A patient expresses concerns over having black stool. The fecal occult blood test is negative. Which response by the nurse is most appropriate?

You should schedule a colonoscopy as soon as possible.

This is probably a false negative.

Are you under a lot of stress?

Do you take iron supplements?

Answer and Explanation

The Correct Answer is D

Choice A reason: A negative fecal occult blood test suggests no gastrointestinal bleeding, reducing the urgency for a colonoscopy. Black stool can result from benign causes like iron supplements, so immediate invasive procedures are not warranted without further history or symptoms.

Choice B reason: Assuming a false negative without evidence is premature. Fecal occult blood tests are reliable for detecting bleeding. Black stool may stem from non-bleeding causes like medications or diet, and suggesting a false result could unnecessarily alarm the patient.

Choice C reason: Stress does not directly cause black stool. While stress can exacerbate gastrointestinal issues, black stool is more likely due to dietary factors, medications, or rare conditions. This question is vague and less relevant to the symptom’s likely etiology.

Choice D reason: Iron supplements commonly cause black stool due to the oxidation of iron in the gastrointestinal tract, a benign side effect. Given the negative fecal occult blood test, asking about iron supplements is the most appropriate, targeted response to identify a likely cause.

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Correct Answer is A

Explanation

Choice A reason: A bladder scan is the first step to assess urine retention noninvasively. It measures bladder volume, determining if the client is retaining urine post-catheter removal. This guides further interventions, preventing unnecessary procedures and addressing potential complications like urinary retention or bladder distention.

Choice B reason: Increasing fluids without assessing bladder volume is premature and risky. If retention exists, more fluid could exacerbate bladder distention, causing discomfort or injury. Fluid management should follow confirmation of voiding ability, ensuring the bladder can empty effectively to avoid complications.

Choice C reason: Assisting to the bathroom assumes the client can void, which may not be true post-catheter. Without confirming bladder function via a scan, this action risks missing retention, potentially leading to bladder overdistention or urinary tract complications, delaying appropriate intervention.

Choice D reason: Inserting a straight catheter is invasive and should not be the first action. Without a bladder scan to confirm retention, catheterization risks unnecessary discomfort or infection. Noninvasive assessment precedes invasive interventions to ensure patient safety and appropriate management of post-catheter voiding issues.

A. Endoscopy B. Ultrasound C. Chest radiography D. Intravenous pyelogram or Computerized Tomography (CT)

Correct Answer is D

Explanation

Choice A reason: Endoscopy visualizes the gastrointestinal or urinary tract but is not the primary test for renal calculi. It may be used for ureteral stones but is invasive and less effective than imaging for initial diagnosis.

Choice B reason: Ultrasound can detect renal calculi, especially in pregnant patients or those avoiding radiation, but it is less sensitive than CT for small stones or precise location. It is not the preferred initial test in most cases.

Choice C reason: Chest radiography is irrelevant for renal calculi, as it images the thoracic cavity, not the kidneys or ureters. Flank pain from stones is unrelated to chest pathology, making this test inappropriate.

Choice D reason: Intravenous pyelogram (IVP) or CT scans are gold standards for diagnosing renal calculi. CT provides detailed images of stone size, location, and obstruction, while IVP assesses urinary tract function, making them the expected tests.

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A patient expresses concerns over having black stool. The fecal occult blood test is negative. Which response by the nurse is most appropriate?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has not voided for 8 hours following the removal of an indwelling urinary catheter. Which of the following actions should the nurse take first?

Correct Answer is A

Explanation

A patient is being seen for complaints of severe flank pain lasting for 2 days. The emergency department physician suspects that the patient has renal calculi. Which of the following tests would the nurse expect the health care provider to order?

Correct Answer is D

Explanation

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