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