Family Nurse Practitioner Practice Exam

Extreme tenderness at McBurney’s point is a classic sign associated with acute appendicitis. McBurney’s point is located in the right lower quadrant of the abdomen, approximately one-third of the distance from the anterior superior iliac spine to the umbilicus. This area is where the appendiceal base is situated and is where pain is most commonly elicited during the physical examination of a patient with appendicitis.

In acute appendicitis, the inflammation of the appendix leads to localized pain, often starting as a vague discomfort around the periumbilical area before shifting to the right lower quadrant. This shift in pain is characteristic, and the tenderness at McBurney's point is used as a clinical indicator to support the diagnosis. The presence of rebound tenderness and guarding may further indicate irritation of the peritoneum, which often accompanies appendicitis.

While the other conditions listed can cause abdominal pain, their clinical presentations do not typically include extreme tenderness specifically at McBurney’s point as seen in acute appendicitis. Acute cholecystitis usually presents with pain in the right upper quadrant, acute gastroenteritis often involves diffuse abdominal discomfort and may present with diarrhea and vomiting, and acute diverticulitis typically manifests with pain