Progressive Care Nursing Certification (PCCN) Practice Exam

Significant diarrhea lasting three days, coupled with foul-smelling stools and abdominal pain, may suggest which condition?

1. C. difficile

2. Pancreatitis

3. Upper gastrointestinal bleeding

4. Appendicitis

The correct answer is: C. difficile

The presence of significant diarrhea lasting several days, accompanied by foul-smelling stools and abdominal pain, is indicative of an infection with Clostridioides difficile, commonly known as C. difficile. This bacterium can proliferate in the gut, especially after the use of antibiotics, leading to symptoms such as watery diarrhea, abdominal cramping, and often a distinctive foul odor associated with the stools. The duration and nature of the diarrhea, in conjunction with the foul smell, point towards a disruption in normal gut flora and the presence of toxins produced by C. difficile, which cause the gastrointestinal symptoms. Additionally, the abdominal pain often results from the inflammation and irritation of the intestinal lining during an active infection. In contrast, conditions like pancreatitis may produce abdominal pain but are less commonly associated with the characteristic foul-smelling diarrhea. Upper gastrointestinal bleeding typically leads to different stool characteristics, such as dark, tarry stools (melena), rather than foul-smelling liquid diarrhea. Appendicitis usually presents with localized pain and may lead to diarrhea, but the primary symptom is abdominal pain, often accompanied by nausea and vomiting, without the typical foul-smell association. Therefore, the clinical presentation aligns most closely with a C. difficile infection.