Questions 54

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Gastrointestinal NCLEX RN Questions Questions

Extract:

The emergency department (ED) nurse is caring for a 45-year-old male client.
Item 2 of 6
Nurses’ Notes
0600: The client reports sudden, severe epigastric pain. He has a history of chronic alcohol use disorder (30+ years), GERD, and hypertension. His home medications include pantoprazole and lisinopril. Upon assessment, the client is noted to be alert and oriented x4. He is mildly diaphoretic, with pulses 2+ and regular. Abdomen is distended, guarding on palpation, diminished bowel sounds, and no stool in the last 24 hours. He reports nausea and vomiting, and his pain is worse after eating fatty foods, rated 7/10 and radiating to his back. Breath sounds slightly diminished bilaterally, no adventitious sounds, denies cough or dyspnea. He reports heavy alcohol intake two days ago. Fingerstick glucose is 145 mg/dL (8.06 mmol/L) [70-110 mg/dL; 4-6 mmol/L]. Temperature is 101.3°F (38.5°C), heart rate of 112 bpm, respiratory rate of 24 breaths/min, blood pressure of 98/64 mmHg, and oxygen saturation of 95% on room air.
Orders
0600
• Cardiac monitoring
• NPO
• CBC
• CMP
• LFTs
• Amylase
• Lipase
• CT abdomen with contrast


Question 1 of 5

The nurse is reviewing assessment findings to differentiate between acute pancreatitis and cholecystitis. For each assessment finding below, click to specify if the finding is consistent with the disease process of acute pancreatitis or cholecystitis. Each finding may support more than one (1) disease process. Each column must have at least one (1) response option selected.

Assessment Findings Acute Pancreatitis Cholecystitis
Severe epigastric pain
Gray-blue discoloration of the flanks
Nausea and vomiting
Leukocytosis
Elevated lipase and amylase
Hypocalcemia

Correct Answer: A,C,D,E,F;A,C,D

Rationale: Acute pancreatitis: A (Severe epigastric pain), C (Nausea and vomiting), D (Leukocytosis), E (Elevated lipase and amylase), F (Hypocalcemia). Cholecystitis: A, C, D. Elevated lipase/amylase and hypocalcemia are specific to pancreatitis.

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Question 2 of 5

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