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: Homan sign tests for deep vein thrombosis, not balance. Swaying with eyes closed indicates a positive Romberg sign, so this is incorrect for the documented finding.

Choice B reason: Lack of coordination is vague and not specific to the Romberg test, which assesses proprioception. Positive Romberg sign describes the sway, so this is incorrect for documentation.

Choice C reason: A positive Romberg sign is documented when a patient sways or loses balance with eyes closed, indicating proprioceptive or cerebellar issues. This is the correct term for the finding.

Choice D reason: Ataxia describes general movement, not the specific Romberg test outcome. Swaying in this context is a Romberg sign, so this is incorrect for the nurse’s documentation.

A. A 15-year-old female soccer player with a broken leg B. A 4-month-old with bruises on the arms C. An 8-year-old gymnast with a broken right arm D. A 2-year-old with bruises on the knees

Correct Answer is B

Explanation

Choice A reason: A 15-year-old soccer player with a broken leg likely sustained the injury during sports, a common occurrence. Bruises on a 4-month-old’s arms are more concerning, as infants are non-mobile and less likely to bruise accidentally, suggesting possible abuse.

Choice B reason: Bruises on a 4-month-old’s arms are highly concerning, as infants this age are not mobile and cannot self-injure. Such bruising may indicate non-accidental trauma or abuse, requiring immediate investigation, making this the most concerning patient for possible abuse.

Choice C reason: An 8-year-old gymnast with a broken arm may have been injured during gymnastics, a plausible accident. A 4-month-old with arm bruises is more alarming, as infants are less likely to bruise without external force, so this is less concerning.

Choice D reason: A 2-year-old with knee bruises is typical from active play or falls while learning to walk. Bruises on a non-mobile 4-month-old’s arms are more suspicious for abuse, making this less concerning than the infant’s situation.

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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

When the nurse asks an older patient to stand with feet together and arms at his side with his eyes closed, he starts to sway and moves his feet farther apart. How should the nurse document this finding?

Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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