Deck 24: Alterations in Pancreatic Function

Question 1

A patient with acute pancreatitis begins to demonstrate confusion and agitation.How will the nurse evaluate this finding? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Neurological changes are a common finding in acute pancreatitis.
B)Confusion is due to the increases of serum ammonia common in pancreatitis.
C)An acute cerebral vascular accident is imminent and the healthcare provider should be contacted.
D)The patient's intracranial pressure is rising sharply.
E)The patient's mental status should be documented using the Glasgow Coma Scale.

Answer 1

Neurological changes are a common finding in acute pancreatitis.
The patient's mental status should be documented using the Glasgow Coma Scale.

Question 2

A patient will have a magnetic resonance cholangiopancreatography (MRCP)to evaluate for pancreatitis.What information would the nurse provide to the patient regarding this test?

A)"A small plug of tissue will be removed for biopsy."
B)"This test is invasive and will require conscious sedation."
C)"This test will allow direct visualization of the pancreatic duct."
D)"No contrast is used for this test."

Answer 2

"No contrast is used for this test."

Question 3

A patient diagnosed with acute pancreatitis is demonstrating signs of respiratory distress.What physiologic rationale would the nurse explain for this change in respiratory assessment? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Pancreatic enzymes can destroy a component of surfactant.
B)Increase in the size of the abdomen may cause atelectasis.
C)Increased intracranial pressure from pancreatic damage reduces neurological control of respiratory rate and depth.
D)Inflammation of the diaphragm may result in pleural effusion.
E)Lung damage may occur from factors released systemically.

Answer 3

Pancreatic enzymes can destroy a component of surfactant.
Increase in the size of the abdomen may cause atelectasis.
Inflammation of the diaphragm may result in pleural effusion.
Lung damage may occur from factors released systemically.

Question 4

A patient is being assessed for acute pancreatic dysfunction.Which preparation should the nurse ensure before serum laboratory samples are collected?

A)The patient should be maintained on bedrest for at least 4 hours prior to the samples being drawn.
B)Schedule the serum amylase level to be drawn first.
C)Have the patient drink a carbohydrate-bearing solution 30 minutes before the blood draw.
D)Ensure that a serum amylase P level is drawn.

Question 5

A patient is diagnosed with subtotal pancreatic necrosis.Which intervention would the nurse include in this patient's plan of care?

A)Maintain bedrest.
B)Restrict fluids.
C)Administer proton pump inhibitor.
D)Monitor arterial blood gases.

Question 6

The nurse is participating in the use of Ranson's criteria to assess a patient with pancreatitis.Which statement reflects a disadvantage of using these criteria?

A)It takes 48 hours for complete assessment.
B)Ranson's criteria are not valid for patients over 5
C)This scoring system is not useful for persons with renal disease.
D)Invasive testing is necessary as part of Ranson's criteria.

Question 7

A patient with acute pancreatitis is diagnosed with a pseudocyst.Which nursing intervention should be added to this patient's plan of care?

A)Monitor urine output.
B)Increase assessment for signs and symptoms of infection.
C)Limit protein intake.
D)Reduce fluid intake.

Question 8

A patient with acute pancreatitis is demonstrating signs of hypovolemic shock.The nurse will conduct additional assessment for which expected cause of this hypovolemia?

A)Increased urine output
B)Undiagnosed gastrointestinal ulcerations
C)Pulmonary edema
D)Fluid shifts and decreased vascular resistance

Question 9

The nurse is caring for a patient with acute pancreatitis experiencing pain.How would the nurse expect to treat this pain?

A)Acetaminophen
B)Nonsteroidal anti-inflammatory drugs (NSAIDs)
C)Demerol
D)Morphine

Question 10

A patient with acute pancreatitis has been treated to minimize pancreatic stimulation,but vomiting continues.The nurse would anticipate which intervention?

