A client with chronic pancreatitis is being evaluated.
Which findings are most consistent with this condition? Select all that apply.
Increased Amylase.
Decreased calcium related to binding of calcium.
Increased Lipase.
Decreased serum glucose.
Elevated serum calcium.
Correct Answer : A,B,C
Chronic pancreatitis involves long-term inflammation of the pancreas leading to permanent structural damage and functional impairment. Knowledge of pancreatic enzyme dynamics, calcium sequestration during fat necrosis, and the resulting endocrine dysfunction is essential to identify clinical manifestations and laboratory abnormalities.
Choice A rationale
Chronic inflammation causes cellular destruction and leakage of enzymes into the bloodstream. During acute exacerbations of chronic pancreatitis, serum amylase levels rise above the normal range of 23 to 85 U/L due to pancreatic ductal obstruction.
Choice B rationale
Fat necrosis leads to the release of free fatty acids, which bind with ionized calcium in a process called saponification. This results in hypocalcemia, where serum calcium levels fall below the normal 9.0 to 10.5 mg/dL.
Choice C rationale
Serum lipase is highly specific to the pancreas and increases during inflammatory episodes. Lipase levels remain elevated longer than amylase, exceeding the normal reference range of 0 to 160 U/L as pancreatic acinar cells undergo damage.
Choice D rationale
Chronic pancreatitis often leads to the destruction of insulin-producing beta cells in the islets of Langerhans. This typically results in secondary diabetes mellitus and hyperglycemia, rather than decreased serum glucose levels below the normal 70 to 99 mg/dL.
Choice E rationale
Hypocalcemia is the expected finding due to calcium binding in necrotic fat. Elevated serum calcium is not consistent with pancreatitis; in fact, hypercalcemia is sometimes a causative factor for pancreatitis rather than a clinical manifestation of the disease.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Acute neurological deficits following a stroke increase the risk of secondary complications. Knowledge of cranial nerve involvement and protective reflexes is vital. The nurse must prioritize airway and respiratory safety within the critical 24 hour post ischemic event window.
Choice A rationale
Right sided weakness often includes the facial and pharyngeal muscles, impairing the gag reflex and swallowing. This increases the risk of food or secretions entering the lungs, leading to pneumonia or acute respiratory distress during recovery.
Choice B rationale
While urinary retention can occur after a stroke due to neurogenic bladder or immobility, it is not an immediate life threat. It requires monitoring and management but takes lower priority than ensuring the client maintains a patent airway.
Choice C rationale
Contractures are a long term complication of immobility and muscle spasticity following a stroke. While range of motion exercises are important for rehabilitation, they are not a priority during the first 24 hours of acute stabilization.
Choice D rationale
Depression is a common psychological consequence of the lifestyle changes and deficits caused by a stroke. However, psychological assessment occurs later in the care plan after the client is physiologically stable and out of danger.
Correct Answer is A
Explanation
This scenario requires understanding acid-base balance and renal pathophysiology. Acute kidney injury impairs the kidneys ability to excrete hydrogen ions and regenerate bicarbonate. Identifying metabolic acidosis with partial respiratory compensation is necessary based on the interpretation of arterial blood gas values.
Choice A rationale
Metabolic acidosis occurs in kidney injury due to decreased acid excretion. The pH is low at 7.26 (7.35 to 7.45) and bicarbonate is low at 14 (22 to 28), while the PaCO2 of 30 shows compensatory hyperventilation.
Choice B rationale
A pH of 7.26 indicates acidosis, but the normal bicarbonate level of 24 and elevated PaCO2 of 46 indicate respiratory acidosis. This occurs with hypoventilation and carbon dioxide retention rather than the metabolic issues seen in kidney failure.
Choice C rationale
The pH of 7.49 indicates alkalosis. A high bicarbonate of 30 with a normal PaCO2 of 40 represents uncompensated metabolic alkalosis. This is typical of excessive acid loss or base gain, which is opposite of kidney failure.
Choice D rationale
The pH of 7.49 and low PaCO2 of 30 suggest respiratory alkalosis. Bicarbonate is normal at 24. This state results from hyperventilation and excessive carbon dioxide loss, which does not characterize the pathophysiology of acute kidney injury.
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