Deck 60: Coordinating Care for Patients With Biliary and Pancreatic Disorders

Question 1

In providing teaching to a patient about management of acute pancreatitis, the nurse explains which prescribed medication is used to relax the sphincter of Oddi?
1)Spasmolytics
2)H₂ antagonists
3)Anticholinergic agents
4)Pancreatic enzymes

Answer 1

1

Question 2

The nurse monitors for which clinical manifestation in the patient diagnosed with cholecystitis?
1)Rovsing's sign
2)Murphy's sign
3)Cullen's sign
4)Turner's sign

Answer 2

2

Question 3

In providing teaching to a patient about management of acute pancreatitis, the nurse explains which prescribed medication is used for digesting fats and proteins?
1)Spasmolytics
2)Proton pump inhibitors
3)Anticholinergic agents
4)Pancreatic enzymes

Answer 3

4

Question 4

The nurse correlates which factor as a potential cause of an elevated ALT (alanine transaminase) in the patient with acute pancreatitis?
1)Poor nutrition
2)Bile flow obstruction
3)Gallstone pancreatitis
4)Fat necrosis and malnutrition

Question 5

The nurse correlates which data from a patient's health history to a risk factor for acalculous cholecystitis?
1)Spider bite
2)Gallstones
3)Sickle cell disease
4)Diabetes insipidus

Question 6

The nurse correlates which factor as a potential cause of hypocalcemia in the patient with acute pancreatitis?
1)Inadequate nutrition
2)Bile flow obstruction
3)Gallstone pancreatitis
4)Fat necrosis and malnutrition

Question 7

Which statement by the patient about T-tube management for biliary drainage indicates the need for further teaching?
1)"The drainage should be less than 500 mL per day."
2)"I should only empty the bag once a day."
3)"I will have the tube removed in about 2 weeks."
4)"I need to monitor for redness around the site."

Question 8

In providing teaching to a patient about management of acute pancreatitis, the nurse explains which prescribed medication is used to decrease gastric acid secretions?
1)Spasmolytics
2)H₂ antagonists
3)Anticholinergic agents
4)Pancreatic enzymes

Question 9

In completing an admission assessment, which patient data meets the Ranson's criteria for acute pancreatitis?
1)Patient age is 43 years
2)WBC 13.1 10³/mm^3-
3)BUN 10 mg/dL
4)Glucose 250mg/dL

Question 10

In providing care to a patient with a Ranson's score of 7, the nurse recognizes that this indicates what chance of mortality?
1)2% chance of mortality
2)15% chance of mortality
3)40% chance of mortality
4)100% chance of mortality

Question 11

The nurse provides education to a patient who is diagnosed with acute pancreatitis. Which patient statement indicates the need for additional teaching?
1)"I will avoid all alcohol intake."
2)"I will take vitamin supplements each day."
3)"I will stop smoking so that my body can heal."
4)"I will increase my intake of protein-rich foods."

Question 12

The nurse correlates which finding in the patient's history as a risk factor for chronic pancreatitis?
1)Trauma
2)Gallstones
3)Cystic fibrosis
4)Medication reactions

Question 13

Which statement from the patient diagnosed with acute pancreatitis indicates the need for further teaching regarding approved therapeutic agents?
1)"Opioids are used to treat pain."
2)"Spasmolytics are used to relax the sphincter of Oddi."
3)"Proton pump inhibitors are used to decrease gastric acid secretions."
4)"Anticholinergics are used to increase intestinal motility."

Question 14

The nurse correlates which factor as the highest risk factor for the development of chronic pancreatitis?
1)Cigarette smoking
2)Gallstones
3)Heavy alcohol use
4)Medication reactions

Question 15

In providing care to the patient diagnosed with gallstones, the nurse includes information about which preferred treatment for this disease process?
1)Lithotripsy
2)Low-fat diet
3)Oral agents to dissolve the stones
4)Laparoscopic cholecystectomy

Question 16

The nurse correlates which factor as a potential cause of an elevated AST (aspartate aminotransferase) in the patient with acute pancreatitis?
1)Inadequate nutrition
2)Bile flow obstruction
3)Gallstone pancreatitis
4)Fat necrosis and malnutrition

