Lewis Med/Surg -Chp. 48 |Advanced Pancreatic and Biliary Disorders Nursing Examination: Acute Pancreatitis Pathophysiology, Alcohol-Induced Pancreatic Injury, Serum Amylase Elevation, Serum Lipase Elevation, Hypocalcemia Tetany Risk, Cullen Sign Periumbil

Lewis Med/Surg -Chp. 48 |Advanced Pancreatic and Biliary Disorders Nursing Examination: Acute Pancreatitis Pathophysiology, Alcohol-Induced Pancreatic Injury, Serum Amylase Elevation, Serum Lipase Elevation, Hypocalcemia Tetany Risk, Cullen Sign Periumbilical Ecchymosis, Grey Turner Flank Ecchymosis, Pancreatic Abscess Formation, Respiratory Failure Complications, Nasogastric Decompression Therapy, Pancreatic Rest NPO Management, Fluid Electrolyte Stabilization, Gallstone Cholelithiasis Disease, Acute Cholecystitis Inflammation, Cystic Duct Obstruction, Biliary Colic Pain Syndrome, Right Upper Quadrant Tenderness, Jaundice Hyperbilirubinemia Indicator, Clay Colored Stool Sign, Dark Amber Urine Manifestation, Steatorrhea Fat Malabsorption, Pruritus Bile Salt Accumulation, Fat Soluble Vitamin Deficiency A D E K Exam Questions Verified and Provided with Complete A+ Graded Rationales Latest Updated 2026 A 54-year-old patient admitted with diabetes mellitus, malnutrition, osteomyelitis, and alcohol abuse has a serum amylase level of 280 U/L and a serum lipase level of 310 U/L. To what diagnosis does the nurse attribute these findings? A. Malnutrition B. Osteomyelitis C. Alcohol abuse D. Diabetes mellitus C. Alcohol Use The patient with alcohol abuse could develop pancreatitis as a complication, which would increase the serum amylase (normal 30-122 U/L) and serum lipase (normal 31-186 U/L) levels as shown. When caring for a patient with a biliary obstruction, the nurse will anticipate administering which vitamin supplements (select all that apply)? A. Vitamin A B. Vitamin D C. Vitamin E D. Vitamin K E. Vitamin B A. Vitamin A B. Vitamin D C. Vitamin E D. Vitamin K Biliary obstruction prevents bile from entering the small intestine and thus prevents the absorption of fat-soluble vitamins. Vitamins A, D, E, and K are all fat-soluble and thus would need to be supplemented in a patient with biliary obstruction. The patient with right upper quadrant abdominal pain has an abdominal ultrasound that reveals cholelithiasis. What should the nurse expect to do for this patient? A. Prevent all oral intake. B. Control abdominal pain. C. Provide enteral feedings. D. Avoid dietary cholesterol. B. Control abdominal pain. Patients with cholelithiasis can have severe pain, so controlling pain is important until the problem can be treated. NPO status may be needed if the patient will have surgery but will not be used for all patients with cholelithiasis. Enteral feedings should not be needed, and avoiding dietary cholesterol is not used to treat cholelithiasis A patient with cholelithiasis needs to have the gallbladder removed. Which patient assessment is a contraindication for a cholecystectomy? A. Low-grade fever of 100° F and dehydration B. Abscess in the right upper quadrant of the abdomen C. Activated partial thromboplastin time (aPTT) of 54 seconds D. Multiple obstructions in the cystic and common bile duct C. Activated partial thromboplastin time (aPTT) of 54 seconds An aPTT of 54 seconds is above normal and indicates insufficient clotting ability. If the patient had surgery, significant bleeding complications postoperatively are very likely. Fluids can be given to eliminate the dehydration; the abscess can be assessed, and the obstructions in the cystic and common bile duct would be relieved with the cholecystectomy. The patient with sudden pain in the left upper quadrant radiating to the back and vomiting was diagnosed with acute pancreatitis. What intervention(s) should the nurse expect to include in the patient's plan of care? A. Immediately start enteral feeding to prevent malnutrition. B. Insert an NG and maintain NPO status to allow pancreas to rest. C. Initiate early prophylactic antibiotic therapy to prevent infection. D. Administer acetaminophen (Tylenol) every 4 hours for pain relief. B. Insert an NG and maintain NPO status to allow pancreas to rest. Initial treatment with acute pancreatitis will include an NG tube if there is vomiting and being NPO to decrease pancreatic enzyme stimulation and allow the pancreas to rest and heal. Fluid will be administered to treat or prevent shock. The pain will be treated with IV morphine because of the NPO status. Enteral feedings will only be used for the patient with severe acute pancreatitis in whom oral intake is not resumed. Antibiotic therapy is only needed with acute necrotizing pancreatitis and signs of infection. The patient with suspected pancreatic cancer is having many diagnostic studies done. Which one can be used to establish the diagnosis of pancreatic adenocarcinoma and for monitoring the response to treatment? A. Spiral