Pancreatitis Practice Questions

Pancreatitis Practice Questions 5.0 (1 review) Students also studied Terms in this set (32) Science MedicineGastroenterology Save Exam 4- Cirrhosis NCLEX Teacher 26 terms RegisteredNurse22 Preview Pancreatitis, NCLEX 59 terms melissa-knight Preview Pancreatitis NCLEX (ATI, Evolve, Lew...13 terms Jennster17Preview Hepatit 12 terms erin What is the patient with chronic pancreatitis more likely to have than the patient with acute pancreatitis?

• has acute abdominal pain
• the need to abstain from alcohol
• malabsorption and diabetes mellitius
• require a high-carbohydrate, high-protein, low-fat diet
• malabsorption and diabetes mellitius

Chronic damage to the pancreas causes a deficiency of digestive enzymes and insulin resulting in malabsorption and diabetes. Abstinence from alcohol is necessary in both types of pancreatitis , as is a high-carbohydrate diet, high protein, and low fat diet. Although abdominal pain is a major manifestation of chronic pancreatitis, more commonly a constant heavy, gnawing feeling occurs.A 67-year-old male patient with acute pancreatitis has a nasogastric (NG) tube to suction and is NPO. Which information obtained by the nurse indicates that these therapies have been effective?

• Bowel sounds are present.
• Grey Turner sign resolves.
• Electrolyte levels are normal.
• Abdominal pain is decreased
• Abdominal pain is decreased

Which assessment finding is of most concern for a 46- year-old woman with acute pancreatitis?

• Absent bowel sounds
• Abdominal tenderness
• Left upper quadrant pain
• Palpable abdominal mass
• Palpable abdominal mass

A palpable abdominal mass may indicate the presence of a pancreatic abscess, which will require rapid surgical drainage to prevent sepsis. Absent bowel sounds, abdominal tenderness, and left upper quadrant pain are common in acute pancreatitis and do not require rapid action to prevent further complications

Which laboratory test result will the nurse monitor when evaluating the effects of therapy for a 62-year-old female patient who has acute pancreatitis?

• Calcium
• Bilirubin
• Amylase
• Potassium
• Amylase

Amylase is elevated in acute pancreatitis. Although changes in the other values may occur, they would not be useful in evaluating whether the prescribed therapies have been effective The nurse will ask a 64-year-old patient being admitted with acute pancreatitis specifically about a history of

• diabetes mellitus.
• high-protein diet.
• cigarette smoking.
• alcohol consumption.
• alcohol consumption.

The nurse will teach a patient with chronic pancreatitis to take the prescribed pancrelipase (Viokase)

• at bedtime.
• in the morning.
• with each meal.
• for abdominal pain
• with each meal.

Pancreatic enzymes are used to help with digestion of nutrients and should be taken with every mea A 54-year-old patient admitted with diabetes mellitus, malnutrition, osteomyelitis, and alcohol abuse has a serum amylase level of 280 U/L and a serum lipase level of 310 U/L. To what diagnosis does the nurse attribute these findings?

• Malnutrition
• Osteomyelitis
• Alcohol abuse
• Diabetes mellitus
• Alcohol abuse

The patient with alcohol abuse could develop pancreatitis as a complication, which would increase the serum amylase (normal 30-122 U/L) and serum lipase (normal 31-186 U/L) levels as shown.The patient with sudden pain in the left upper quadrant radiating to the back and vomiting was diagnosed with acute pancreatitis. What intervention(s) should the nurse expect to include in the patient's plan of care?

• Immediately start enteral feeding to prevent

malnutrition.

• Insert an NG and maintain NPO status to allow

pancreas to rest.

• Initiate early prophylactic antibiotic therapy to prevent

infection.

• Administer acetaminophen (Tylenol) every 4 hours for

pain relief.

• Insert an NG and maintain NPO status to allow pancreas to rest.

Initial treatment with acute pancreatitis will include an NG tube if there is vomiting and being NPO to decrease pancreatic enzyme stimulation and allow the pancreas to rest and heal. Fluid will be administered to treat or prevent shock. The pain will be treated with IV morphine because of the NPO status. Enteral feedings will only be used for the patient with severe acute pancreatitis in whom oral intake is not resumed. Antibiotic therapy is only needed with acute necrotizing pancreatitis and signs of infection.

The nurse is caring for a 55-year-old man patient with acute pancreatitis resulting from gallstones. Which clinical manifestation would the nurse expect the patient to exhibit?

• Hematochezia
• Left upper abdominal pain
• Ascites and peripheral edema
• Temperature over 102o F (38.9o C)
• Left upper abdominal pain

A nurse is completing an admission assessment of a client who has pancreatitis. Which of the following is an expected finding?

• Pain in right upper quadrant radiating to right shoulder
• Report of pain being worse when sitting upright
• Pain relieved with defecation
• Epigastric pain radiating to left shoulder
• Epigastric pain radiating to left shoulder

A client who has pancreatitis will report severe, boring epigastric pain that radiates to the back, left flank, or left shoulder.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
• Gallstones and alcohol abuse

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.
• A 15 year old female with cystic fibrosis.

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

B. ERCP

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
• Cullen's Sign

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
• Steatorrhea

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
• Check the patient's blood glucose

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."
• "It is very important I limit my alcohol intake to no more than 2-3 glasses of wine

a week." 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
• Stools appear formed and solid