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53 Cards in this Set
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A nurse teaches a patient about diabetes, and the symptoms of hypoglycemia and ketoacidosis. The patient demonstrates understanding of the teaching by stating that a form of glucose should be taken if experiencing which of the following symptoms?
a. Shakiness b. Blurred vision c. Polyuria d. “fruity” breath odor |
A – shakiness.
Shakiness is a sign of hypoglycemia and would indicate the need for food or glucose. A “fruity” breath odor, blurred vision, and polyuria are signs of hyperglycemia. |
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A patient with diabetes demonstrates acute anxiety when first admitted for treatment of hyperglycemia. Which of the following is an appropriate nursing intervention to help reduce the patient’s anxiety?
a. Describe medical terms to the patient so he will understand what is happening b. Administer a sedative c. Convey empathy, trust, and respect to the patient d. Let the patient express their anxiety as it will subside eventually |
C – convey empathy, trust, and respect to the patient
Appropriate intervention is to address the feelings related to anxiety. The patient won’t relate to medical terms when feeling anxious. Administering a sedative isn’t the appropriate intervention. |
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Patient teaching is being performed on a patient about complications of type 1 diabetes. Which of the following patient statements indicate an understanding of measures to prevent diabetic ketoacidosis (DKA)?
a. “I will adjust my insulin dose according to my glucose levels” b. “I will notify my physician if my blood glucose level is higher than 250 mg/dL” c. “I will decrease my insulin dose when experiencing symptoms of DKA” d. “I will have to stop taking my insulin if I’m feeling too sick” |
B – “I will notify my physician if my blood glucose level is higher than 250mg/dL”
DKA is caused by partial or total lack of insulin and symptoms occur when serum glucose is higher than 300 mg/dL. Insulin should never be stopped and may need to be increased during times of illness. Doses should not be adjusted w/out physician’s order. |
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A nurse is monitoring a patient at risk for hyperglycemic hyperosmolar state (HHS). Which of the following would indicate hyperglycemia on the patient and requires appropriate intervention?
a. Confusion b. Tachycardia c. Diaphoresis d. Polyuria |
D – polyuria
Classical symptoms of hyperglycemia are the 3Ps (polyuria, polydipsia, polyphagia). All the other options are signs and symptoms of hypoglycemia. |
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A nurse is preparing a care plan for a diabetic patient who has hyperglycemia. Which of the following nursing diagnoses is the priority for the patient?
a. Deficient knowledge b. Anxiety c. Imbalanced nutrition, less than body requirements d. Deficient fluid volume |
D – deficient fluid volume
An increased blood glucose level will cause the kidneys to excrete glucose in the urine accompanied by fluids and electrolytes, causing dehydration. |
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Which of the following are signs and symptoms of hypoglycemia? [select all that apply]
a. Weakness b. Fatigue c. Hot, dry skin d. Polyuria e. Polydipsia |
A – weakness, B – fatigue
Signs and symptoms of hypoglycemia include weakness, fatigue, confusion, tachycardia, and palpitations. |
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Which of the following are signs and symptoms of hyperglycemia? [select all that apply]
a. Polyuria b. Polydipsia c. Polyphagia d. Decreased urine output e. Anorexia |
A – polyuria, B – polydipsia, C – polyphagia
The classical signs of hyperglycemia include the 3Ps (polyuria, polydipsia, polyphagia). |
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A nurse is performing an assessment on a patient diagnosed w/ myxedema. Which of the following would the nurse expect to note on the patient?
