ESTUDYR
NCLEX-RN Case Study: Acute Pancreatitis II
Client Scenario
1800 Nurses' Notes:
A 48-year-old male with a history of gallstones and heavy alcohol use presents to the
Emergency Department with "boring" midepigastric pain that radiates to his back. He states
the pain started after a heavy meal and is a 10/10. He is lying in a fetal position and appears
diaphoretic.
Physical Assessment:
Gastrointestinal: Abdomen is guarded and rigid. Bowel sounds are hypoactive.
Integumentary: Bluish discoloration is noted around the umbilicus and on the left
flank.
Vital Signs: BP 92/56, HR 122, RR 24, Temp 101.4°F.
Item 1: Recognizing Cues (Visual/Signs)
Question: The nurse observes discoloration on the client's abdomen. Match the physical
sign to the correct anatomical location based on the diagram below.
Bluish discoloration around the umbilicus ➔ ✅Cullen’s Sign
Bluish discoloration on the flanks (sides) ➔ ✅Grey Turner’s Sign
Rationale: These signs indicate retroperitoneal hemorrhage (internal bleeding) caused by
pancreatic enzymes "digesting" local blood vessels. This is a medical emergency suggesting
hemorrhagic pancreatitis.
Item 2: Analyzing Cues (Labs)
Question: The nurse reviews the laboratory results. Which findings confirm a diagnosis of
Acute Pancreatitis? (Select All That Apply)
1. ✅Serum Amylase: 600 U/L (Normal: 30–110 U/L)
NCLEX-RN Case Study: Acute Pancreatitis II
Client Scenario
1800 Nurses' Notes:
A 48-year-old male with a history of gallstones and heavy alcohol use presents to the
Emergency Department with "boring" midepigastric pain that radiates to his back. He states
the pain started after a heavy meal and is a 10/10. He is lying in a fetal position and appears
diaphoretic.
Physical Assessment:
Gastrointestinal: Abdomen is guarded and rigid. Bowel sounds are hypoactive.
Integumentary: Bluish discoloration is noted around the umbilicus and on the left
flank.
Vital Signs: BP 92/56, HR 122, RR 24, Temp 101.4°F.
Item 1: Recognizing Cues (Visual/Signs)
Question: The nurse observes discoloration on the client's abdomen. Match the physical
sign to the correct anatomical location based on the diagram below.
Bluish discoloration around the umbilicus ➔ ✅Cullen’s Sign
Bluish discoloration on the flanks (sides) ➔ ✅Grey Turner’s Sign
Rationale: These signs indicate retroperitoneal hemorrhage (internal bleeding) caused by
pancreatic enzymes "digesting" local blood vessels. This is a medical emergency suggesting
hemorrhagic pancreatitis.
Item 2: Analyzing Cues (Labs)
Question: The nurse reviews the laboratory results. Which findings confirm a diagnosis of
Acute Pancreatitis? (Select All That Apply)
1. ✅Serum Amylase: 600 U/L (Normal: 30–110 U/L)
