A nurse admits a client to the emergency department who reports nausea and vomiting that worsens when he lies down. Antacids do not help. The provider suspects acute pancreatitis. Which of the following laboratory test results should the nurse expect to see?
Increased serum amylase
Increased serum calcium
Decreased WBC
Decreased serum lipase
The Correct Answer is A
Choice A Reason:
Increased serum amylase is a key indicator of acute pancreatitis. Amylase is an enzyme produced by the pancreas to help digest carbohydrates. In cases of acute pancreatitis, the pancreas becomes inflamed, leading to the release of amylase into the bloodstream. Elevated levels of serum amylase, typically more than three times the upper limit of normal, are a strong indication of acute pancreatitis. This enzyme level usually rises within a few hours of the onset of pancreatitis and can remain elevated for several days.
Choice B Reason:
Increased serum calcium is not typically associated with acute pancreatitis. In fact, acute pancreatitis can often lead to hypocalcemia (low calcium levels) due to fat saponification in the pancreas, where calcium binds with fatty acids. Therefore, an increase in serum calcium would not be expected in a patient with acute pancreatitis. Monitoring calcium levels is important, but an increase is not a diagnostic marker for this condition.
Choice C Reason:
Decreased WBC (white blood cell count) is not a characteristic finding in acute pancreatitis. On the contrary, acute pancreatitis often leads to an elevated WBC count due to the inflammatory response in the body. Leukocytosis (increased WBC) is a common finding in many inflammatory and infectious conditions, including acute pancreatitis. Therefore, a decreased WBC count would not be expected and does not support the diagnosis of acute pancreatitis.
Choice D Reason:
Decreased serum lipase is incorrect. Similar to amylase, lipase is another enzyme produced by the pancreas, which helps in the digestion of fats. In acute pancreatitis, serum lipase levels also increase significantly, often more than three times the upper limit of normal. Lipase levels tend to rise slightly later than amylase but remain elevated for a longer period, making it a useful marker for diagnosing acute pancreatitis. Therefore, decreased serum lipase would not be expected in this condition.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["31"]
Explanation
Let’s calculate the IV infusion rate step by step.
Step 1: Determine the total volume to be infused.
The total volume ordered is 1,000 mL.
Step 2: Determine the total time for the infusion.
The total time is 8 hours.
Step 3: Calculate the infusion rate in mL per hour.
Total volume (1,000 mL) ÷ Total time (8 hours) = 125 mL per hour.
Result: 125
Step 4: Determine the drop factor.
The IV tubing delivers 15 drops per milliliter.
Step 5: Calculate the infusion rate in drops per minute.
Infusion rate (125 mL per hour) × Drop factor (15 drops per mL) = 1,875 drops per hour.
Result: 1,875
Step 6: Convert the infusion rate to drops per minute.
Total drops per hour (1,875 drops) ÷ 60 minutes = 31.25 drops per minute.
Result: 31.25
Step 7: Round the result to the nearest whole number if necessary.
31.25 rounded to the nearest whole number is 31.
The nurse should run the IV infusion at a rate of 31 drops per minute.
Correct Answer is C
Explanation
Choice A Reason:
Weigh the client daily: While monitoring weight is important for clients with Addison’s disease, it is not the primary action to prevent an Addisonian crisis. Daily weight monitoring helps track fluid balance and detect any sudden changes that might indicate complications, but it does not directly address the hormonal imbalance that characterizes Addisonian crisis.
Choice B Reason:
Restrict food intake: Restricting food intake is not recommended for clients with Addison’s disease. Proper nutrition is crucial for maintaining energy levels and overall health. Clients with Addison’s disease need a balanced diet to manage their condition effectively. Restricting food intake could lead to malnutrition and exacerbate symptoms.
Choice C Reason:
Administer oral corticosteroids: This is the correct action. Addison’s disease is characterized by insufficient production of cortisol and aldosterone by the adrenal glands. Administering oral corticosteroids helps replace the deficient hormones and manage the symptoms of Addison’s disease. During an Addisonian crisis, immediate administration of corticosteroids is critical to prevent severe complications such as shock, coma, or even death.
Choice D Reason:
Provide a low carbohydrate diet: A low carbohydrate diet is not specifically recommended for clients with Addison’s disease. Instead, a balanced diet that includes adequate carbohydrates, proteins, and fats is essential. Carbohydrates are important for maintaining energy levels, especially since clients with Addison’s disease may experience fatigue and weakness. Restricting carbohydrates could lead to low blood sugar levels, which can be dangerous for these clients.
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