Pancreatitis Practice Questions

Pancreatitis Practice Questions 5.0 (1 review) Students also studied Terms in this set (12) Science MedicineNursing Save Pharm Chap 52 17 terms Ranger1909Preview Pancreatitis Practice Questions 32 terms xrmw3hfcg7Preview Pancreatitis NCLEX (ATI, Evolve, Lew...13 terms Jennster17Preview Shock a 28 terms T_A The client is admitted to the medical department with a diagnosis of R/O acute pancreatitis. Which laboratory values should the nurse monitor to confirm this diagnosis?

• Creatinine and BUN.
• Troponin and CK-MB.
• Serum amylase and lipase.
• Serum bilirubin and calcium.
• These laboratory values are monitored for clients in kidney failure.
• These laboratory values are elevated in clients with a myocardial infarction.
• Serum amylase increases within two (2) to 12 hours of the onset of acute

pancreatitis to two (2) to three (3) times normal and returns to normal in three (3) to four (4) days; lipase elevates and remains elevated for seven (7) to 14 days.

• Bilirubin may be elevated as a result of compression of the common duct, and

hypocalcemia develops in up to 25% of clients with acute pancreatitis, but these laboratory values do not confirm the diagnosis.Which client problem has priority for the client diagnosed with acute pancreatitis?

• Risk for fluid volume deficit.
• Alteration in comfort.

3. Imbalanced nutrition: less than body requirements.

• Knowledge deficit.
• The client will be NPO to help decrease pain, but it is not the priority problem

because the client will have intravenous fluids.

• Autodigestion of the pancreas results in severe epigastric pain, accompanied

by nausea, vomiting, abdominal tenderness, and muscle guarding.

• Nutritional imbalance is a possible client problem, but it is not priority.
• Knowledge deficit is always a client problem, but it is not priority over pain.

The nurse is preparing to administer a.m. medications to clients. Which medication should the nurse question before administering?

• Pancreatic enzymes to the client who has finished

breakfast.

• The pain medication, morphine, to the client who has a

respiratory rate of 20.

• The loop diuretic to the client who has a serum

potassium level of 3.9 mEq/L.

• The beta blocker to the client who has an apical pulse

of 68 bpm.

• Pancreatic enzymes must be administered with meals to enhance the

digestion of starches and fats in the gastrointestinal tract.

• The client’s respiratory rate is within normal limits; therefore, the morphine

should be administered to the client who is having pain.

• This is a normal potassium level; therefore, the nurse does not need to question

administering this medication.

• The apical pulse is within normal limits; therefore, the nurse should not question

administering this medication.

The client is diagnosed with acute pancreatitis. Which health-care provider's admitting order should the nurse question?

• Bedrest with bathroom privileges.
• Initiate IV therapy of D5W at 125 mL/hr.
• Weigh client daily.
• Low-fat, low-carbohydrate diet.
• Bedrest will decrease metabolic rate, gastrointestinal secretion, pancreatic

secretions, and pain; therefore, this HCP’s order should not be questioned.

• The client will be NPO; therefore, initiating IV therapy is an appropriate order.
• Short-term weight gain changes reflect fluid balance because the client will be

NPO and receiving IV fluids. Daily weight is an appropriate HCP’s order.

• The client will be NPO, which will decrease stimulation of the pancreatic

enzymes, resulting in decreased autodigestion of the pancreas, therefore decreasing pain.The nurse is completing discharge teaching to the client diagnosed with acute pancreatitis. Which instruction should the nurse discuss with the client?

• Instruct the client to decrease alcohol intake.
• Explain the need to avoid all stress.
• Discuss the importance of stopping smoking.
• Teach the correct way to take pancreatic enzymes.
• Alcohol must be avoided entirely because it can cause stones to form, blocking

pancreatic ducts and the outflow of pancreatic juice, causing further inflammation and destruction of the pancreas.

• Stress stimulates the pancreas and should be dealt with, but it is unrealistic to

think a client can avoid all stress. By definition, the absence of all stress is death.

• Smoking stimulates the pancreas to release pancreatic enzymes and should

be stopped.

• The client has acute pancreatitis, and pancreatic enzymes are only needed for

chronic pancreatitis.The male client diagnosed with chronic pancreatitis calls and reports to the clinic nurse he has been having a lot of "gas," along with frothy and very foul-smelling stools.Which intervention should the nurse implement?

• Explain this is common for chronic pancreatitis.
• Ask the client to bring in a stool specimen to the clinic.
• Arrange an appointment with the HCP for today.
• Discuss the need to decrease fat in the diet so this

won't happen.

• Any change in the client’s stool should be a cause for concern to the clinic

nurse.

• This is not necessary because the nurse knows changes in stool occur as a

complication of pancreatitis, and the client needs to see the HCP.

