NU371 HESI Case Study: Pancreatitis Test Questions and
Answers Graded A+
Meet the Client - -A client is admitted to hematocrit (HCT) 42% (0.42 Proportion of 1.0).
the emergency department (ED) complaining of b) White blood cell count of 10,000/uL (10
severe abdominal and back pain with vomiting x109/L).
for the last 24 hours. The client was diagnosed c) Amylase of 982 U/L (16.4 mckat/L) and lipase
with chronic pancreatitis 2 years ago and this is of 400 U/L (6.68 ukat/L).
the fourth admission for an acute exacerbation of d) Blood alcohol (ethanol) level of 75 mg/dL
pancreatitis. (16.28 mmol/L). - -c) Amylase of 982 U/L
(16.4 mckat/L) and lipase of 400 U/L (6.68
ukat/L).
Assessment - -The nurse is completing the -
client's Emergency Department (ED) admission Serum amylase and lipase levels can increase to
assessment. an excess of 3 times their normal upper limits
within 24 hours of an acute exacerbation of
pancreatitis. Normal levels are amylase < 160
To support the admitting diagnosis of acute U/L (2.67 ukat/L) and lipase < 160 U/L (2.67
pancreatitis, what information should the nurse ukat/L).
obtain from the client?
a) History or current use of tobacco products.
b) How often alcohol is consumed and date of Emergency Department Nursing Interventions -
last drink. -The ED nurse starts an intravenous (IV)
c) Medication taken in the last 24 hours. infusion of 5% Dextrose and sodium chloride
d) Weight loss or gain in the last 6 months. - 0.45% at 125 mL/hour with a 20 gauge
-b) How often alcohol is consumed and angiocatheter in the client's left forearm. The
date of last drink. client complains of severe abdominal pain rated 9
- on a 0-10 numerical pain scale. The client's
Long-term use of alcohol is commonly abdomen is soft and tender in the upper
associated with the development of chronic quadrants. The nurse notes audible bowel
pancreatitis, and alcohol ingestion is the primary sounds in all 4 quadrants. Click for Image
cause of an acute exacerbation of pancreatitis.
Which medication should the nurse expect to
The client shares with the nurse that they have administer to relieve the client's pain?
been drinking alcohol every day for the last few a) Ondansetron 0.15 mg IV push diluted and
years and admits to drinking a little more than administered over 15 minutes.
usual last night. The client also reports smoking b) Ranitidine IV piggy back administered over 30
2 packs of cigarettes a day for the last 20 years. minutes.
To further evaluate the client's condition, the c) Morphine 5 mg IV push administered diluted
health care provider (HCP) prescribes several over 5 minutes.
laboratory tests. - -- d) Promethazine 25 mg deep intramuscular
injection. - -c) Morphine 5 mg IV push
administered diluted over 5 minutes.
Which laboratory data indicates that the client is -
experiencing acute pancreatitis? Morphine is considered a first line opioid
a) Hemoglobin (Hgb) 12.9 g/dL (129 g/L) and analgesic and one of the most commonly
prescribed opioids for moderate to severe pain.
1/8
, NU371 HESI Case Study: Pancreatitis Test Questions and
Answers Graded A+
Previous Section - --
The HCP writes admitting prescriptions for the
client. - -- Nursing Interventions on the Medical Unit -
-The nasogastric tube is draining green
bile, and the client reports pain rated 4 on a 0 to
Which diet should the nurse expect the HCP to 10 pain scale.
prescribe for the client?
a) Regular diet.
b) Low-fat diet. Which intervention regarding positioning should
c) Clear-liquid diet. the nurse implement to help alleviate the client's
d) Nothing by mouth. - -d) Nothing by pain?
mouth. a) Ensure that the client remains in a supine
- position.
All oral intake is withheld to inhibit pancreatic b) Place 6-inch blocks under the foot of the bed.
stimulation and the secretion of pancreatic c) Encourage side lying with legs drawn to chest.
enzymes. d) No specific position will help the client's pain. -
-c) Encourage side lying with legs drawn to
chest.
The ED nurse prepares to transfer the client to -
the medical floor. - -- The pain from pancreatitis is caused by
stretching of the peritoneum secondary to edema
caused by the inflamed pancreas. Sitting up,
Which intervention should the nurse implement leaning forward, or lying in a fetal position helps
prior to transferring the client to the floor? alleviate this pain.
A) Insert a nasogastric tube and connect to low,
intermittent suction.
B) Notify the case manager of the client's The nurse develops a plan of care for the client. -
admission. --
c) Place a 16-gauge indwelling urinary catheter.
d) Insert a second large bore IV catheter. -
-A) Insert a nasogastric tube and connect Which intervention should the nurse include in
to low, intermittent suction. the plan of care?
- a) Encourage the client to ambulate in the hall.
Nasogastric suction is used to relieve nausea b) Administer oxygen via nasal cannula.
and vomiting, to decrease painful abdominal c) Irrigate the nasogastric tube every 4 hours.
distention and paralytic ileus, and to remove d) Keep the client's room humidified and warm. -
hydrochloric acid so that it does not enter the -b) Administer oxygen via nasal cannula.
duodenum and stimulate the pancreas. -
Oxygen will help decrease the workload of the
respiratory system and the tissue's utilization of
Three hours after being admitted to the ED, the oxygen.
client is transferred to the medical unit in stable
condition.
