Certified Neuroscience Registered Nurse (CNRN) Practice Exam

What is an indication of needing surgical revision in cases of an anastomotic leak?

1. Persistent mild abdominal pain

2. Severe abdominal pain with imaging findings

3. Normal vital signs

4. Absence of fever

The correct answer is: Severe abdominal pain with imaging findings

In cases of an anastomotic leak, severe abdominal pain coupled with imaging findings is a critical indicator that surgical revision may be necessary. This combination suggests that there could be significant complications arising from the leak, such as peritonitis, abscess formation, or other serious intra-abdominal issues that require immediate intervention. Severe pain is an objective symptom indicating that the body is responding to potentially life-threatening conditions, and when supported by imaging findings, it provides strong evidence that surgical correction is needed. Imaging may reveal fluid collections, bowel distensibility, or other complications that would merit surgical exploration or revision to prevent further morbidity or mortality. Other factors, such as persistent mild abdominal pain, normal vital signs, or absence of fever, do not provide sufficient grounds for surgical intervention. Mild pain can be managed conservatively, and normal vital signs typically suggest that the patient is stable. Similarly, the absence of fever may not correlate directly with the need for surgical revision, as infections can present without a fever in certain scenarios. Therefore, the presence of severe symptoms and supportive imaging findings is the clear indicator for surgical revision in the case of an anastomotic leak.