• Steatorrhea (fatty, frothy, foul-smelling stool) is caused by a decrease in

pancreatic enzyme secretion and indicates impaired digestion and possibly an increase in the severity of the pancreatitis. The client should see the HCP.

• Decreasing fat in the diet will not help stop this type of stool.

The nurse is discussing complications of chronic pancreatitis with a client diagnosed with the disease.Which complication should the nurse discuss with the client?

• Diabetes insipidus.
• Crohn's disease.
• Narcotic addiction.
• Peritonitis.
• The client is at risk for diabetes mellitus (destruction of beta cells), not diabetes

insipidus, a disorder of the pituitary gland. 2. Crohn’s disease is an inflammatory disorder of the lining of the gastrointestinal system, especially of the terminal ileum.

• Narcotic addiction is related to the frequent, severe pain episodes often

occurring with chronic pancreatitis which require narcotics for relief.

• Peritonitis, an inflammation of the lining of the abdomen, is not a common

complication of chronic pancreatitis.The client is immediate post procedure endoscopic retrograde cholangiopancreatogram (ERCP). Which intervention should the nurse implement?

• Assess for rectal bleeding.
• Increase fluid intake.
• Assess gag reflex.
• Keep in supine position.
• During this procedure, a scope is placed down the client’s mouth; therefore,

assessing for rectal bleeding is not an intervention.

• The client’s throat has been anesthetized to insert the scope; therefore, fluid

and food are withheld until the gag reflex has returned.

• The gag reflex will be suppressed as a result of the local anesthesia applied

to the throat to insert the endoscope into the esophagus; therefore, the gag reflex must be assessed prior to allowing the client to resume eating or drinking.

• The client should be in a semi-Fowler’s or side-lying position to prevent

aspiration.

The client diagnosed with acute pancreatitis is in pain.Which position should the nurse assist the client to assume to help decrease the pain?

• Recommend lying in the prone position with legs

extended.

• Maintain a tripod position over the bedside table.
• Place in side-lying position with knees flexed.
• Encourage a supine position with a pillow under the

knees.

• Lying on the stomach will not help to decrease the client’s pain.
• This is a position used by clients with chronic obstructive pulmonary disease to

help lung expansion.

• This fetal position decreases pain caused by the stretching of the peritoneum

as a result of edema.

• Laying supine causes the peritoneum to stretch, which increases the pain.

The client with an acute exacerbation of chronic pancreatitis has a nasogastric tube. Which interventions should the nurse implement? Select all that apply.

• Monitor the client's bowel sounds.
• Monitor the client's food intake.
• Assess the client's intravenous site.
• Provide oral and nasal care.
• Monitor the client's blood glucose.
• The return of bowel sounds indicates the return of peristalsis, and the

nasogastric suction is usually discontinued within 24 to 48 hours thereafter.

• The client will be NPO secondary to the chronic pancreatitis, and the client

cannot eat with a nasogastric tube.

• The nurse should assess for signs of infection or infiltration. 4. Fasting and

the N/G tube increase the client’s risk for mucous membrane irritation and breakdown.

• Blood glucose levels are monitored because clients with chronic pancreati tis

can develop diabetes mellitus.The nurse is administering a pancreatic enzyme to the client diagnosed with chronic pancreatitis. Which statement best explains the rationale for administering this medication?

• It is an exogenous source of protease, amylase, and

lipase.

• This enzyme increases the number of bowel

movements.

• This medication breaks down in the stomach to help

with digestion.

• Pancreatic enzymes help break down fat in the small

intestine.

• Pancreatic enzymes enhance the digestion of starches (carbohydrates) in the

gastrointestinal tract by supplying an exogenous (outside) source of the pancreatic enzymes protease, amylase, and lipase.

• Pancreatic enzymes decrease the number of bowel movements.
• The enzymes are enteric coated and should not be crushed because the

hydrochloric acid in the stomach will destroy the enzymes; these enzymes work in the small intestine.

• Pancreatic enzymes help break down carbohydrates, and bile breaks down fat.

The client diagnosed with acute pancreatitis is being discharged home. Which statement by the client indicates the teaching has been effective?

• "I should decrease my intake of coffee, tea, and cola."
• "I will eat a low-fat diet and avoid spicy foods."
• "I will check my amylase and lipase levels daily."
• "I will return to work tomorrow but take it easy."
• Coffee, tea, and cola stimulate gastric and pancreatic secretions and may

precipitate pain, so these foods should be avoided, not decreased.

• High-fat and spicy foods stimulate gastric and pancreatic secretions and may

precipitate an acute pancreatic attack.

• Amylase and lipase levels must be checked via venipuncture with laboratory

tests, and there are no daily tests the client can monitor at home.

• The client will be fatigued as a result of decreased metabolic energy

production and will need to rest and not return to work immediately.