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Biliary and Pancreatic Disorders Chapter 60

front 1

When preparing discharge teaching for a patient diagnosed with chronic pancreatitis, which information would the nurse include?

1.Take pancreatic enzymes as needed

2.Eat foods high in fat

3.Limit alcohol intake

4.Avoid drinking coffee

back 1

4.Avoid drinking coffee

front 2

Which intervention would the nurse perform when caring for a patient diagnosed with acute pancreatitis?

1.Provide sips of water as needed

2.Encourage activity

3.Keep head of bed in a high Fowler’s position

4.Place nasogastric tube to low suction

back 2

4.Place nasogastric tube to low suction

front 3

A patient is diagnosed with gallstones in the bile duct and is scheduled for endoscopic retrograde cholangiopancreatography. Which action should the nurse initiate when caring for this patient? Select all that apply.

1.Observe the patient for a systemic inflammatory response after the procedure

2.Monitor the patient for changes in vital signs after the procedure

3.Encourage the patient to drink water before the procedure

4.Have the patient avoid food the morning before the procedure

5.Instruct the patient to take blood pressure medications the morning of the procedure

back 3

1.Observe the patient for a systemic inflammatory response after the procedure

2.Monitor the patient for changes in vital signs after the procedure

5.Instruct the patient to take blood pressure medications the morning of the procedure

front 4

Which discharge instruction should a nurse provide a patient after a laparoscopic cholecystectomy? Select all that apply.

1.“Keep the dressing on for 48 hours and then remove.”

2.“Lift items that are light in weight, no more than 10 pounds.”

3.“Take a tub bath within the first 48 hours.”

4.“Try to prevent constipation.”

5.“Report yellow eyes or skin.”

back 4

2.“Lift items that are light in weight, no more than 10 pounds.”

4.“Try to prevent constipation.”

5.“Report yellow eyes or skin.”

front 5

Which clinical manifestation is present in a patient diagnosed with chronic pancreatitis? Select all that apply.

1.Vomiting

2.Constant pain

3.Murphy sign

4.Steatorrhea

5.Weight gain

back 5

1.Vomiting

2.Constant pain

4.Steatorrhea

front 6

A nurse is teaching a patient with chronic pancreatitis about the precautionary measures that need to be taken to prevent further deterioration. Which statement by the patient indicates successful teaching?

1.“I should only drink alcohol once per day.”

2.“I should crush pancreatic enzymes before taking them.”

3.“I should restrict intake of caffeine.”

4.“I should increase the fat in my diet.”

back 6

3.“I should restrict intake of caffeine.”

front 7

Which assessment finding indicates acute pancreatitis? Select all that apply.

1.Abdominal fullness

2.Positive Cullen sign

3.Positive Murphy sign

4.Positive Grey-Turner sign

5.Pain in the abdomen upon movement

back 7

1.Abdominal fullness

2.Positive Cullen sign

4.Positive Grey-Turner sign

front 8

What does a Ranson score of 3 to 4 indicate in a patient with pancreatitis?

1.2% mortality rate

2.15% mortality rate

3.40% mortality rate

4.100% mortality rate

back 8

2.15% mortality rate

front 9

The nurse is caring for the patient with correction of the pancreatic disease in the image. Which action performed by the nurse is likely to cause complications?

1.Encouraging the use of an incentive spirometer every hour

2.Administering insulin to the patient

3.Irrigating a nasogastric tube (NGT) postsurgery

4.Ensuring that proper hydration level is maintained

back 9

3.Irrigating a nasogastric tube (NGT) postsurgery

front 10

The nurse is teaching a new nurse about management of acute pancreatitis. Which statement by the new nurse indicates effective learning?

1.“Activity should be encouraged to promote lung expansion.”

2.“IV antibiotics should be administered for fever.”

3.“Oral rehydration should be used when dehydrated.”

4.“Management should be in the intensive care unit with a Ranson’s score of 4.”

back 10

4.“Management should be in the intensive care unit with a Ranson’s score of 4.”

front 11

Which medication classification is used to treat acute necrotizing pancreatitis?

1.Antibiotics

2.Spasmolytics

3.Opioid narcotics

4.Anticholinergics

back 11

1.Antibiotics

front 12

Which clinical manifestation would be associated with acute pancreatitis? Select all that apply.

1.Abdominal pain

2.Hypoxia

3.Steatorrhea

4.Weight loss

5.Hypotension

back 12

Which intervention would the nurse perform when caring for a patient diagnosed with acute pancreatitis?1.Abdominal pain

2.Hypoxia

3.Steatorrhea

5.Hypotension

front 13

Which laboratory value would increase with acute pancreatitis? Select all that apply.A patient is diagnosed with gallstone-induced pancreatitis. The healthcare provider prescribes removal of the gallbladder. Which surgical method is appropriate in th

1.Cholecystectomy

2.Distal pancreatectomy

3.Pancreaticoduodenectomy

4.Endoscopic sphincterotomy

back 13

1.Cholecystectomy

front 14

Which assessment finding would indicate retroperitoneal hemorrhage in a patient diagnosed with acute pancreatitis?

