Chapter 50 Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition

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Chapter 50  Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

1. A nurse is assessing a patient who has been diagnosed with cholecystitis, and is experiencing localized abdominal pain. When assessing the characteristics of the patient’s pain, the nurse should anticipate that it may radiate to what region?

  1. A)  Left upper chest
  2. B)  Inguinal region
  3. C)  Neck or jaw
  4. D)  Right shoulder

Ans: D

Feedback:

The patient may have biliary colic with excruciating upper right abdominal pain that radiates to the back or right shoulder. Pain from cholecystitis does not typically radiate to the left upper chest, inguinal area, neck, or jaw.

2. A 55-year-old man has been newly diagnosed with acute pancreatitis and admitted to the acute medical unit. How should the nurse most likely explain the pathophysiology of this patient’s health problem?

  1. A)  “Toxins have accumulated and inflamed your pancreas.”
  2. B)  “Bacteria likely migrated from your intestines and became lodged in your pancreas.”
  3. C)  “A virus that was likely already present in your body has begun to attack your pancreatic

    cells.”

  4. D)  “The enzymes that your pancreas produces have damaged the pancreas itself.”

Ans: D

Feedback:

Although the mechanisms causing pancreatitis are unknown, pancreatitis is commonly described as the autodigestion of the pancreas. Less commonly, toxic substances and microorganisms are implicated as the cause of pancreatitis.

3. A patient’s assessment and diagnostic testing are suggestive of acute pancreatitis. When the nurse is performing the health interview, what assessment questions address likely etiologic factors? Select all that apply.

  1. A)  “How many alcoholic drinks do you typically consume in a week?”
  2. B)  “Have you ever been tested for diabetes?”
  3. C)  “Have you ever been diagnosed with gallstones?”
  4. D)  “Would you say that you eat a particularly high-fat diet?”
  5. E)  “Does anyone in your family have cystic fibrosis?”

Ans: A, C

Feedback:

Eighty percent of patients with acute pancreatitis have biliary tract disease such as gallstones or a history of long-term alcohol abuse. Diabetes, high-fat consumption, and cystic fibrosis are not noted etiologic factors.

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4. A patient’s abdominal ultrasound indicates cholelithiasis. When the nurse is reviewing the patient’s laboratory studies, what finding is most closely associated with this diagnosis?

  1. A)  Increased bilirubin
  2. B)  Decreased serum cholesterol
  3. C)  Increased blood urea nitrogen (BUN)
  4. D)  Decreased serum alkaline phosphatase level

Ans: A

Feedback:

If the flow of blood is impeded, bilirubin, a pigment derived from the breakdown of red blood cells, does not enter the intestines. As a result, bilirubin levels in the blood increase. Cholesterol, BUN, and alkaline phosphatase levels are not typically affected.

5. A nurse who provides care in a walk-in clinic assesses a wide range of individuals. The nurse should identify which of the following patients as having the highest risk for chronic pancreatitis?

  1. A)  A 45-year-old obese woman with a high-fat diet
  2. B)  An 18-year-old man who is a weekend binge drinker
  3. C)  A 39-year-old man with chronic alcoholism
  4. D)  A 51-year-old woman who smokes one-and-a-half packs of cigarettes per day

Ans: C

Feedback:

Excessive and prolonged consumption of alcohol accounts for approximately 70% to 80% of all cases of chronic pancreatitis.

 

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