Biliary and Pancreatic Disorders Chapter 60
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
4.Avoid drinking coffee
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
4.Place nasogastric tube to low suction
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
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
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.”
2.“Lift items that are light in weight, no more than 10 pounds.”
4.“Try to prevent constipation.”
5.“Report yellow eyes or skin.”
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
1.Vomiting
2.Constant pain
4.Steatorrhea
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.”
3.“I should restrict intake of caffeine.”
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
1.Abdominal fullness
2.Positive Cullen sign
4.Positive Grey-Turner sign
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
2.15% mortality rate
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
3.Irrigating a nasogastric tube (NGT) postsurgery
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.”
4.“Management should be in the intensive care unit with a Ranson’s score of 4.”
Which medication classification is used to treat acute necrotizing pancreatitis?
1.Antibiotics
2.Spasmolytics
3.Opioid narcotics
4.Anticholinergics
1.Antibiotics
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
Which intervention would the nurse perform when caring for a patient diagnosed with acute pancreatitis?1.Abdominal pain
2.Hypoxia
3.Steatorrhea
5.Hypotension
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
1.Cholecystectomy
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
4.Cullen’s sign
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
3.Cholecystography
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
2.Murphy sign
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
1.Glucose
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
4.Abdominal pain on movement, pruritus on palms, and dark amber-colored urine
Which condition would be considered a risk factor of chronic pancreatitis?
1.Cystic fibrosis
2.Cytomegalovirus
3.Diabetes mellitus
4.Sickle cell disease
1.Cystic fibrosis
Which laboratory value would increase with acute pancreatitis? Select all that apply.
1.Lipase
2.White blood cells
3.Amylase
4.Calcium
5.Albumin
1.Lipase
2.White blood cells
3.Amylase
Which medication would increase appetite following a surgical procedure for pancreatic cancer?
1.Dicyclomine
2.Megestrol acetate
3.Pancrelipase
4.Omeprazole
2.Megestrol acetate
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)
3.Hepatobiliary iminodiacetic acid (HIDA) scan
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
3.Patient C
Which laboratory finding is associated with acute pancreatitis?
1.Increased lipase level
2.Increased calcium level
3.Increased albumin level
4.Decreased amylase level
1.Increased lipase level
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.
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.
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
4.Pain medications
Which medication is typically prescribed to manage severe pain in acute cholecystitis?
1.Meperidine
2.Morphine
3.Ibuprofen
4.Acetaminophen
1.Meperidine
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
3.Chenodiol
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
4.Pancreatic enzyme replacement therapy
Which risk factor would be associated with pancreatic cancer?
1.Cigarette smoking
2.Alcohol use
3.Being female
4.Diet low in fat
3.Being female
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
1.Cholecystectomy