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Chapter 23 Question 1 A patient is diagnosed with acute interstitial pancreatitis. The nurse would reinforce which information about this patient’s prognosis? 1. This disorder often progresses to multiple organ dysfunction with a poor outcome. 2. This disorder often causes pancreatic edema, which will resolve with good results. 3. Extensive fat and tissue necrosis occurs with this type of pancreatitis. 4. The patient will most likely have irreversible damage to the pancreas. Question 2 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? 1. Introduction of medication to reduce high-density lipoprotein level 2. Assessment of gall bladder functioning 3. Encouragement to reduce daily alcohol intake 4. Assessment for hypocalcemia Question 3 A patient is diagnosed with acute pancreatitis. Which education about the basic mechanism of this disease would the nurse provide? 1. “The chemicals being produced by your pancreas are going to work too early and they are damaging the pancreatic tissues.” 2. “Your pancreas has lost the ability to produce insulin.” 3. “A major part of your inflammatory system is inhibited.” 4. “Your blood pressure is elevated because of increased blood flow to your pancreas.” Question 4 A patient is being assessed for acute pancreatic dysfunction. Which preparation should the nurse ensure before serum laboratory samples are collected? 1. The patient should be maintained on bedrest for at least 4 hours prior to the samples being drawn. 2. Schedule the serum amylase level to be drawn first. 3. Keep the patient NPO for at least 8 hours before the lipase sample is drawn. 4. Ensure that a serum lipase P level is drawn. Question 5 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? 1. The ultrasound is the only way to assess the severity of damage to the pancreas. 2. The ultrasound can assess for gallstones as the cause of the pain. 3. Once the patient has had a CT scan the ultrasound must be delayed for at least 72 hours. 4. The CT scan will be done only after the ultrasound has demonstrated that complications such as hemorrhage do not exist. Question 6 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? 1. The patient is most comfortable sitting on side of the bed with arms extended back and legs dangling. 2. The patient is most comfortable lying flat in bed. 3. The patient is most comfortable lying on left side, knees pulled up to the chest. 4. The patient is only comfortable while walking around the perimeter of the room with arms wrapped around the abdomen. Question 7 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? 1. Homan’s sign 2. Cullen’s sign 3. Grey Turner’s sign 4. Chvostek’s sign Question 8 A patient with acute pancreatitis begins to demonstrate confusion and agitation. How will the nurse evaluate this finding? 1. Neurological changes are a common finding in acute pancreatitis. 2. Confusion is due to the increases of serum ammonia common in pancreatitis. 3. An acute cerebral vascular accident is imminent and the health care provider should be contacted. 4. The patient’s intracranial pressure is rising sharply. 5. The patient’s mental status should be documented using the Glasgow Coma Scale. Question 9 The nurse is monitoring the laboratory values of a patient with acute pancreatic dysfunction. Which values would indicate further assessment is required? 1. Hemoglobin level 13.5 mg/dL 2. Serum sodium level 143 mEq/L 3. Serum potassium level 4.0 mEq/L 4. Serum calcium level 8.0 mg/dL 5. BUN level is 80 mg/dL Question 10 A patient with acute pancreatitis is diagnosed with a pseudocyst. Which nursing intervention should be added to this patient’s plan of care? 1. Monitor urine output. 2. Increase assessment for signs and symptoms of infection. 3. Limit protein intake. 4. Reduce fluid intake.