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.

Accepted Answer

Confusion and agitation in a patient with acute pancreatitis can be due to various factors including metabolic disturbances. Neurological changes can occur in acute pancreatitis, making it important to monitor and document the patient's mental status, for which the Glasgow Coma Scale is a useful tool.

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."

Accepted Answer

MRCP is a non-invasive imaging technique that uses magnetic resonance imaging (MRI) to visualize the biliary and pancreatic ducts without the need for contrast agents.

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.

Accepted Answer

Acute pancreatitis can lead to respiratory distress through several mechanisms: A) Pancreatic enzymes damaging surfactant, which is crucial for lung function; B) Swelling of the abdomen, which can compress the lungs and lead to atelectasis; D) Inflammation spreading to the diaphragm, potentially causing pleural effusion; and E) Systemic inflammatory response can lead to lung damage. C is incorrect because increased intracranial pressure is not a direct consequence of acute pancreatitis.

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.

Accepted Answer

The serum amylase P level is the best choice for assessing acute pancreatic dysfunction. Serum amylase levels may be elevated due to causes other than pancreatic dysfunction, such as salivary gland disorders or bowel perforation. Therefore, serum amylase P level, which is more specific to the pancreas, is preferred. The other options are not necessary nor relevant for serum laboratory sample collection for acute pancreatic dysfunction.

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.

Accepted Answer

Proton pump inhibitors are used to reduce gastric acid secretion, which can help in managing pancreatic necrosis by reducing pancreatic stimulation and preventing further damage.

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.

Accepted Answer

Ranson's criteria for assessing the severity of pancreatitis require data collected at admission and over the first 48 hours, making it a disadvantage for immediate assessment and management decisions.

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.

Accepted Answer

Pseudocysts can become infected, so increasing assessment for signs and symptoms of infection is an important nursing intervention. Monitoring urine output (A) is important for overall fluid balance but not necessarily specific to a pseudocyst. Limiting protein intake (C) and reducing fluid intake (D) are not necessary interventions for a pseudocyst.

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

Accepted Answer

In acute pancreatitis, fluid shifts cause leakage of fluid and proteins from the intravascular space into the retroperitoneal space and lead to hypovolemia. Additionally, decreased vascular resistance can occur due to the release of inflammatory mediators, causing further hypovolemia. Increased urine output (option A) is not a typical finding in hypovolemic shock. Undiagnosed gastrointestinal ulcerations (option B) may cause bleeding and lead to hypovolemia but is not a typical finding in acute pancreatitis. Pulmonary edema (option C) is typically associated with fluid overload rather than hypovolemia.

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

Accepted Answer

Morphine is the best choice for treating pain in patients with acute pancreatitis as it is a strong opioid analgesic that can effectively relieve pain. NSAIDs and acetaminophen are not recommended due to their potential to worsen the patient's condition. Demerol is not recommended due to its association with toxicity and negative effects on the pancreas.

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

Accepted Answer

Vomiting in acute pancreatitis can be caused by gastric distension from swallowed air or reflux of bile and pancreatic enzymes. Placement of a nasogastric tube to intermittent suction can help relieve these symptoms by decompressing the stomach and reducing stimulation of the pancreas. NPO status may already be in place, and administering morphine can further stimulate the pancreas. Increased ambulation may not directly address the vomiting and could potentially cause discomfort for the patient.

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

Accepted Answer

Grey Turner's sign is characterized by faint bruising over the flank area and is indicative of hemorrhagic pancreatitis. This finding should be reported to the healthcare provider and documented in the patient's medical record. Options A, B, and D are not relevant to this particular assessment finding.

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).

Accepted Answer

The answer of A patient diagnosed with acute pancreatitis is...

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.

Accepted Answer

Acute interstitial pancreatitis often causes pancreatic edema, which can often be resolved with adequate treatment and management. While there is a risk for complications such as infection and organ dysfunction, the prognosis largely depends on the severity of the pancreatitis and the effectiveness of treatment. Options A, C, and D are not necessarily true for every case of acute interstitial pancreatitis.

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.

Accepted Answer

The ultrasound is necessary to assess the presence of gallstones as a potential cause of the patient's symptoms. CT scans can still be done after the ultrasound, and delaying it for 72 hours is not necessary. While CT scans can assess for complications such as hemorrhage, the ultrasound is needed first to determine the cause of the symptoms.

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.

Accepted Answer

Patients with acute pancreatitis often experience relief in pain when lying on their left side with knees pulled up to the chest. This allows for the pancreas to rest and reduces tension on the inflamed organ. The other choices do not support the diagnosis of acute pancreatitis.

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.

Accepted Answer

Administering analgesics helps manage pain, which can improve breathing. Treating the inflammatory response can reduce systemic effects impacting respiration. Ambulating as tolerated can help improve lung function and prevent complications like pneumonia.

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."

Accepted Answer

Acute pancreatitis occurs when the digestive enzymes (amylase and lipase) produced by the pancreas are activated prematurely, causing inflammation and damage to the pancreatic tissues. This can be caused by various factors such as alcohol use, gallstones, and certain medications. Option B is incorrect as loss of insulin production is associated with type 1 diabetes, not acute pancreatitis. Option C is incorrect as acute pancreatitis does not directly affect the inflammatory system. Option D is incorrect as increased blood pressure is not a characteristic feature of acute pancreatitis.

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.

Accepted Answer

Patients with acute pancreatitis and hypovolemic shock require careful fluid management and monitoring of hemodynamic status. Monitoring pulmonary arterial wedge pressure (B) and central venous pressure (E) helps assess the patient's fluid status and guide fluid therapy. Administering several liters of intravenous fluids in the first few hours of treatment (C) is crucial for restoring circulating volume and preventing or treating hypovolemic shock. Administering high doses of potassium (A) without careful monitoring can be dangerous, especially in a fluid-compromised patient, and anticholinergic medications (D) are not indicated for the treatment of hypovolemic shock.

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

Accepted Answer

D) A serum calcium level of 8 mg/dL is low, indicating hypocalcemia, which can occur in acute pancreatitis due to fat necrosis binding calcium. E) A BUN level of 80 mg/dL is significantly elevated, indicating possible renal issues or severe dehydration, which can be associated with acute pancreatitis.

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

Accepted Answer

The answer of A 55-year-old female patient is admitted with...

Quiz 24: Alterations in Pancreatic Function

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

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

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

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

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

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

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

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 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?

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

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.

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