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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. Restlessness can occur with electrolyte imbalances or hypoxia, but it is not a hallmark of low albumin or protein malnutrition.
B. Low serum albumin and total protein decrease plasma oncotic pressure, allowing fluid to shift from the vascular space into interstitial tissues, leading to peripheral and sometimes generalized edema (anasarca).
C. Pallor is more indicative of anemia, which may coexist but is not a direct effect of hypoalbuminemia.
D. Confusion can result from electrolyte disturbances, hypoxia, or hepatic encephalopathy, but it is not a direct manifestation of low albumin.
Correct Answer is A
Explanation
Rationale:
A. Hypertonic solutions, like TPN with 25% dextrose, can irritate peripheral veins and cause phlebitis. Administering them through a central line allows rapid dilution in a large volume of blood, reducing vein irritation and promoting safe infusion.
B. Blood glucose monitoring is not dependent on the line type; it is done via peripheral blood samples.
C. The infusion rate is determined by the prescribed therapy, not by whether a central line is used.
D. Central lines do not decrease the risk of infection; in fact, they carry a higher risk of central line–associated bloodstream infections compared with peripheral lines.
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