1.Chvostek’s sign

2.Trousseau’s sign

3.Murphy’s sign

4.Cullen’s sign

back 14

4.Cullen’s sign

front 15

The healthcare provider scheduled a diagnostic test of the gallbladder which required the patient to drink an oral radiopaque dye. Which test is the patient scheduled for?

1.Ultrasound

2.Cholangiogram

3.Cholecystography

4.Endoscopic retrograde cholangiopancreatography

back 15

3.Cholecystography

front 16

Which finding is observed when the nurse has the patient breathe deeply while palpating the right upper quadrant of the abdomen to determine the presence of pain?

1.Cullen sign

2.Murphy sign

3.Chvostek sign

4.Grey-Turner sign

back 16

2.Murphy sign

front 17

Which laboratory value would increase when chronic pancreatitis impairs the endocrine function of the pancreas?

1.Glucose

2.Alkaline phosphatase (ALP)

3.Direct bilirubin

4.Lipase

back 17

1.Glucose

front 18

The nurse is assessing four different patients and documents clinical manifestations. Which patient is most likely to have the illness in the image?

1.Right upper quadrant pain, abdominal tenderness, and fever

2.Epigastric pain in the upper left quadrant, anorexia, and indigestion

3.Abdominal pain worsening after drinking and eating, oily stools, and weight loss

4.Abdominal pain on movement, pruritus on palms, and dark amber-colored urine

back 18

4.Abdominal pain on movement, pruritus on palms, and dark amber-colored urine

front 19

Which condition would be considered a risk factor of chronic pancreatitis?

1.Cystic fibrosis

2.Cytomegalovirus

3.Diabetes mellitus

4.Sickle cell disease

back 19

1.Cystic fibrosis

front 20

Which laboratory value would increase with acute pancreatitis? Select all that apply.

1.Lipase

2.White blood cells

3.Amylase

4.Calcium

5.Albumin

back 20

1.Lipase

2.White blood cells

3.Amylase

front 21

Which medication would increase appetite following a surgical procedure for pancreatic cancer?

1.Dicyclomine

2.Megestrol acetate

3.Pancrelipase

4.Omeprazole

back 21

2.Megestrol acetate

front 22

Which diagnostic test is performed to determine the production and flow of bile?

1.Abdominal ultrasound

2.Computed tomography (CT) scan

3.Hepatobiliary iminodiacetic acid (HIDA) scan

4.Endoscopic retrograde cholangiopancreatography (ERCP)

back 22

3.Hepatobiliary iminodiacetic acid (HIDA) scan

front 23

The healthcare provider prescribed four different medications for four different patients with acute pancreatitis. Which patient is likely to have decreased gastric acid secretions?

1.Patient A

2.Patient B

3.Patient C

4.Patient D

back 23

3.Patient C

front 24

Which laboratory finding is associated with acute pancreatitis?

1.Increased lipase level

2.Increased calcium level

3.Increased albumin level

4.Decreased amylase level

back 24

1.Increased lipase level

front 25

Which statement is true regarding cholecystitis? Select all that apply.

1.It is more common in men than in women.

2.It is associated with the five Fs.

3.It is more common in African Americans than in people who are Caucasian.

4.It is categorized as either calculous cholecystitis or acalculous cholecystitis.

5.It is caused by the intake of cholesterol-lowering medications.

back 25

2.It is associated with the five Fs.

4.It is categorized as either calculous cholecystitis or acalculous cholecystitis.

5.It is caused by the intake of cholesterol-lowering medications.

front 26

The nurse cares for a 46-year-old patient with abdominal pain. After placing oxygen and starting IV fluids, what action should the nurse take?

1.Deliver an antipyretic as prescribed

2..Deliver insulin as prescribed

3.Administer an antibiotic as prescribed

4.Pain medications

back 26

4.Pain medications

front 27

Which medication is typically prescribed to manage severe pain in acute cholecystitis?

1.Meperidine

2.Morphine

3.Ibuprofen

4.Acetaminophen

back 27

1.Meperidine

front 28

The laboratory report of a patient with gallstones reveals increased liver enzymes. Which medication will likely to be prescribed to this patient?

1.Demerol

2.Naproxen

3.Chenodiol

4.Acetaminophen

back 28

3.Chenodiol

front 29

The patient with chronic pancreatitis is experiencing weight loss from malabsorption of nutrients. Which therapy will be prescribed?

1.Chemotherapy

2.Insulin therapy

3.Antibiotic therapy

4.Pancreatic enzyme replacement therapy

back 29

4.Pancreatic enzyme replacement therapy

front 30

Which risk factor would be associated with pancreatic cancer?

1.Cigarette smoking

2.Alcohol use

3.Being female

4.Diet low in fat

back 30

3.Being female

front 31

A patient is diagnosed with gallstone-induced pancreatitis. The healthcare provider prescribes removal of the gallbladder. Which surgical method is appropriate in this situation?

1.Cholecystectomy

2.Distal pancreatectomy

3.Pancreaticoduodenectomy

4.Endoscopic sphincterotomy

back 31

1.Cholecystectomy