A patient who is visiting the clinic complains of having stomach pains for 2 weeks and describes his stools as being soft and black for approximately the last 10 days. He denies taking any medications. How should the nurse interpret these symptoms?

Absent bile pigment from liver or gallbladder problems

Excessive fat in the stool caused by malabsorption

Increased iron intake, resulting from a change in diet

Occult blood resulting from gastrointestinal bleeding

Answer and Explanation

The Correct Answer is D

Choice A reason: Absent bile pigment causes pale, clay-colored stools due to impaired bile flow from liver or gallbladder issues. Black stools suggest blood or medication effects, not bile absence, making this interpretation inconsistent with the patient’s soft, black stool description.

Choice B reason: Excessive fat in stools (steatorrhea) from malabsorption causes bulky, greasy, foul-smelling stools, typically pale or light-colored, not black. The patient’s black stools point to a different etiology, such as bleeding, making this an incorrect interpretation.

Choice C reason: Increased iron intake, such as from supplements, can cause black stools, but the patient denies medications. Dietary iron alone is unlikely to produce consistently black stools without supplementation, and stomach pain suggests a pathological cause, making this less likely.

Choice D reason: Soft, black stools (melena) typically indicate occult blood from gastrointestinal bleeding, often from the upper GI tract (e.g., stomach or duodenum). Stomach pain supports this, as bleeding from ulcers or gastritis can cause both symptoms, making this the correct interpretation.

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Correct Answer is C

Explanation

Choice A reason: Standing 6 feet away is too far for a whisper test, which is typically done at 1–2 feet. Whispering words for repetition is the standard method, so this is incorrect for hearing assessment.

Choice B reason: Occluding one ear tests unilateral hearing but isn’t the primary voice test method. Whispering random words and checking repetition directly assesses hearing, so this is not the best action.

Choice C reason: Whispering random numbers, words, or letters at 1–2 feet and asking the patient to repeat them is the standard voice test for hearing. This method is effective, making it the correct choice.

Choice D reason: Shielding lips muffles sound unnecessarily and prevents lip-reading, which isn’t the goal. Clear whispering and repetition test auditory function, so this is incorrect for the voice test.

A. Appendix B. Spleen C. Gallbladder D. Spine

Correct Answer is A

Explanation

Choice A reason: Tenderness in the right lower quadrant on light palpation is a classic sign of appendicitis, as the appendix is located in this region. Inflammation causes localized peritoneal irritation, leading to pain, which may be accompanied by rebound tenderness or guarding, making this the correct structure.

Choice B reason: The spleen is located in the left upper quadrant, not the right lower quadrant. Tenderness in the right lower quadrant does not correspond to splenic pathology, such as splenomegaly or rupture, making this an incorrect structure for the described finding.

Choice C reason: The gallbladder is in the right upper quadrant, where tenderness might suggest cholecystitis. Right lower quadrant tenderness does not align with gallbladder pathology, as its anatomical location is distinct, making this an incorrect structure for the observed symptom.

Choice D reason: The spine is a midline structure, and tenderness in the right lower quadrant is unrelated to spinal pathology. Spinal issues typically cause back or radicular pain, not localized abdominal tenderness, making this an incorrect choice for the finding.

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A patient who is visiting the clinic complains of having stomach pains for 2 weeks and describes his stools as being soft and black for approximately the last 10 days. He denies taking any medications. How should the nurse interpret these symptoms?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

In performing a voice test to assess hearing, which of these actions would the nurse perform?

Correct Answer is C

Explanation

During an abdominal assessment, the nurse elicits tenderness on light palpation in the right lower quadrant. The nurse recognizes this finding could indicate a problem with what structure?

Correct Answer is A

Explanation

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