Always remember to follow PEMDAS - parenthesis, exponents, multiplication, division, addition, and subtraction!
Your answer would be, A. 53. First you would solve within the parenthesis. 5+6 equals 11. The you would multiply 4 by 11, making it 44. Lastly, you would add nine to 44, to get 53. In conclusion, you're answer is A. Hope that helped! :)