Pancreatitis NCLEX questions

Pancreatitis NCLEX questions Leave the first rating Students also studied Terms in this set (9) Science MedicineGastroenterology Save Pancreatitis, NCLEX 59 terms melissa-knight Preview Pancreatitis NCLEX (ATI, Evolve, Lew...13 terms Jennster17Preview Pancreatitis NCLEX Questions 12 terms florahill10Preview Pancre 32 terms xrm You're caring for a 45 year old patient who is admitted with suspected acute pancreatitis. The patient reports having extreme mid-epigastric pain that radiates to the back. The patient states the pain started last night after eating fast food. As the nurse, you know the two most

common causes of acute pancreatitis are:*

• High cholesterol and alcohol abuse
• History of diabetes and smoking
• Pancreatic cancer and obesity
• Gallstones and alcohol abuse

The answer is D. Main causes of acute pancreatitis are gallstones and alcohol consumption. Heavy, long-term alcohol abuse is the main cause of CHRONIC pancreatitis.Which patient below is at MOST risk for CHRONIC pancreatitis?*

• A 25 year old female with a family history of gallstones.
• A 35 year old male who reports social drinking of

alcohol.

• A 15 year old female with cystic fibrosis.
• A 66 year old female with stomach cancer.

The answer is C. Patients in options A and B are at slight risk for ACUTE pancreatitis not chronic. Remember the main causes of ACUTE pancreatitis are gallstones and alcohol consumption. In option C, the patient with cystic fibrosis is at MAJOR risk for CHRONIC pancreatitis because they are lacking the protein CFTR which plays a role in the movement of chloride ions to help balance salt and water in the epithelial cells that line the ducts of the pancreas. There is a decreased production of bicarbonate secretion by the epithelial cells. Therefore, this leads to thick mucus in the pancreatic ducts that can lead to blockage of the pancreatic ducts which can cause the digestive enzymes to activate and damage the pancreas. Overtime, the pancreas will experience fibrosis of the pancreas' tissue and will no longer produce digestive enzyme to help with food digestion.

Your patient with acute pancreatitis is scheduled for a test that will use a scope to assess the pancreas, bile ducts, and gallbladder. The patient asks you, "What is the name of the test I'm going for later today?" You tell the patient

it is called:*

A. MRCP

B. ERCP

• CT scan of the abdomen

D. EGD

The answer is B. ERCP (Endoscopic Retrograde Cholangio-Pancreatography) is used to diagnosis and sometimes treat the causes of pancreatitis. It will assess the pancreas, bile ducts, and gallbladder. In addition, the doctor may be able to remove gallstones, dilate the blocked ducts with a stent or balloon, drain presenting cysts etc.A patient is admitted to the ER with the following signs

and symptoms: very painful mid-epigastric pain felt in the

back, elevated glucose, fever, and vomiting. During the head-to-toe assessment, you notice bluish discoloration around the belly button. As the nurse, you know this is called?*

• Grey-Turner's Sign
• McBurney's Sign
• Homan's Sign
• Cullen's Sign

The answer is D. This is known as Cullen's Sign. It represents retroperitoneal bleeding from the leakage of digestive enzymes from the inflamed pancreas into the surrounding tissues which is causing bleeding and it is leaking down to umbilicus tissue. Remember the C in Cullen for "circle" and the belly button forms a circle. The patient can also have Grey-Turner's Sign which is a bluish discoloration at the flanks (side of the abdomen). Remember this by TURNER ("turn her" over on her side) which is where the bluish discoloration will be.While assisting a patient with chronic pancreatitis to the bathroom, you note the patient's stool to be oily/greasy

in appearance. In your documentation you note this as:*

• Steatorrhea
• Melena
• Currant
• Hematochezia

The answer is A. Steatorrhea is an oily/greasy appearance of the stool which can occur in chronic pancreatitis. This occurs due to the inability of the pancreas to produce digestive enzymes which help break down fats. Fats are not being broken down; therefore, it is being excreted into the stool. Melena is used to describe tarry/black stool, hematochezia is used to describe red stools, and currant are jelly type stools.A patient with acute pancreatitis is reporting excessive thirst, excessive voiding, and blurred vision. As the nurse, it is priority you?*

• Reassure the patient this is normal with pancreatitis
• Check the patient's blood glucose
• Assist the patient with drinking a simple sugar drink like

orange juice

• Provide a dark and calm environment

The answer is B. Patients with acute pancreatitis are at risk for hyperglycemia (the signs and symptoms the patient are reporting are classic symptoms of hyperglycemia). Remember the endocrine function of the pancreas (which is to release insulin/glucagon etc. is insufficient) so the nurse must monitor the patient's blood glucose levels even if the patient is not diabetic.A patient who received treatment for pancreatitis is being discharged home. You're providing diet teaching to the patient. Which statement by the patient requires immediate re-education about the diet restrictions?*

• "It will be hard but I will eat a diet low in fat and avoid

greasy foods."

• "It is very important I limit my alcohol intake to no more

than 2-3 glasses of wine a week."

• "I will concentrate on eating complex carbohydrates

rather than refined carbohydrates."

• "I will purchase foods that are high in protein."

The answer is B. A patient with pancreatitis should AVOID any amount of alcohol because of its effects on the pancreas. Remember alcohol is a cause of both acute and chronic pancreatitis. All the other options are correct.

The physician orders a patient with pancreatitis to take a pancreatic enzyme. What assessment finding demonstrates the pancreatic enzymes are working properly?*

• Abdominal girth is decreased
• Skin turgor is less than 2 seconds
• Blood glucose is 250
• Stools appear formed and solid

The answer is D. Pancreatic enzymes help the body break down carbs, proteins, and fats because the body is not sufficiently producing digestive enzymes anymore. Hence, the stool will not appear as oily or greasy (decrease in steatorrhea) but appear solid and formed.During a home health visit, you are assessing how a patient takes the prescribed pancreatic enzyme. The patient is unable to swallow the capsule whole, so they open the capsule and mix the beads inside the capsule with food/drink. Which food or drink is safe for the patient to mix the beads with?*

• Pudding
• Ice cream
• Milk
• Applesauce

The answer is D. The patient should mix the medications with acidic foods like applesauce. It is very important the patient does NOT use alkaline foods for mixing (like dairy products, pudding etc.) because they can damaged the enzyme.