Nokea
A patient with pancreatitis is on nothing by mouth status (NPO). The patient asks the nurse 'Why am I unable to have anything by mouth?'. Which is the best response?
- A. Diagnostic tests depend on you not eating anything.'
- B. The pancreas is stimulated whenever you eat or drink and causes pain.'
- C. Eating causes the need for a bowel movement, which excretes your medication too rapidly.'
- D. Resting your gastrointestinal tract will cure your pancreatitis.'
Correct Answer: B
Rationale: Food and fluids are withheld to avoid stimulating pancreatic activity, and IV fluids are administered.
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What should the nurse monitor in caring for the patient undergoing a paracentesis?
- A. The urinary output
- B. Hypervolemia
- C. Fluid removal over at least 30 minutes
- D. Seizure
Correct Answer: C
Rationale: The fluid removed during a paracentesis is removed over a period of 30 to 90 minutes to prevent sudden changes in blood pressure leading to syncope. The bed should be in a high Fowler's position. Food and fluid restriction is usually not necessary.
The nurse caring for a patient who has had an open cholecystectomy with a T Tube will take which action?
- A. open the T tube to the air so that it will drain freely.
- B. position and secure the drainage bag at mid-chest level.
- C. place the collection bag so the tube is not kinked.
- D. irrigate the T tube with normal saline to ensure the free flow of bile.
Correct Answer: C
Rationale: The T tube is placed below the level of the common bile duct to prevent the reflux of bile. The bag must be positioned so the tube is not kinked, or bile cannot drain from the liver. Normally T tubes are not irrigated.
Which factors are most commonly associated with pancreatitis?
- A. Coronary artery disease
- B. Alcoholism and biliary tract disease
- C. Cirrhosis
- D. History of myocardial infarction
Correct Answer: B
Rationale: Alcoholism and biliary tract disease are the two factors most commonly associated with pancreatitis.
Which is a by-product of protein metabolism?
- A. Urine
- B. Protease
- C. Amylase
- D. Ammonia
Correct Answer: D
Rationale: Protein products enter the bloodstream and are changed in the bowel to ammonia; the products then pass through the portal vein to the liver where the ammonia is converted to urea, which is then excreted by the kidneys.
The nurse clarifies that which event happens to unconjugated bilirubin, which is made up of broken-down red cells?
- A. It is stored in the gallbladder to make bile.
- B. Water-insoluble bilirubin must be converted by the liver.
- C. A by-product is excreted directly into the bowel for excretion.
- D. Red blood cells are necessary for digestion of fats.
Correct Answer: B
Rationale: Unconjugated bilirubin is a water-insoluble product that must be converted in the liver to conjugated bilirubin (water soluble) so that it may be excreted through the bowel.