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AACN Exam CCRN-Adult Topic 1 Question 16 Discussion

Actual exam question for AACN's CCRN-Adult exam
Question #: 16
Topic #: 1
[All CCRN-Adult Questions]

A patient presents with fever and chills, is diaphoretic, and reports experiencing abdominal and intermittent left shoulder pain for the past week. An

ultrasound shows an enlarged spleen. Vital signs are:

BP 106/59

HR 118

RR 23

T 101.2 F (38.4 C)

When reviewing the lab report, which of the following findings is most significant to this presentation?

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Suggested Answer: A

The patient's presentation is suggestive of splenic abscess, which is a rare but serious complication of splenomegaly. Splenic abscess is caused by bacterial or fungal infection of the spleen, usually from hematogenous spread or contiguous spread from adjacent organs. The most common symptoms are fever, chills, abdominal pain, and left shoulder pain (Kehr sign). The most significant laboratory finding is positive blood cultures, which indicate systemic infection and sepsis. Other laboratory findings may include leukocytosis, anemia, thrombocytopenia, elevated inflammatory markers, and abnormal liver function tests. However, these are nonspecific and may vary depending on the underlying cause of splenomegaly and the type of microorganism involved.


Splenic Abscess - Infectious Disease Advisor

Cross-sectional imaging findings of splenic infections: is ... - Springer

Contribute your Thoughts:

Lina
3 days ago
I'm a bit unsure about this one. The symptoms could point to a few different things. I'll need to carefully review all the lab values to try to piece together the most likely diagnosis.
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Lino
9 days ago
The enlarged spleen and fever/chills suggest an infectious etiology, so I'd be most interested in seeing if there are positive blood cultures. That would be the most significant finding to point to the source of the infection.
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Rueben
14 days ago
Hmm, this seems like a case of possible sepsis or an infectious process. I'd want to look closely at the lab findings to see if there are any clues about the underlying cause.
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