a. Fine muscle tremors b. Bulging eyeballs c. Dry skin d. Diaphoresis |
C – dry skin
Myxedema is a sign of hypothyroidism. Symptoms include periorbital edema, dry skin, dry coarse hair, non-pitting edema on hands and feet. All the other options are noted on a patient with hyperthyroidism. |
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Which of the following factors of diabetes are likely causes of beta-cell destruction in the pancreas that accompanies the condition? [select all that apply]
a. Failure to produce glucagon b. Autoimmune factors c. Human leukocyte antigen (HLA) d. Genetic factors e. Viral infection |
B – autoimmune factors, C – HLA, D – genetic factors, E – viral infection
Destruction of beta-cells results in the inability to produce insulin (type 1 diabetes). Causes include genetic factors, especially presence of HLA tissue, autoimmune factors, and viral infections. |
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The nurse is performing patient teaching about the causes of hypoglycemia on a patient recently diagnosed w/ diabetes. Additional teaching is needed if the patient identifies which of the following as a cause of hypoglycemia?
a. Decreased daily insulin dosage b. Increased daily insulin dosage c. Inadequate amount of fluid intake d. Skipping meals |
A – decreased daily insulin dosage
Causes of hypoglycemia include inadequate fluid intake, skipping meals, and increased daily dose of insulin. Decreasing the daily insulin dose will lead to hyperglycemia. |
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During a routine checkup, the patient reported to her healthcare provider a new onset of intolerance to cold. Which of the following should the healthcare provider also assess regarding symptoms associated with hypothyroidism?
a. Weight loss and tachycardia b. Increased respiration and HR c. Diaphoresis and palpitations d. Weakness and lethargy |
D – weakness and lethargy
Weakness and lethargy are common signs of hypothyroidism. Other symptoms include weight gain, bradycardia, decreased respiratory rate, and dry skin. |
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A patient w/ type 1 diabetes expressed his concern to the nurse that he might lose his job because he’s been having frequent hypoglycemic symptoms. His boss thinks he’s drunk when he’s experiencing those symptoms and that he’s been drinking while on the job. Which action by the nurse would best assist the patient to meet his needs?
a. Ask the patient if he’s been actually drinking at work b. Contact the local employment office to help patient find another job c. Ask the patient what he does to treat his hypoglycemia d. Examine factors w/ the client what may be causing those hypoglycemic symptoms |
D – examine factors w/ the client what may be causing the hypoglycemic symptoms
The best strategy to assist the patient to meet his needs is to decrease hypoglycemia symptoms by first identifying and then eliminating those factors. |
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A newly diagnosed diabetic patient is started on a two-dose insulin protocol combination of short-acting and intermediate-acting insulin injected twice daily. What portion of the total dose is given before breakfast and what portion before dinner?
a. 1/3 before breakfast and 2/3 before dinner b. 2/3 before breakfast and 1/3 before dinner c. Half before breakfast and half before dinner d. ¾ before breakfast and ¼ before dinner |
B – 2/3 before breakfast and 1/3 before dinner
Initially, the two-dose insulin protocol is 2/3 of the dose before breakfast and 1/3 before dinner. Any future changes in ratios are based on results of blood glucose monitoring. |
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When obtaining the history of a 24-year old patient w/ type 1 diabetes, the nurse expects to identify the presence of:
a. Edema b. Anorexia c. Weight loss d. Hypoglycemic episodes |
C – weight loss
Protein and lipids are broken down because carbohydrates can’t be used by the cells, resulting in weight loss and muscle wasting. Hyperglycemia (not hypoglycemia) is associated w/ both type 1 and type 2 diabetes. |
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A patient is diagnosed w/ DKA. The nurse identifies that the elevated ketone level present w/ this condition is caused by the breakdown of:
a. Fats b. Protein c. Potassium d. Carbohydrates |
A – fats
Breakdown of fats in the cells results in free fatty acids in the liver, which then causes formation of ketone bodies. Protein metabolism results in nitrogenous waste production, causing elevated BUN. |
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A nurse is teaching the patient how to mix regular insulin with NPH insulin in the same syringe. Which of the following, if performed by the patient, indicates the need for further teaching?
