Certified Pediatric Emergency Nurse (CPEN) Practice Exam

The presence of positive rebound tenderness during an abdominal examination is a critical assessment sign that suggests the need for urgent imaging, such as an ultrasound or CT scan. Rebound tenderness indicates that there is irritation or inflammation of the peritoneum, which can be associated with serious conditions like appendicitis, perforated viscera, or acute abdominal processes that require immediate attention.

This sign is particularly important in the pediatric population, where abdominal pain can stem from various causes, including gastrointestinal infections, appendicitis, intussusception, or even traumatic injuries. Early identification of conditions that necessitate surgical intervention can be life-saving, as a delay in diagnosis and treatment could lead to significant morbidity.

While decreased appetite, abdominal bloating, and fever without abdominal pain are symptoms that could indicate an underlying illness, they do not specifically point to a condition that requires immediate imaging. These signs can be associated with less acute issues or may not reveal the severity or cause of abdominal pain as effectively as rebound tenderness does.