2/8
Answers Graded A+
Meet the Client - -A client is admitted to hematocrit (HCT) 42% (0.42 Proportion of 1.0).
the emergency department (ED) complaining of b) White blood cell count of 10,000/uL (10
severe abdominal and back pain with vomiting x109/L).
for the last 24 hours. The client was diagnosed c) Amylase of 982 U/L (16.4 mckat/L) and lipase
with chronic pancreatitis 2 years ago and this is of 400 U/L (6.68 ukat/L).
the fourth admission for an acute exacerbation of d) Blood alcohol (ethanol) level of 75 mg/dL
pancreatitis. (16.28 mmol/L). - -c) Amylase of 982 U/L
(16.4 mckat/L) and lipase of 400 U/L (6.68
ukat/L).
Assessment - -The nurse is completing the -
client's Emergency Department (ED) admission Serum amylase and lipase levels can increase to
assessment. an excess of 3 times their normal upper limits
within 24 hours of an acute exacerbation of
pancreatitis. Normal levels are amylase < 160
To support the admitting diagnosis of acute U/L (2.67 ukat/L) and lipase < 160 U/L (2.67
pancreatitis, what information should the nurse ukat/L).
obtain from the client?
a) History or current use of tobacco products.
b) How often alcohol is consumed and date of Emergency Department Nursing Interventions -
last drink. -The ED nurse starts an intravenous (IV)
c) Medication taken in the last 24 hours. infusion of 5% Dextrose and sodium chloride
d) Weight loss or gain in the last 6 months. - 0.45% at 125 mL/hour with a 20 gauge
-b) How often alcohol is consumed and angiocatheter in the client's left forearm. The
date of last drink. client complains of severe abdominal pain rated 9
- on a 0-10 numerical pain scale. The client's
Long-term use of alcohol is commonly abdomen is soft and tender in the upper
associated with the development of chronic quadrants. The nurse notes audible bowel
pancreatitis, and alcohol ingestion is the primary sounds in all 4 quadrants. Click for Image
cause of an acute exacerbation of pancreatitis.
Which medication should the nurse expect to
The client shares with the nurse that they have administer to relieve the client's pain?
been drinking alcohol every day for the last few a) Ondansetron 0.15 mg IV push diluted and
years and admits to drinking a little more than administered over 15 minutes.
usual last night. The client also reports smoking b) Ranitidine IV piggy back administered over 30
2 packs of cigarettes a day for the last 20 years. minutes.
To further evaluate the client's condition, the c) Morphine 5 mg IV push administered diluted
health care provider (HCP) prescribes several over 5 minutes.
laboratory tests. - -- d) Promethazine 25 mg deep intramuscular
injection. - -c) Morphine 5 mg IV push
administered diluted over 5 minutes.
Which laboratory data indicates that the client is -
experiencing acute pancreatitis? Morphine is considered a first line opioid
a) Hemoglobin (Hgb) 12.9 g/dL (129 g/L) and analgesic and one of the most commonly
prescribed opioids for moderate to severe pain.
1/8
, NU371 HESI Case Study: Pancreatitis Test Questions and
Answers Graded A+
Previous Section - --
The HCP writes admitting prescriptions for the
client. - -- Nursing Interventions on the Medical Unit -
-The nasogastric tube is draining green
bile, and the client reports pain rated 4 on a 0 to
Which diet should the nurse expect the HCP to 10 pain scale.
prescribe for the client?
a) Regular diet.
b) Low-fat diet. Which intervention regarding positioning should
c) Clear-liquid diet. the nurse implement to help alleviate the client's
d) Nothing by mouth. - -d) Nothing by pain?
mouth. a) Ensure that the client remains in a supine
- position.
All oral intake is withheld to inhibit pancreatic b) Place 6-inch blocks under the foot of the bed.
stimulation and the secretion of pancreatic c) Encourage side lying with legs drawn to chest.
enzymes. d) No specific position will help the client's pain. -
-c) Encourage side lying with legs drawn to
chest.
The ED nurse prepares to transfer the client to -
the medical floor. - -- The pain from pancreatitis is caused by
stretching of the peritoneum secondary to edema
caused by the inflamed pancreas. Sitting up,
Which intervention should the nurse implement leaning forward, or lying in a fetal position helps
prior to transferring the client to the floor? alleviate this pain.
A) Insert a nasogastric tube and connect to low,
intermittent suction.
B) Notify the case manager of the client's The nurse develops a plan of care for the client. -
admission. --
c) Place a 16-gauge indwelling urinary catheter.
d) Insert a second large bore IV catheter. -
-A) Insert a nasogastric tube and connect Which intervention should the nurse include in
to low, intermittent suction. the plan of care?
- a) Encourage the client to ambulate in the hall.
Nasogastric suction is used to relieve nausea b) Administer oxygen via nasal cannula.
and vomiting, to decrease painful abdominal c) Irrigate the nasogastric tube every 4 hours.
distention and paralytic ileus, and to remove d) Keep the client's room humidified and warm. -
hydrochloric acid so that it does not enter the -b) Administer oxygen via nasal cannula.
duodenum and stimulate the pancreas. -
Oxygen will help decrease the workload of the
respiratory system and the tissue's utilization of
Three hours after being admitted to the ED, the oxygen.
client is transferred to the medical unit in stable
condition.
2/8