a. Withdraws the NPH insulin first b. Withdraws the regular insulin first c. Injects air into the NPH insulin vial first d. Injects the amount of air equal to the required dose into the vial |
A – withdraws the NPH insulin first
When preparing a mixture of regular insulin w/ another insulin preparation, the regular insulin is withdrawn first to avoid contaminating the vial of regular insulin w/ the other type. |
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A nurse is teaching the patient about medication instructions on taking levothyroxine (synthroid). The nurse tells the patient to take the medication:
a. With food b. On an empty stomach c. At lunchtime d. At bedtime w/a snack |
B – on an empty stomach
levothyroxine (synthroid) should be taken on an empty stomach to enhance absorption. Dosing should be done in the morning before breakfast. |
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A nurse is providing medication instructions on a patient taking levothyroxine (synthroid). The nurse instructs the patient to notify the healthcare provider if which of the following occurs?
a. Excessive dry skin b. Cold intolerance c. Fatigue d. Tremors |
D – tremors
Excessive doses of levothyroxine (synthroid) can produce signs and symptoms of hyperthyroidism (tachycardia, chest pain, tremors, nervousness, heat intolerance, and sweating). The patient should notify the physician if experiencing those symptoms. |
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A patient w/ type 2 diabetes is prescribed to take a sulfonylurea drug, glipizide (glucotrol). Which of the following medications of the patient would cause or contribute to hyperglycemia?
a. Prednisone b. Atenolol c. Lisinopril d. Ibuprofen |
A – prednisone
Prednisone may cause or worsen hyperglycemia in patients taking sulfonylureas. All the other medications cause or worsen hypoglycemia symptoms in patients taking sulfonylureas. |
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Which of the following is an appropriate nursing diagnosis for a patient with hypothyroidism?
a. Imbalanced nutrition: more than body requirements b. Imbalanced nutrition: less than body requirements related to hypermetabolism c. Activity intolerance related to fatigue associated w/ the disorder d. Deficient fluid volume related to diarrhea |
C – activity intolerance related to fatigue associated w/ the disorder
A major problem for persons w/ hypothyroidism is fatigue. Other signs and symptoms include lethargy, personality changes, cold intolerance, muscle weakness, and constipation. |
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A nurse is about to administer glargine (lantus) insulin and a dose of aspart (novolog) insulin to a patient w/ diabetes. How should the nurse administer the insulins?
a. Shake both vials of insulin before drawing up each dose in separate syringes b. Roll the glargine insulin vial, and then roll the aspart insulin vial. Then draw up the longer-acting insulin first c. Put air into the glargine insulin vial, and then put air into the aspart insulin vial, and draw up the correct dose of aspart insulin first d. Put air into the glargine insulin vial, draw up the correct dose in a syringe, then w/ a different syringe, put air into the aspart vial and draw up the correct dose. |
D – Put air into the glargine insulin vial, draw up the correct dose in a syringe, then w/ a different syringe, put air into the aspart vial and draw up the correct dose.
Glargine (lantus) insulin is a long-acting insulin and it should not be mixed w/ any other type of insulin. |
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A patient w/ type 1 diabetes is admitted to the emergency department. Which of the following respiratory patterns of the patient requires immediate action?
a. Shallow respirations alternating w/ long expirations b. Deep, rapid respirations w/ long inspirations c. Regular depth of respirations w/ frequent pauses d. Short respirations and inspirations |
B – deep, rapid respirations w/ long inspirations
Deep, rapid respirations is indicative of Kussmaul’s respirations, which occur in metabolic acidosis. The respirations increase in depth and rate, and the breath has a “fruity” or acetone-like odor. |
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The best indicator that the patient has learned to give an insulin self-injection correctly is when the patient can:
a. Perform the procedure correctly and safely b. Critique the nurse’s performance of the procedure c. Explain all the steps of the procedure correctly d. Correctly answer the questions related to the procedure in the next med-surg exam |
A – perform the procedure correctly and safely
A patient who performs the procedure correctly and safely demonstrates that he has acquired the skill. Evaluation requires performance of the skill by the patient while the nurse is observing. |
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ACE inhibitors may be prescribed for patients w/ diabetes to reduce vascular changes and possibly prevent or delay the development of:
a. COPD b. Pancreatic cancer c. Cerebrovascular accident d. Renal failure |
D – renal failure
Renal failure frequently results from the vascular changes associated w/ diabetes. ACE inhibitors increase renal blood flow and are effective in decreasing diabetic nephropathy. |
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Which of the following is the most common symptom of hypoglycemia?
