The nurse is assessing a patient with suspected appendicitis. Which point of tenderness is specifically associated with this condition?

1. A

   McBurney’s point

2. B

   Erb’s point

3. C

   Murphy’s point

4. D

   Cullen’s point

Appeared in: BTSC 3 August 2025

Explanation

• McBurney's point is the classic location for maximal tenderness in acute appendicitis.
• It is located in the right lower quadrant (RLQ) of the abdomen, about one-third of the distance from the anterior superior iliac spine (the prominent hip bone) to the umbilicus (navel).
• This anatomical landmark corresponds to the most common position of the appendix base, and pressure here elicits pain when the appendix is inflamed and irritates the parietal peritoneum.

Why Other Options Were Wrong

• Option B: This is an auscultatory point on the chest used for listening to heart sounds, not an abdominal landmark for tenderness.
• Option C: This refers to Murphy's sign, which is pain in the right upper quadrant (RUQ) elicited during inspiration, indicating gallbladder inflammation.
• Option D: This refers to Cullen's sign, which is bruising around the umbilicus, indicating retroperitoneal hemorrhage.

Related Visual

Clinical Relevance

• Nursing practice connection: Use the key finding related to Abdominal Assessment: Identifying Appendicitis-Specific Tenderness to guide bedside assessment, documentation, and the next nursing action.
• Accurate identification of McBurney's point tenderness is a critical nursing assessment skill for the early suspicion of appendicitis, facilitating prompt medical evaluation and intervention.
• A delay in diagnosis can lead to appendix perforation, peritonitis, and sepsis, which are life-threatening complications. A focused abdominal assessment is key to patient safety.
• What if? If the patient's pain was in the right upper quadrant and worsened with deep breaths, the nurse should suspect cholecystitis (positive Murphy's sign) instead of appendicitis and adjust their reporting to the physician accordingly.

How to Approach the Question

• First, identify the core clinical condition presented in the question: 'suspected appendicitis'.
• Next, analyze the question's specific requirement: to find the 'point of tenderness' associated with this condition.
• This is a factual recall question. Systematically review the four options, which are all named anatomical points or signs.
• Recall or deduce the anatomical location and clinical significance of each point. McBurney's point is in the RLQ (appendicitis), Erb's point is on the chest (heart sounds), Murphy's point is in the RUQ (gallbladder), and Cullen's point is umbilical bruising (hemorrhage).
• Match the condition (appendicitis) with its corresponding landmark (McBurney's point) to select the correct answer.

Concept Tested & Keywords

• Concept Tested: Abdominal Assessment: Identifying Appendicitis-Specific Tenderness
• Stem keywords: appendicitis, point of tenderness, assessing
• Lead-in keywords: specifically associated
• Clinical cues: suspected appendicitis

Question ID

Q4ocI2VLSATT6ASzIln7pw

Copy ID

Reference Book

E6 Medicine Harrison 22e Part 2 p. 499-501

E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 180-182