The nurse is assessing a patient with abdominal pain. How will the nurse document ecchymosis around the area of umbilicus?

Correct Answer: A

Rationale: The correct answer is A: Cullen sign. Ecchymosis around the umbilicus indicates intra-abdominal bleeding. Cullen sign specifically refers to bruising around the umbilicus, which can be a sign of retroperitoneal bleeding. Rovsing sign is rebound tenderness in appendicitis. McBurney sign is tenderness at McBurney's point in appendicitis. Grey-Turner's sign is bruising on the flanks, indicating retroperitoneal or pancreatitis-related bleeding. Cullen sign is the most appropriate choice for ecchymosis around the umbilicus.

Correct Answer: B

Rationale: The correct answer is B: lipids. Cholecystokinin (CCK) is released in response to the presence of lipids in the duodenum. When lipids are detected, CCK is secreted by the enteroendocrine cells in the small intestine. CCK plays a crucial role in the digestion and absorption of lipids by stimulating the release of bile from the gallbladder and pancreatic enzymes. Explanation for why the other choices are incorrect: A: Chyme is a mixture of partially digested food and gastric juices. While chyme may contain lipids, it is not the specific stimulus for CCK release. C: Protein stimulates the release of other hormones like gastrin and secretin, not CCK. D: Gastrin is a hormone that stimulates gastric acid secretion, not CCK release in response to lipids.

Correct Answer: B

Rationale: The correct answer is B: cystic. The common bile duct is formed by the merger of the hepatic duct from the liver and the cystic duct from the gallbladder. The cystic duct carries bile from the gallbladder to the common bile duct, which then transports bile to the small intestine. Choices A, C, and D are incorrect because the common bile duct is not formed by the merger of the common hepatic, pancreatic, or Santorini ducts. Each of these ducts serves a different function in the digestive system.

Correct Answer: B

Rationale: Correct Answer: B: intrinsic factor Rationale: 1. Intrinsic factor is essential for the absorption of vitamin B12 in the ileum. 2. Parietal cells secrete intrinsic factor in the stomach. 3. Without intrinsic factor, vitamin B12 cannot be absorbed, leading to pernicious anemia. Summary of Incorrect Choices: A: Hydrochloric acid is also secreted by parietal cells but is not directly involved in vitamin B12 absorption. C: Pepsinogen is a precursor to pepsin, which is involved in protein digestion, not vitamin B12 absorption. D: Mucus protects the stomach lining and does not play a role in vitamin B12 absorption.

Correct Answer: D

Rationale: The correct answer is D: pellagra. Pellagra is caused by a deficiency of nicotinic acid (niacin), which is a type of vitamin B3. Nicotinic acid is essential for the metabolism of carbohydrates and fats. Symptoms of pellagra include dermatitis, diarrhea, dementia, and eventually death if left untreated. Rationale: 1. Anaemia (Choice A) is not caused by a deficiency of nicotinic acid. 2. Osteomalacia (Choice B) is caused by a deficiency of vitamin D, not nicotinic acid. 3. Xerophthalmia (Choice C) is caused by a deficiency of vitamin A, not nicotinic acid. In summary, pellagra is the correct answer because it directly relates to the deficiency of nicotinic acid, while the other choices are caused by deficiencies of different vitamins.