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NCLEX
GALLBLADDER & CO.
PANCREAS
"FINK WORTHY" MULTIPLE CHOICE
100
A male client with pancreatitis complains of pain. The nurse expects the physician to prescribe meperidine (Demerol) instead of morphine to relieve pain because: a. meperidine provides a better, more prolonged analgesic effect. b. morphine may cause spasms of Oddi’s sphincter. c. meperidine is less addictive than morphine. d. morphine may cause hepatic dysfunction.
Answer B. Rationale: For a client with pancreatitis, the physician will probably avoid prescribing morphine because this drug may trigger spasms of the sphincter of Oddi (a sphincter at the end of the pancreatic duct), causing irritation of the pancreas. Meperidine has a somewhat shorter duration of action than morphine. The two drugs are equally addictive. Morphine isn’t associated with hepatic dysfunction
100
Organ that concentrates and stores bile
What is the gallbladder
100
A fish shaped endocrine organ with the head located behind the stomach and tail behind the spleen
What is the pancreas!
100
The client with chronic pancreatitis needs information on dietary modification to manage the health problem. The nurse teaches the client to limit which item in the diet? A. Fat B. Protein C. Carbohydrates D. Water soluble vitamins
What is fat (A)
200
A male client with cholelithiasis has a gallstone lodged in the common bile duct. When assessing this client, the nurse expects to note: a. yellow sclerae. b. light amber urine. c. circumoral pallor. d. black, tarry stools
Answer A. Rationale: Yellow sclerae may be the first sign of jaundice, which occurs when the common bile duct is obstructed. Urine normally is light amber. Circumoral pallor and black, tarry stools don’t occur in common bile duct obstruction; they are signs of hypoxia and GI bleeding, respectively.
200
The disorder when the gallbladder never fills
What is acute cholecystitis
200
Pancreatic juice backs up into it irritating tissues and causing the pancreas to become...
What is inflammed
200
The nurse has taught the client with chronic pancreatitis about risk factor modification to reduce the incidence of recurrence. The nurse determines that the client has understood the information if the client states that it will be necessary to control which factor? A. Alcohol intake B. Duodenal ulcer C. Cohn’s disease D. Diabetes mellitus
What is alcohol intake (A)
300
Which condition is most likely to have a nursing diagnosis of fluid volume deficit? a. Appendicitis b. Pancreatitis c. Cholecystitis d. Gastric ulcer
Answer B. Hypovolemic shock from fluid shifts is a major factor in acute pancreatitis. The other conditions are less likely to exhibit fluid volume deficit.
300
Common bile duct stones are called...
What is choledochlithiasis
300
An inflammatory process involving autodigestion of the pancreas by its own enzymes...
What is acute pancreatitis
300
The nurse is assessing a client who is experiencing an acute episode of cholecystitis. Where should the nurse anticipate the location of the pain? A. Right lower quadrant, radiating to back B. Right lower quadrant, radiating to the umbilicus C. Right upper quadrant, radiating to the left scapula and shoulder D. Right upper quadrant, radiating to right scapula and shoulder
What is right upper quadrant, radiating to right scapula and shoulder (D)
400
A client is admitted with acute pancreatitis. Which of the following laboratory results is expected for this client? A. Serum creatinine of 4.3 mg/dL B. Alanine aminotransferase (ALT) of 125 IU/L. C. Serum amylase of 306 IU/L. D. Troponin T level of 3.5 g/L.
Correct answer: C The normal value for serum amylase is 30 to 100 IU/L, so a level of 306 IU/L is indicative of pancreatitis. Pancreatitis involves activation of pancreatic enzymes, such as amylase and lipase. Therefore, serum amylase is often at least twice the normal level and lipase levels can be 5 times the normal level in a client with acute pancreatitis. Serum creatinine level (normal value 0.5 to 1.2 mg/dL) is elevated with kidney dysfunction. Injury or disease of the liver causes elevated ALT level (normal value 7 to 40 IU/L). Troponin T level (normal value <0.2 g/L) is elevated with heart damage, such as a myocardial infarction.
400
Infection of the bile duct is called...
What is cholangits
400
Weight loss, jaundice, pain, Cullen’s sign, and Turner’s sign are common signs and symptoms of ...
What is acute pancreatitis
400
A client had a Whipple procedure 3 days ago for pancreatic cancer. Which of the following client assessments is most important for the nurse to follow up. A. Bowel sounds are auscultated 10/min B. Wound edges are slightly edematous, reddish, and soft C. Client reports abdominal pain radiating to shoulder and has a fever D. WBC 9,000/mm^3
What is client reports abdominal pain radiating to shoulder and has a fever (C)
500
Which of the following is most important for a nurse to teach a client who is hospitalized with acute pancreatitis? A) technique regarding how to give home injections of insulin. B) important of monitoring amylase and lipase levels. C) avoidance of alcohol use for 1 year. D) use of aspirin instead of acetaminophen as an OTC medication.
What is C --chronic alcohol consumption can lead to chronic pancreatitis.
500
this manifestation of cholecystitis is pain caused by right subcostal palpation and deep breathing.
What is Murphy's Sign
500
This system leads to further release of pancreatic juice, increases digestive activity, but slows down heart rate and contractility.
What is the parasympathetic system.
500
What is the most important intervention for a patient with pancreatitis? A) restore fluids and electrolytes B) pain medications C) NPO and gastric decompression D) activity restriction E) H2 blockers
What is restore fluids and electrolytes (especially potassium!!)