a. Nervousness b. Hot, dry skin c. Bradycardia d. Kussmaul’s respirations |
A – nervousness
The four classical signs and symptoms of hypoglycemia are nervousness, perspiration, weakness, and confusion. Hot, dry skin and Kussmaul’s respirations are classical signs of hyperglycemia. |
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The nurse is caring for a patient w/ diabetes. Which of the following medications of the patient may cause a complication w/ the treatment plan of the patient w/ diabetes?
a. ACE inhibitors b. Steroids c. Aspirin d. Sulfonylureas |
B – steroids
Steroids can cause hyperglycemia because of their effects on carbohydrate metabolism. |
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During discharge procedure, the patient recently diagnosed w/ diabetes begins to cry and states; “I just can’t stand the thought of having to give myself a shot every day.” Which of the following would be the best response by the nurse?
a. “If you don’t give yourself your insulin shots, you will die.” b. “What is it about giving yourself the insulin shots that bothers you?” c. “we can teach your daughter to give the shots so you won’t have to do it” d. “I can arrange a home care nurse to give you your shots everyday” |
B – “what is it about giving yourself the insulin shots that bothers you?”
The best response is to allow the patient to verbalize her fears about giving herself a shot each day. Tactics that increase fear aren’t effective in changing behavior. |
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The nurse is preparing a teaching plan for a 45 year old client recently diagnosed w/ type 2 diabetes mellitus. What is the first step in this process?
a. Establish goals b. Choose video materials and brochures c. Set priorities of learning needs d. Assess the patient’s learning needs |
D – assess the patient’s learning needs
Before development and implementation of the teaching plan, it is vital to determine what the patient already knows regarding the condition and what the patient needs to know. |
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A diabetic client has been diagnosed w/ HTN and the physician has prescribed a beta blocker (atenolol) for the patient. When performing patient teaching, it is important for the nurse to inform the patient that adding the beta blocker to the current regimen can cause:
a. Impotence b. Hyperglycemia c. Hypoglycemia d. Excessive thirst |
C – hypoglycemia
There is a direct interaction between the effects of insulin and beta blockers. The nurse should be aware that there is a potential for increased hypoglycemia effects of insulin when a beta blocker is added to the regimen. |
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Which of the following psychosocial manifestations is most commonly seen in patients diagnosed w/ hypothyroidism?
a. Manic behavior b. Irritability c. Depression d. Decreased attention span |
C – depression
Depression is the most common reason for seeking medical attention in patients w/ hypothyroidism. Family members often bring the patient for the initial evaluation. |
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A nurse is assessing a patient diagnosed w/ acute pancreatitis for pain. What type of pain is consistent w/ the patient?
a. Severe and constant pain located in the left lower quadrant and radiating to the groin b. Burning and aching, located in the epigastric area and radiating to the back c. Burning and aching, located in the left lower quadrant and radiating to the hip d. Severe and constant pain located in the epigastric area and radiating to the back |
D – severe and constant pain located in the epigastric area and radiating to the back
Clinical manifestations of acute pancreatitis vary widely and depend on severity of inflammation. Typically, a patient is diagnosed after presenting w/ severe abdominal pain in the mid-epigastric area or left upper quadrant and radiates to the back, left flank, or left shoulder. |
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Which of the following would a nurse find in assessing a patient diagnosed w/ viral hepatitis?
