Progressive Care Nursing Certification (PCCN) Practice Exam

What is the most common cause of gastrointestinal perforation?

1. Bowel obstruction

2. Ruptured appendicitis

3. Colonic ulcers

4. Gastric ulcers

The correct answer is: Ruptured appendicitis

The most common cause of gastrointestinal perforation is ruptured appendicitis. When the appendix becomes inflamed and infected, it can lead to an increase in pressure within the appendiceal lumen. If this pressure continues to rise without intervention, the appendix can eventually rupture, leading to perforation. This results in the spillage of intestinal contents into the peritoneal cavity, which can cause peritonitis, a serious and potentially life-threatening condition. In cases of bowel obstruction, perforation can occur, but it is not the most common cause. Obstructions can lead to increased hydrostatic pressure and distension, which can create conditions favorable for perforation, yet ruptured appendicitis remains the more prevalent cause in clinical practice. Colonic ulcers and gastric ulcers can also lead to perforation, particularly when the ulceration is deep or extensive. However, ruptured appendicitis is more frequently encountered as the initial event leading to perforation, especially in the emergency or acute care settings. Understanding the underlying mechanisms and clinical scenarios associated with appendicitis is essential for appropriate diagnosis and management in progressive care nursing.