A)NPO (nothing by mouth)status
B)Placement of a nasogastric tube to intermittent suction
C)Administration of morphine
D)Increased ambulation

Question 11

A patient is admitted with the diagnosis of possible acute pancreatitis.Upon assessment,the nurse notes faint bruising over the patient's flank region.How would the nurse report and document this finding?

A)Homan's sign
B)Cullen's sign
C)Grey Turner's sign
D)Chvostek's sign

Question 12

A patient diagnosed with acute pancreatitis is being monitored in the intensive care unit.The patient's cardiac output is trending downward.Increasing intravenous fluids by protocol has not been effective.Which nursing interventions are indicated?

A)Place the patient in a prone position.
B)Offer the patient fluids by mouth.
C)Irrigate the patient's nasogastric (NG)tube.
D)Assess for development of systemic inflammatory response syndrome (SIRS).

Question 13

A patient is diagnosed with acute interstitial pancreatitis.The nurse would reinforce which information about this patient's prognosis?

A)This disorder often progresses to multiple organ dysfunction with a poor outcome.
B)This disorder often causes pancreatic edema,which will resolve with good results.
C)Extensive fat and tissue necrosis occurs with this type of pancreatitis.
D)The patient will most likely have irreversible damage to the pancreas.

Question 14

A patient with symptoms of acute pancreatitis is scheduled for an abdominal ultrasound and a CT scan.The ultrasound department is very busy,so the patient is asked to wait.What rationale would the nurse provide for not doing the CT scan first?

A)The ultrasound is the only way to assess the severity of damage to the pancreas.
B)The ultrasound can assess for gallstones as the cause of the pain.
C)Once the patient has had a CT scan,the ultrasound must be delayed for at least 72 hours.
D)The CT scan will be done only after the ultrasound has demonstrated that complications such as hemorrhage do not exist.

Question 15

A patient comes into the emergency department with complaints of abdominal pain that have become very severe.Which observation would the nurse evaluate as supporting the tentative diagnosis of acute pancreatitis?

A)The patient is most comfortable sitting on the side of the bed with arms extended back and legs dangling.
B)The patient is most comfortable lying flat in bed.
C)The patient is most comfortable lying on left side,knees pulled up to the chest.
D)The patient is only comfortable while walking around the perimeter of the room with arms wrapped around the abdomen.

Question 16

The nurse has identified that a patient with acute pancreatitis has impairment of respiratory gas exchange.What interventions will the nurse include in this patient's plan of care? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Administer analgesics as prescribed.
B)Monitor for ileus development.
C)Treat inflammatory response.
D)Ambulate as tolerated.
E)Avoid opioid medications.

Question 17

A patient is diagnosed with acute pancreatitis.Which education about the basic mechanism of this disease would the nurse provide?

A)"The chemicals being produced by your pancreas are going to work too early and they are damaging the pancreatic tissues."
B)"Your pancreas has lost the ability to produce insulin."
C)"A major part of your inflammatory system is inhibited."
D)"Your blood pressure is elevated because of increased blood flow to your pancreas."

Question 18

The nurse is caring for a patient with acute pancreatitis demonstrating signs of hypovolemic shock.Which interventions will be included in this patient's plan of care? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Administer high doses of potassium.
B)Monitor pulmonary arterial wedge pressure.
C)Administer several liters of intravenous fluids in the first few hours of treatment.
D)Administer anticholinergic medication.
E)Monitor central venous pressure.

Question 19

The nurse is monitoring the laboratory values of a patient with acute pancreatic dysfunction.Which values would indicate further assessment is required? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Hemoglobin level 13.5 mg/dL
B)Serum sodium level 143 mEq/L
C)Serum potassium level 4 mEq/L
D)Serum calcium level 8 mg/dL
E)BUN level is 80 mg/dL

Question 20

A 55-year-old female patient is admitted with the diagnosis of acute pancreatitis.The nurse anticipates which treatment to be necessary for this patient?

A)Introduction of medication to reduce high-density lipoprotein level
B)Assessment of gallbladder functioning
C)Encouragement to reduce daily alcohol intake
D)Assessment for hypocalcemia