a. Dark stool b. Malaise c. Weight gain d. Left upper quadrant pain |
B – malaise
In hepatitis, fatigue and malaise are common. Stools will be light- or clay-colored and patient may report right upper quadrant pain w/ jarring movements. |
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A nurse is completing a care plan for a patient recently diagnosed w/ acute pancreatitis. Which of the following interventions should the nurse include in the care plan? [select all that apply]
a. Administer anticholinergics as prescribed b. Give small, frequent high-carb, high protein, and low fat foods c. Maintain patient in supine position to relieve pain d. Administer antiemetics as prescribed e. Encourage visitors to direct patient’s attention away from pain |
A – administer anticholinergics as prescribed, D – administer antiemetics as prescribed, E – encourage visitors to direct patient’s attention away from pain
The patient is maintained on NPO status in the early stages of pancreatitis. Antiemetics for n/v are prescribed as needed. A side-lying position (w/legs drawn up to chest) may decrease the abdominal pain of pancreatitis. Anticholinergics help decrease vagal stimulation, motility, and pancreatic flow. Lowering the patient’s anxiety level may also substantially reduce pain. Provide reassurance, offer diversional activities such as TV, music, reading material and encourage visitors to direct attention away from pain. |
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A patient diagnosed w/ cirrhosis and ascites is scheduled for paracentesis. The nurse taking care of the patient should note which of the following signs or symptoms as complications of the procedure?
a. Hypotension and tachycardia b. Dyspnea and chest pain c. Dehydration and confusion d. Hypertension and bradycardia |
A – hypotension and tachycardia
In paracentesis, rapid, drastic removal of ascitic fluid leads to decreased abdominal pressure, which may contribute to vasodilation and shock. The nurse should observe for impending signs and symptoms of shock (e.g., hypotension and tachycardia) |
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Which of the following lab values will be decreased in a patient diagnosed w/ acute pancreatitis?
a. Serum glucose b. Serum calcium and magnesium c. Serum amylase and serum lipase d. Bilirubin and alanine amino-transferase |
B – serum calcium and magnesium
In acute pancreatitis, decreased serum calcium and magnesium is caused by fatty acids combined w/ calcium, seen in fat necrosis. Serum glucose is elevated in acute pancreatitis due to impaired carbohydrate metabolism and decreased insulin release. |
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A nurse is reviewing the lab values of his patient recently diagnosed w/ cirrhosis. The patient’s low albumin level is indicated by which physiological factor?
a. Decreased clotting factors b. Jaundice c. Clay-colored stools d. Peripheral edema |
D – peripheral edema
When albumin levels are low, osmotic pressure is decreased, which can lead to peripheral edema. Jaundice and clay-colored stools are indicated by an elevated bilirubin level. Decreased clotting factors are caused by prolonged PT-INR. |
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A nursing student is preparing her patient for paracentesis. Before the procedure, the nursing student should put the patient into which of the following positions?
a. Side-lying b. Supine c. Upright d. Upside-down |
C – upright
Patient safety procedures for paracentesis include monitoring vital signs, weight, asking the patient to void before the procedure to prevent bladder injury, and positioning the patient in the bed w/ the head of the bed elevated. |
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A nursing student is doing her assessment on a patient diagnosed w/ acute pancreatitis. Which of the following assessment findings would be the best indicator of the patient’s condition?
a. Exposure to occupational chemicals b. Chronic alcohol use c. Bradycardia d. Weight gain |
B – chronic alcohol use
Excessive alcohol intake, particularly in men, is the most frequent cause of acute pancreatitis. |
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The nurse is teaching a patient w/ acute pancreatitis about pain management. The patient shows understanding of the teaching when she states that pain will be reduced if the patient avoids which position?
a. Leaning forward b. Lying flat c. Side-lying, drawing legs up to the chest d. Sitting up, w/ feet elevated |
B – lying flat
In pancreatitis, pain is aggravated when the patient is lying supine. Helping the patient assume a side-lying position (w/ legs drawn up to the chest) may decrease abdominal pain of pancreatitis. |
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Which of following dietary factor should be limited in patient w/ hepatic encephalopathy?
