Nokea
The nurse is aware that an elevated serum amylase is diagnostic of pancreatitis at an early stage as an elevation can be assessed as early as how many hours after the onset of pancreatic disease?
- A. 2 hours
- B. 8 hours
- C. 24 hours
- D. 36 hours
Correct Answer: A
Rationale: An increase in the serum amylase can be detected as early as 2 hours after the onset of pancreatic disease. In simple acute pancreatitis, the level returns to normal in about 36 hours. In chronic disease, it remains elevated.
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The nurse is aware that the hepatitis A immunization provides immunity in:
- A. 5 days.
- B. 10 days.
- C. 15 days.
- D. 30 days.
Correct Answer: D
Rationale: Primary immunization with hepatitis A vaccine provides immunity within 30 days.
A patient with cirrhosis of the liver will have which blood test results monitored?
- A. Blood urea nitrogen (BUN)
- B. Platelet counts
- C. Aspartate aminotransferase (AST)
- D. Hemoglobin and Hematocrit (HGB and HCT)
Correct Answer: C
Rationale: The nurse will monitor the patient with cirrhosis for an elevated AST level which would indicate worsening liver function. The BUN monitors kidney function. The platelet count is part of the complete blood count which is not necessary to monitor with cirrhosis. The HGB and HCT monitor for anemia.
Which should the nurse expect of a patient with a malabsorption of vitamin K?
- A. Anemia
- B. Excess platelet production
- C. Increased coagulation time
- D. Elevated for infection due to diminished white blood cell count
Correct Answer: C
Rationale: Prothrombin times are increased because malabsorption of vitamin K or inability to produce the clotting factors VII, IX, and X cause the patient to have bleeding tendencies.
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.
Which is a classic location and radiation of the pain associated with cholecystitis?
- A. Substernal, radiating to the left shoulder and arm
- B. Epigastric, radiating to the back
- C. Right upper abdomen, radiating to the back or right scapula
- D. Left upper abdomen, radiating to the jaw and neck
Correct Answer: C
Rationale: It localizes in the right upper quadrant epigastric region. The pain radiates around the mid torso to the right scapular area.