Free BCEN Certified Emergency Nurse (CEN) Practice Question

The patient's presentation of sudden onset, severe, localized lower abdominal pain with associated nausea, vomiting, and fever is indicative of ovarian torsion. Ovarian torsion typically presents with sharp pain that can be intermittent or constant and may be accompanied by nausea or vomiting. Fever is not commonly associated with ovarian torsion, but the presence of it does not rule out the diagnosis. The sudden onset during physical activity and worsening pattern of pain are also characteristic of torsion. While ectopic pregnancy could also present with lower abdominal pain, the unremarkable menstrual history and timing of the symptoms make it less likely than torsion in this case. Appendicitis usually presents with more diffuse abdominal pain initially that becomes localized to the right lower quadrant, and the quality of pain can be different from the sharp pain of torsion.