a. Sodium b. Carbohydrates c. Calories d. Protein |
D – protein
Ammonia is a byproduct of protein metabolism. Patients w/ hepatic encephalopathy have high serum ammonia levels. Limiting protein intake will prevent further elevation of ammonia levels and prevent further complications. |
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A patient was admitted to the emergency department for severe abdominal pain, and nausea. Vital signs are T = 100°F, R=40, BP= 140/56, P=76. History includes chronic alcohol use for 10 years. The patient was diagnosed w/ acute pancreatitis. Based on the data presented, which of the following should be the primary concern for the patient?
a. Inadequate nutrition b. Electrolyte imbalance c. Acute pain d. Ineffective coping |
C – acute pain
In acute pancreatitis, the main focus of nursing care is aimed at controlling pain by interventions that decrease GI tract activity, thus decreasing pancreatic stimulation. |
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A nurse is assessing a patient experiencing signs and symptoms of cholecystitis. Which area should the nurse anticipate the location of pain?
a. Left upper quadrant, radiating to the left scapula and shoulder b. Left lower quadrant, radiating to the legs c. Right upper quadrant, radiating to the right scapula and shoulder d. Right lower quadrant, radiating to the back |
C – right upper quadrant, radiating to the right scapula and shoulder
In cholecystitis, pain may be described as indigestion of varying intensity, ranging from mild, persistent ache to steady, constant pain in the right upper quadrant and may radiate to the right shoulder or scapula. |
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Neomycin sulfate (Mycifradin) is prescribed for a patient diagnosed w/ portal-systemic encephalopathy (PSE). The nurse should know that the medication was prescribed for the patient to:
a. Prevent infection b. Prevent fluid retention and ascites c. Destroy normal flora in the bowel d. Prevent GI bleeding |
C – destroy normal flora in the bowel
Neomycin sulfate (mycifradin), a broad-spectrum antibiotic, may be given to act as an intestinal antiseptic. It destroys the normal flora of the bowel, diminishing protein breakdown and decreasing the rate of ammonia production. |
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A patient diagnosed w/ diabetic ketoacidosis (DKA) is mostly at risk for which electrolyte imbalance?
a. Hyperkalemia b. Hypokalemia c. Hypercalcemia d. Hypocalcemia |
B – hypokalemia
In DKA, regardless of initial potassium value, there is a large total-body potassium deficit. With insulin therapy, serum potassium levels fall rapidly as potassium shifts into cells. |
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The nurse is caring for a patient who just returned from esophagogastroduodenoscopy (EGD) procedure. Which of the following is not included in the plan of care regarding the patient?
a. Monitor for signs of bleeding b. Teach patient not to drive after the procedure c. Use cough drops to relieve throat discomfort d. Offer fluids for fluid and electrolyte replacement |
D – offer fluids for fluid and electrolyte replacement
The priority for care is to prevent aspiration. Don’t offer fluids or food by mouth until gag reflex is intact. Monitor signs of perforation, such as pain, bleeding, or fever. Teach patient not to drive for at least 12 hours after procedure because of sedation. Cough drops can be used to relieve throat discomfort. |
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Which of the following nursing diagnoses should be the nurse’s top priority in caring for a patient diagnosed w/ cirrhosis and ascites?
a. Excess fluid volume b. Imbalanced nutrition; less than body requirements c. Disturbed body image d. Ineffective breathing pattern |
D – ineffective breathing pattern
Excessive ascitic fluid volume may cause the patient to have respiratory problems. Dyspnea develops as a result of increased intra-abdominal pressure, which limits thoracic expansion and diaphragmatic excursion. |
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A nurse is assessing a patient who underwent esophagogastroduodenoscopy (EGD). Which of the following would indicate a need for immediate intervention by the nurse?
a. Fever b. Absent gag reflex c. Sore throat d. Drowsiness |
A – fever
Drowsiness, sore throat, and absent gag reflex are normal findings after the procedure. Pain, bleeding, and fever are signs of perforation which is a complication of EGD. |
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The nurse is teaching a patient w/ chronic pancreatitis about enzyme replacement therapy. Which of the following should the nurse include in the teaching?
