A nurse is completing the admission assessment of a client who has acute pancreatitis. Which finding is the first priority?
A) History of cholelithiasis
B) Elevated serum amylase levels
C) Decrease in bowel sounds upon auscultation
D) Hand spasms present when blood pressure is checked
D.
...
a nurse is completing the admission assessment of a client who has acute pancreatitis which finding is the first priority
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Pancreatitis NCLEX
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Pancreatitis NCLEX (ATI, Evolve, Lewis,
Success)
A nurse is completing the admission assessment of a client who has acute pancreatitis.
Which finding is the first priority?
A) History of cholelithiasis
B) Elevated serum amylase levels
C) Decrease in bowel sounds upon auscultation
D) Hand spasms present when blood pressure is checked - Answer D.
Rationale: the greatest risk to the client is ECG changes and hypotension from
hypocalcemia. Hand spasms when taking blood pressure is a manifestation of
hypocalcemia
A nurse is completing an admission assessment of a client who has pancreatitis. Which
of the following findings should the nurse expect?
A. Pain in the UQ rating to the shoulder
B. Report of pain being worse when sitting upright
C. Pain relieved with defecation
D. Epigastric pain radiating to the left shoulder - Answer D.
Rationale: A client with pancreatitis will report pain being worse when lying down in the
fetal position, and pain that radiates to the back. left flank, or left, shoulder.
A nurse is assessing a client who has pancreatitis. Which of the following actions should
the nurse take to assess the presence of Cullen's sign.
A. Tap lightly at the costovertebral margin on the client's back
B. Palpate the RLQ
C. Inspect the skin around the umbilicus
D. Auscultate the area below the scapula - Answer C.
Rationale: Cullen's sign is indicated by a bluish-gray discoloration in the periumbillical
area
A nurse is completing nutritional teaching for a client who has pancreatitis. Which of the
following statements by the client indicates an understanding of the teaching? (SATA)
A. I plan to eat small, frequent meals.
B. I will eat easy-to-digest foods with limited spice
C. I will use skim milk when cooking
D. I plan to drink regular cola
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