The nurse assesses a client who presents to the emergency department with acute abdominal pain, an elevated amylase, lipase, and alanine aminotransferase level of 180 units/L. The client is diagnosed with acute pancreatitis. Which cause of pancreatitis should the nurse suspect?

Biliary stone disease

Alcohol abuse

Cirrhosis

Hypertriglyceridemia

Answer and Explanation

The Correct Answer is A

Rationale:

A. Elevated alanine aminotransferase (ALT) above 150 units/L in the context of acute pancreatitis strongly suggests biliary obstruction from gallstones as the cause. ALT is a liver-specific enzyme, and significant elevations often indicate hepatocellular injury due to gallstone migration or blockage of the common bile duct, which can precipitate pancreatitis. This pattern—elevated amylase, lipase, and ALT—is characteristic of biliary pancreatitis.

B. Alcohol-induced pancreatitis usually presents with markedly elevated amylase and lipase, but ALT is typically normal or only mildly elevated. While alcohol is a common cause of pancreatitis, the lab pattern in this client points more toward a biliary etiology.

C. Cirrhosis may cause chronic liver enzyme elevations, but it is not a common direct cause of acute pancreatitis. Acute elevations of pancreatic enzymes (amylase and lipase) are not explained by cirrhosis alone.

D. This can cause pancreatitis, typically when triglyceride levels exceed 1000 mg/dL. Liver enzymes may not be significantly elevated in hypertriglyceridemia-induced pancreatitis. The presence of markedly elevated ALT suggests biliary obstruction rather than a metabolic cause.

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Free Nursing Study Resources

Correct Answer is ["A","C","D","E"]

Explanation

Rationale:

A. Hepatitis A is highly contagious via the fecal-oral route. There is no specific medication to prevent transmission once infected. Family members need to practice strict hygiene, including handwashing and avoiding shared utensils, to prevent spread.

B. Towels and personal items can harbor the virus, and not sharing them reduces the risk of transmission. No further teaching is needed for this statement.

C. This indicates misunderstanding. Hepatitis A is not transmitted via airborne droplets, so masks are unnecessary. Transmission occurs primarily through fecal-oral contamination, not respiratory secretions.

D. Alcohol is hepatotoxic and should be completely avoided during hepatitis A infection and recovery to prevent additional liver damage. This statement indicates a need for further teaching.

E. Sexual activity, especially oral-anal contact, can spread hepatitis A. Close contact and kissing may also pose a risk if hand hygiene is inadequate. The client needs further teaching about precautions to prevent transmission to intimate partners.

A. Heart rate: 92/min B. Respiratory rate: 20/min C. BP: 122/58 mm Hg D. Oxygen saturation: 96% on room air E. Client rates pain as 3 on a 0 to 10 pain scale F. Bowel sounds hypoactive in all four quadrants. G. Client vomiting brown liquid and reports continuing nausea. H. Urinating without difficulty, urine is clear yellow.

Correct Answer is ["A","B","D","E","H"]

Explanation

Correct Answers

Heart rate: 92/min is correct because this reflects improvement from the previous tachycardia of 109/min, indicating stabilization of the client’s hemodynamic status.
Respiratory rate: 20/min is correct because this shows improvement from the previous tachypnea of 26/min, indicating better respiratory function and decreased distress.
BP: 122/58 mm Hg is incorrect because the blood pressure remains unchanged from Day 1. While it is stable, it does not specifically demonstrate improvement.
Oxygen saturation: 96% on room air is correct because this is an improvement from 93% and indicates better oxygenation and respiratory status.
Client rates pain as 3 on a 0 to 10 pain scale is correct because pain has decreased from 8 to 3 following medication administration, indicating effective pain management and clinical improvement.
Bowel sounds hypoactive in all four quadrants is incorrect because hypoactive bowel sounds continue to reflect decreased gastrointestinal motility and do not demonstrate improvement.
Client vomiting brown liquid and reports continuing nausea is incorrect because ongoing vomiting and nausea indicate continued gastrointestinal irritation and do not represent progression.
Urinating without difficulty, urine is clear yellow is correct because adequate urine output and normal urine characteristics indicate improved hydration and renal perfusion.

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The nurse assesses a client who presents to the emergency department with acute abdominal pain, an elevated amylase, lipase, and alanine aminotransferase level of 180 units/L. The client is diagnosed with acute pancreatitis. Which cause of pancreatitis should the nurse suspect?

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Naxlex Comprehensive Predictor Exams

The nurse is evaluating how a client with hepatitis A understands the discharge teaching given. Which client statements indicate that further teaching is needed? Select all that apply.

Correct Answer is ["A","C","D","E"]

Explanation

Correct Answer is ["A","B","D","E","H"]

Explanation

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