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

Answer and Explanation

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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Correct Answer is B

Explanation

Rationale:
A. Pain in this area is more commonly associated with appendicitis, not diverticular disease.
B. Lower left quadrant is the typical site of pain in diverticular disease, especially diverticulitis, because the sigmoid colon (most often affected) is located here.
C. Upper left quadrant; Pain in this area is more often linked to conditions involving the spleen, stomach, or pancreas.
D. Upper right quadrant; Pain here is usually related to gallbladder, liver, or biliary tract disorders.

A. Increased serum calcium B. Decreased serum lipase C. Decreased WBC D. Increased serum amylase

Correct Answer is D

Explanation

Rationale:
A. Serum calcium levels are often decreased in acute pancreatitis due to fat saponification, not increased.

B. Serum lipase is typically elevated, not decreased, in acute pancreatitis, and is often more specific than amylase for pancreatic injury.

C. WBC count usually increases due to inflammation and possible infection; a decreased WBC is not expected.

D. Increased serum amylase is a hallmark laboratory finding in acute pancreatitis. Amylase is released from damaged pancreatic cells into the bloodstream. Levels typically rise within 6–12 hours of onset of symptoms and remain elevated for 3–5 days. Monitoring amylase, along with lipase (which remains elevated longer), helps confirm the diagnosis and assess the severity of pancreatic inflammation. Elevated amylase, in the context of abdominal pain radiating to the back, nausea, and vomiting, supports the provider’s suspicion of acute pancreatitis.

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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.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has diverticular disease. When palpating the client's abdomen, in which of the following locations should the nurse expect the client to report abdominal pain?

Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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