breaths per minute
- Oxygen saturation: 98% on room air
- Temperature: 101°F (38.3°C)

Lab results:
- White blood cell count: 15,000/mm³ (elevated)
- Serum amylase: 250 units/L (elevated)
- Serum lipase: 350 units/L (elevated)
- Urinalysis: Positive for white blood cells and bacteria

NCLEX Question 1:
The patient's clinical presentation and laboratory findings are most consistent with which of the following conditions?
A) Appendicitis
B) Cholecystitis
C) Diverticulitis
D) Pancreatitis

NCLEX Question 2:
Which of the following actions should the nurse prioritize for this patient?
A) Administer morphine sulfate for pain relief
B) Initiate a nasogastric tube insertion for decompression
C) Prepare the patient for an immediate appendectomy
D) Start IV fluids and maintain NPO (nothing by mouth) status

NCLEX Question 3:
Which parameter should the nurse monitor closely to evaluate the effectiveness of the treatment for this patient?
A) White blood cell count
B) Blood pressure
C) Oxygen saturation
D) Serum amylase levels
E) Pain level assessment

Hmmm.

No nurses?