In reviewing the medical record for a patient admitted with acute pancreatitis, the nurse sees that the patient has a positive Cullen's sign. Indicate the area in the accompanying figure where the nurse will assess for this change.
Epigastrium
Umbilical
Flank
Subumbilical
The Correct Answer is B
Rationale:
A. Epigastrium refers to the upper central region of the abdomen, just below the sternum; Cullen’s sign does not appear here.
B. Umbilical region (around the navel) is where Cullen’s sign appears as a bluish discoloration due to subcutaneous fat necrosis or retroperitoneal bleeding associated with acute pancreatitis. This is the correct site.
C. Flank discoloration is known as Grey Turner’s sign, another indicator of retroperitoneal bleeding, but distinct from Cullen’s sign.
D. Subumbilical refers to the area below the umbilicus, not the typical site for Cullen’s sign.
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Related Questions
Correct Answer is C
Explanation
Rationale:
A. Hepatotoxic medications can cause toxic or drug-induced liver injury, but they are not the primary cause of biliary cirrhosis.
B. Excessive alcohol consumption is a major cause of alcoholic cirrhosis, not biliary cirrhosis.
C. Obstruction of the bile duct—whether from gallstones, strictures, or autoimmune disorders—leads to cholestasis. Over time, the retained bile damages liver cells, causing inflammation, fibrosis, and ultimately biliary cirrhosis.
D. Hepatitis C primarily causes viral hepatitis-related cirrhosis, not biliary cirrhosis.
Correct Answer is B
Explanation
Rationale:
A. Replacing lost blood components requires blood products, not isotonic crystalloids.
B. Isotonic crystalloid fluids (e.g., 0.9% sodium chloride, lactated Ringer’s) are administered to restore extracellular fluid volume in clients with fluid volume deficit.
C. While isotonic solutions contain electrolytes, their primary purpose is volume replacement, not rapid electrolyte correction.
D. Correcting metabolic acidosis may require specific interventions; isotonic fluids alone do not address acid-base imbalances.
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