American Association of Critical-Care Nurses (AACN) Certification Practice Test

What condition is indicated by the Psoas sign?

1. Cholecystitis

2. Appendicitis

3. Cholangitis

4. Pancreatitis

The correct answer is: Appendicitis

The Psoas sign is a clinical indicator that suggests the presence of appendicitis. It is assessed by having the patient flex their right hip against resistance or extending the right leg while lying on their back. If this movement elicits abdominal pain, it indicates irritation of the iliopsoas muscle associated with inflamed appendix tissue, supporting the diagnosis of appendicitis. In relation to the other conditions listed: cholecystitis typically presents with right upper quadrant pain, Murphy's sign, and maybe referred pain to the right shoulder but is not associated with the Psoas sign. Cholangitis may be indicated by fever, jaundice, and right upper quadrant pain, and it does not elicit the Psoas sign. Pancreatitis usually presents with abdominal pain and may involve other signs of gastrointestinal distress but is unrelated to the Psoas sign, which specifically points to appendiceal issues. Hence, the connection of the Psoas sign with appendicitis makes it the correct choice in this context.