Pancreatitis NCLEX style questions

Pancreatitis NCLEX style questions Leave the first rating Students also studied Terms in this set (15) Science MedicineNursing Save

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• Priority Intervention

A client is admitted with acute pancreatitis. Which order should the nurse implement first?

• Start clear liquid diet
• Administer IV morphine
• Maintain NPO and begin IV fluids
• Give oral acetaminophen

✅ Answer: C

Rationale: NPO + IV fluids are the first-line interventions to rest the pancreas and prevent hypovolemic shock. Pain management is important but comes after stabilizing circulation.

• Pharmacology

Which medication is most appropriate to control severe pain in acute pancreatitis?

• Morphine sulfate IV
• Meperidine IM
• Acetaminophen PO
• Ibuprofen PO.

✅ Answer: A

Rationale: IV opioids (morphine, hydromorphone) are preferred. Meperidine is

avoided due to neurotoxic metabolite (normeperidine).The nurse should monitor a client with acute pancreatitis for which complications? (Select all that apply)

• Hypocalcemia

B. ARDS

• Pseudocyst
• Hypoglycemia
• Shock.

✅ Answers: A, B, C, E

Rationale: Complications include hypocalcemia, respiratory failure (ARDS),

pseudocyst, abscess, shock. Hyperglycemia (not hypoglycemia) is more common.

A nurse notes Chvostek's and Trousseau's signs in a client with pancreatitis. What electrolyte imbalance should be suspected?

• Hypernatremia
• Hypocalcemia
• Hyperkalemia
• Hypomagnesemia

✅ Answer: B

Rationale: Fat necrosis binds calcium, leading to hypocalcemia → tetany, muscle twitching, positive Chvostek/Trousseau signs.When is NG tube suction indicated in acute pancreatitis?

• To give enteral nutrition
• To reduce gastric distention & vomiting
• To monitor amylase levels
• To prevent hypocalcemia

✅ Answer: B

Rationale: NG suction is used if the patient has severe vomiting, ileus, or

abdominal distention.Which diet is best when a client with pancreatitis is stable and starting oral intake?

• High-fat, low-protein
• Low-fat, high-carbohydrate/protein
• Clear liquids with caffeine
• High-sugar, low-protein

✅ Answer: B

Rationale: Diet should be low-fat, high-carb, high-protein, small frequent meals.Avoid alcohol, fatty, and spicy foods.Why are PPIs (omeprazole, pantoprazole) given to patients with pancreatitis?

• Prevent infection
• Reduce gastric acid secretion
• Increase pancreatic enzyme secretion
• Stimulate appetite

✅ Answer: B

Rationale: PPIs decrease gastric acid, helping reduce pancreatic stimulation.

Which finding in a client with pancreatitis requires immediate intervention?

• Mild epigastric pain
• Low-grade fever 100.4°F (38°C)
• SpO₂ 86% on 2 L oxygen
• Fatty stools

✅ Answer: C

Rationale: Hypoxemia indicates possible ARDS → life-threatening complication

requiring priority intervention.Which instruction is correct for a client prescribed pancrelipase (enzyme replacement)?

• Take on an empty stomach
• Chew tablets before swallowing
• Take with each meal/snack
• Take only if abdominal pain worsens

✅ Answer: C

Rationale: Enzyme replacement must be taken with meals to aid fat and nutrient

digestion.Which interventions are appropriate during the acute phase of pancreatitis? (Select all that apply)

A. NPO

• IV fluids
• IV opioids
• Encourage ambulation after meals
• Oxygen therapy as needed

✅ Answers: A, B, C, E

Rationale: NPO, fluids, pain control, and oxygen are appropriate. Ambulation after meals is not safe in acute phase.

Which lab findings would the nurse expect in acute pancreatitis?

• ↓ Amylase & ↓ Lipase
• ↑ Amylase & ↑ Lipase
• ↓ WBC & ↑ Hematocrit
• ↑ Calcium & ↓ Glucos

✅ Answer: B

Rationale: Acute pancreatitis is marked by elevated amylase and lipase. WBC ↑, Ca²⁺ ↓, glucose ↑.Which client is most likely to need an ERCP procedure?

• Pancreatitis from alcohol abuse
• Pancreatitis from gallstones
• Pancreatitis from trauma
• Pancreatitis from hyperlipidemia

✅ Answer: B

Rationale: ERCP removes biliary obstructions (gallstones), a common cause of

pancreatitis.Which teaching point is most important for a client recovering from pancreatitis?

• Avoid fatty foods but moderate alcohol intake is safe.
• Take enzymes with meals and avoid alcohol

completely.

• Use NSAIDs instead of opioids for future pain.
• Resume normal diet once symptoms subside.

✅ Answer: B

Rationale: Enzyme therapy (chronic cases) and strict alcohol avoidance are

crucial.Why is strict I&O and daily weights important in pancreatitis care?

• Prevents hypoglycemia
• Detects fluid shifts and shock
• Helps monitor enzyme replacement therapy
• Prevents pseudocyst rupture

✅ Answer: B

Rationale: Fluid losses can be massive in pancreatitis → risk of hypovolemia and shock. Monitoring fluid balance is critical.Which statement about antibiotics in acute pancreatitis is correct?

• Always given on admission
• Only used if infection or pseudocyst present
• Given to prevent ARDS
• Used to treat hyperglycemia

✅ Answer: B

Rationale: Antibiotics are not routine—they are reserved for confirmed infection or abscess/pseudocyst.