a. Take the enzymes with meals or snacks b. Mix enzyme preparations in protein-containing foods to aid absorption c. Take enzymes on an empty stomach d. Alcohol may be consumed in moderation |
A – take the enzymes w/ meals or snacks
The patient must take the prescribed enzymes w/ meals and snacks to aid in the digestion of food. Enzyme preparations shouldn’t be mixed w/ protein-containing foods because the enzymatic action dissolves the food into a watery substance. Patient should avoid known irritating substances such as caffeinated beverages, and alcohol. |
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A nurse is about to administer the next dose of Lactulose to his patient w/cirrhosis. The nurse noted the patient is experiencing hand tremors and appears confused. Which of the following actions should the nurse do?
a. Hold the medication (Lactulose) b. Assess for GI bleeding c. Decrease the dosage of the medication (Lactulose) d. Assess for complications, side effects of the drug |
B – assess for GI bleeding
Asterixis (hand flapping/tremors) and confusion are signs of portal-systemic encephalopathy (PSE) which is caused by high ammonia levels in the blood. When a patient w/ cirrhosis has GI bleeding, it can result in the formation of increased amounts of ammonia. GI bleeding may lead to hepatic coma (stage IV PSE) Lactulose promotes excretion of ammonia in the stool and should not be withheld to help reduce the ammonia levels in the body. |
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The nurse is providing discharge teaching to a patient w/ cirrhosis and his family member. Which of the following patient statements indicate patient understands the teaching?
a. “I can consume alcohol in moderation and only w/ food” b. “I can increase my daily dose of lactulose” c. “A healthy diet, exercise, and adequate rest will help cure liver damage from cirrhosis” d. “I will take aspirin instead of Tylenol for pain” |
B – “I can increase my daily dose of lactulose”
Family members should be taught about how to recognize signs of PSE and that it’s necessary and safe to increase the daily lactulose at the first sign of PSE. Patients w/ cirrhosis should avoid alcohol and all OTC drugs, especially NSAIDs. Cirrhosis is the extensive, irreversible scarring of the liver, usually caused by chronic reaction to hepatic inflammation and necrosis. |
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A nurse is ordered to administer an anticholinergic drug, dicyclomine (bentyl), to a patient w/ cholecystitis. The nurse should know that the drug is ordered to achieve which desired effect?
a. Decreased biliary spasm b. Increased bile absorption c. Prevent GI bleed d. Treat nausea / vomiting |
A – decreased biliary spasm
Anticholinergic drugs are given to relax smooth muscles and decrease ductal tone and spasm. Antiemetics are given to treat nausea and vomiting. |
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The nurse is reviewing lab results for her patient diagnosed w/ acute pancreatitis. Which of the following lab values would best indicate the presence of the condition?
a. Increased amylase levels, decreased calcium and magnesium levels b. Increased bilirubin and AST levels c. Decreased amylase levels, increased calcium and magnesium levels d. Increased lipase, increased blood glucose levels, increased trypsin levels |
D – increased lipase, increased blood glucose levels, increased trypsin levels
Lipase is more specific in the diagnosis of acute pancreatitis. Trypsin testing is probably the most accurate serum indicator for acute pain but isn’t widely available. |
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A nurse educator is teaching a group of nursing students about problems of the biliary system and pancreas. Which of the following statements about the incidence/prevalence of pancreatitis should the nurse include in the teaching?
a. African-american men over the age of 40 are at risk for developing cholecystitis b. Pancreatic attacks are most common during the school year, usually days before and after final exams c. Pancreatic attacks are most common during holidays and vacations d. Somatostatins are avoided in patients undergoing ERCP to prevent incidence of acute pancreatitis |
C – pancreatic attacks are most common during holidays and vacations
Pancreatic attacks are most common during holidays and vacations when alcohol consumption is usually high, especially in men. To help reduce incidence of acute pancreatitis in ERCP, somatostatins and its analogue octreotide are used. The drugs appear to have an anti-inflammatory and cycloprotective properties. |
