Progressive Care Nursing Certification (PCCN) Practice Exam

A patient with a history of hyperlipidemia and alcohol abuse is experiencing left upper quadrant abdominal pain. Which lab value should the nurse anticipate?

1. Decreased sedimentation rate and elevated calcium level

2. Decreased serum amylase level and increased WBC count

3. Decreased LDH and increased SGOT (AST)

4. Decreased Hct and increased lipase level

The correct answer is: Decreased Hct and increased lipase level

In a patient with a history of hyperlipidemia and alcohol abuse presenting with left upper quadrant abdominal pain, anticipating a decreased hematocrit (Hct) and increased lipase level is clinically appropriate. Increased lipase levels are indicative of pancreatitis, a condition that can be precipitated by excessive alcohol consumption and hyperlipidemia. Inflammation of the pancreas can lead to elevated lipase, a key enzyme involved in fat digestion. The left upper quadrant pain aligns with the potential involvement of the pancreas in this scenario. The decreased hematocrit might suggest either blood loss due to complications associated with pancreatitis, such as hemorrhagic pancreatitis, or dilutional effects from fluid shifts that can happen in inflammatory processes. Monitoring for changes in hematocrit can provide insights into the patient's volume status and overall hemodynamic stability. Other lab values in different choices may not present the same relevance or clinical correlation to the patient’s background issues and symptoms as described in the question.