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 D
Explanation
This question involves delegation principles in hospice care. Knowledge of the scope of practice for volunteers versus clinical staff is required. It focuses on identifying non-clinical, psychosocial support tasks appropriate for an unlicensed, non-medical volunteer to perform.
Choice A rationale
Providing spiritual support is a specialized role typically reserved for chaplains or trained clergy members. While volunteers are supportive, this task involves professional spiritual counseling and assessment beyond a general volunteer scope of practice.
Choice B rationale
Assessing the availability and functionality of medical equipment is a clinical responsibility. The nurse or a medical technician must ensure that the home environment is safe and that technical care requirements are met appropriately.
Choice C rationale
Personal care, such as sponge baths and skin assessments for bony prominences, involves physical contact and monitoring for skin breakdown. These tasks are typically delegated to nursing assistants or home health aides, not volunteers.
Choice D rationale
Volunteers in hospice are trained to provide companionship and emotional presence. Sitting with a client to reminisce provides psychosocial support and comfort, which falls within the volunteer's role of enhancing the client's quality of life.
Correct Answer is A
Explanation
Evaluating a cervical spine injury for neurogenic shock requires knowledge of autonomic nervous system disruption. Specifically, loss of sympathetic tone below the level of injury must be identified. Differentiating neurogenic shock from spinal shock involves assessing hemodynamic parameters and thermoregulation.
Choice A rationale
Neurogenic shock involves loss of sympathetic vascular tone, causing massive vasodilation and hypotension. Unchecked parasympathetic activity leads to bradycardia. Normal heart rate is 60 to 100. Warm, pink skin results from peripheral blood pooling due to vasodilation.
Choice B rationale
Hyperactive reflexes are characteristic of the later stages of spinal cord injury after spinal shock resolves. They do not indicate the acute hemodynamic collapse seen in neurogenic shock, which specifically targets the cardiovascular regulatory systems.
Choice C rationale
Loss of sensation and movement defines spinal shock or the initial cord injury itself. While present in neurogenic shock, these findings are not specific to the autonomic failure that characterizes the life-threatening hemodynamic instability of shock.
Choice D rationale
Spasticity occurs due to upper motor neuron damage after the initial period of areflexia. This is a chronic or subacute finding and is not associated with the acute cardiovascular distributive failure seen in neurogenic shock.
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