What is one of the first assessments that a nurse should include when performing an initial nutritional screening on a new patient?

Choice A reason: Simultaneously palpating both carotid arteries is dangerous, risking reduced cerebral blood flow, especially in cardiovascular patients. Using the bell to listen for bruits is safer, so this is incorrect.

Choice B reason: Deep breaths are for lung auscultation, not carotid, where patients hold breath to reduce noise. The bell detects low-pitched bruits, so instructing deep breaths is incorrect for carotid assessment.

Choice C reason: Compressing the carotid artery risks reducing blood flow or dislodging plaques, which is unsafe. Listening with the bell for bruits is the standard method, so this is incorrect.

Choice D reason: Listening with the bell of the stethoscope detects low-frequency bruits, indicating carotid artery narrowing, which is critical in cardiovascular disease. This is the correct technique for safe assessment.

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.