Nokea
A patient has a recent diagnosis of chronic pancreatitis and is undergoing diagnostic testing to determine pancreatic islet cell function. The nurse should anticipate what diagnostic test?
- A. Glucose tolerance test
- B. ERCP
- C. Pancreatic biopsy
- D. Abdominal ultrasonography
Correct Answer: A
Rationale: A glucose tolerance test evaluates pancreatic islet cell function and provides necessary information for making decisions about surgical resection of the pancreas. This specific clinical information is not provided by ERCP, biopsy, or ultrasound.
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A patient is admitted to the ICU with acute pancreatitis. The patients family asks what causes acute pancreatitis. The critical care nurse knows that a majority of patients with acute pancreatitis have what?
- A. Type 1 diabetes
- B. An impaired immune system
- C. Undiagnosed chronic pancreatitis
- D. An amylase deficiency
Correct Answer: C
Rationale: Eighty percent of patients with acute pancreatitis have biliary tract disease or a history of long-term alcohol abuse. These patients usually have had undiagnosed chronic pancreatitis before their first episode of acute pancreatitis. Diabetes, an impaired immune function, and amylase deficiency are not specific precursors to acute pancreatitis.
A student nurse is caring for a patient who has a diagnosis of acute pancreatitis and who is receiving parenteral nutrition. The student should prioritize which of the following assessments?
- A. Fluid output
- B. Oral intake
- C. Blood glucose levels
- D. BUN and creatinine levels
Correct Answer: C
Rationale: In addition to administering enteral or parenteral nutrition, the nurse monitors serum glucose levels every 4 to 6 hours. Output should be monitored but in most cases it is not more important than serum glucose levels. A patient on parenteral nutrition would have no oral intake to monitor. Blood sugar levels are more likely to be unstable than indicators of renal function.
A nurse who provides care in a walk-in clinic assesses a wide range of individuals. The nurse should identify which of the following patients as having the highest risk for chronic pancreatitis?
- A. A 45-year-old obese woman with a high-fat diet
- B. An 18-year-old man who is a weekend binge drinker
- C. A 39-year-old man with chronic alcoholism
- D. A 51-year-old woman who smokes one-and-a-half packs of cigarettes per day
Correct Answer: C
Rationale: Excessive and prolonged consumption of alcohol accounts for approximately 70% to 80% of all cases of chronic pancreatitis.
A patient has been admitted to the hospital for the treatment of chronic pancreatitis. The patient has been stabilized and the nurse is now planning health promotion and educational interventions. Which of the following should the nurse prioritize?
- A. Educating the patient about expectations and care following surgery
- B. Educating the patient about the management of blood glucose after discharge
- C. Educating the patient about postdischarge lifestyle modifications
- D. Educating the patient about the potential benefits of pancreatic transplantation
Correct Answer: C
Rationale: The patients lifestyle (especially regarding alcohol use) is a major determinant of the course of chronic pancreatitis. The disease is not often managed by surgery and blood sugar monitoring is not necessarily indicated for every patient after hospital treatment. Transplantation is not an option.
A patient has been diagnosed with pancreatic cancer and has been admitted for care. Following initial treatment, the nurse should be aware that the patient is most likely to require which of the following?
- A. Inpatient rehabilitation
- B. Rehabilitation in the home setting
- C. Intensive physical therapy
- D. Hospice care
Correct Answer: D
Rationale: Pancreatic carcinoma has only a 5% survival rate at 5 years regardless of the stage of disease at diagnosis or treatment. As a result, there is a higher likelihood that the patient will require hospice care than physical therapy and rehabilitation.