Question 17

The nurse correlates which factor as a potential cause of decreased serum albumin in the patient with acute pancreatitis?
1)Inadequate nutrition
2)Bile flow obstruction
3)Gallstone pancreatitis
4)Fat necrosis and malnutrition

Question 18

The nurse recognizes that which patient is at highest risk of developing cholecystitis?
1)35-year-old African American male with BMI of 27
2)35-year-old Caucasian female with history of weight loss surgery
3)30-year-old African American female with BMI of 32
4)30-year-old Caucasian male with BMI of 35

Question 19

The nurse correlates which finding from a patient's health history as a risk factor for acute pancreatitis?
1)Systemic lupus
2)Alcoholism
3)Cystic fibrosis
4)Hypertriglyceridemia

Question 20

The nurse recognizes that which patient is at highest risk of developing chronic pancreatitis?
1)50-year-old Caucasian female who consumes a high-fat diet
2)55-year-old Caucasian male who consumes fried foods
3)60-year-old African American male with a 50-pack year history of smoking
4)65-year-old African American female with a history of diabetes

Question 21

Which statement by the patient diagnosed with chronic pancreatitis indicates understanding of this disease process?
1)"I will only have one glass of wine per week."
2)"I will chew the pancreatic enzyme tablets to increase action."
3)"I will avoid coffee and caffeine."
4)"I am at risk of hypoglycemia."

Question 22

Which finding in the patient diagnosed with pancreatic cancer being evaluated for a surgical cure makes the tumor generally unresectable?
1)Lymph node involvement
2)History of chronic pancreatitis
3)Steatorrhea
4)Type 2 diabetes mellitus

Question 23

The nurse provides education to a patient who is diagnosed with chronic pancreatitis. Which patient statements indicate a correct understanding of the causes of this condition? Select all that apply.
1)"Low levels of calcium can cause this condition."
2)"High cholesterol is associated with this diagnosis."
3)"Heavy alcohol use over the years is a cause of this condition."
4)"My mother also had problems with her pancreas when she was living."
5)"My history of sickle cell disease is a risk factor for chronic pancreatitis."

Question 24

In providing care for an older adult patient with a history of alcohol abuse, the nurse correlates which treatments as relevant to the treatment of acute pancreatitis? Select all that apply.
1)Modified-fat diet
2)Opioid analgesics
3)Total parenteral nutrition
4)Nasogastric tube to suction
5)Pancreatic enzyme replacement therapy

Question 25

Which statement by the patient scheduled for vagotomy to treat pancreatic cancer indicates that teaching was effective?
1)"This procedure will cure my cancer."
2)"This procedure will decrease blood loss."
3)"This procedure will result in decreased gastric acid secretion."
4)"This procedure will result in my developing insulin-dependent diabetes mellitus."

Question 26

Which is the priority nursing action when providing care to a patient with a nasogastric tube (NGT) following a pancreaticoduodenectomy (Whipple procedure)?
1)Irrigating the tube
2)Checking for placement
3)Replacing the tube pulled out by the patient
4)Ensuring that the tube is not manipulated

Question 27

The nurse monitors for which clinical manifestations in the patient diagnosed with acute pancreatitis? Select all that apply.
1)Steatorrhea
2)Elevated blood pressure
3)Nausea and vomiting
4)Elevated temperature
5)Severe epigastric pain

Question 28

The nurse monitors for which clinical manifestation in the patient diagnosed with pancreatic cancer?
1)Weight gain
2)Oliguria
3)Sharp back pain
4)Yellowing of the sclera

Question 29

The nurse includes which information in the discharge teaching for the patient diagnosed with chronic pancreatitis? Select all that apply.
1)Avoid caffiene
2)Consume a low-protein diet
3)Encourage daily exercise
4)Eliminate alcoholic beverages
5)Take pancreatic enzyme replacement therapy (PERT) as directed

Question 30

The nurse monitors for which clinical manifestations in the patient diagnosed with chronic pancreatitis? Select all that apply.
1)Asterixis
2)Clay-colored stool
3)Diarrhea
4)Steatorrhea
5)Weight gain