Term melena means:

Appeared in: HP CHO -9 October 2022

Explanation

Melena is the medical term for black, tarry, and foul-smelling stools.
This condition is caused by digested blood, which indicates bleeding from an upper gastrointestinal (GI) source, such as the esophagus, stomach, or duodenum.
The characteristic black color results from the oxidation of the iron in hemoglobin by stomach acid and intestinal enzymes as it passes through the digestive tract.
As little as 50-100 mL of blood in the upper GI tract can cause melena.

Option B: This describes pyuria, which is the presence of pus or white blood cells in the urine.
Option C: This describes dysuria, which means painful or difficult urination.
Option D: This describes glycosuria (or glucosuria), which is the presence of glucose in the urine.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Definition of the medical term 'melena' and differentiation from other medical terms as background academic context rather than a clinical decision trigger.
Recognizing melena is a critical nursing skill as it signifies a potentially life-threatening upper GI bleed that requires prompt medical attention.
A nurse's priority upon discovering melena is to perform a rapid assessment of the patient's hemodynamic stability, including checking blood pressure and heart rate for signs of shock.
It is crucial to differentiate melena from black stools caused by iron supplements or certain foods (like bismuth or licorice). Melena is distinctively tarry and has a foul odor, whereas iron-induced stools are typically just black and formed.

How to Approach the Question

First, identify the keyword in the question stem, which is 'melena'.
Recall the definition of this medical term. The prefix 'melan-' refers to black or dark, which is a clue.
Systematically evaluate each option against your recalled definition.
Option A describes dark, bloody stool, which directly matches the definition of melena.
Options B, C, and D all relate to urination (pyuria, dysuria, glycosuria) and are therefore incorrect.
Confirm your choice by eliminating the options related to the urinary system, leaving only the correct option related to the gastrointestinal system.

Concept Tested & Keywords

Concept Tested: Definition of the medical term 'melena' and differentiation from other medical terms.
Stem keywords: melena, term
Lead-in keywords: means
Negative lead-in flag: false

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E6 Nursing Brunner Adult Health 3SA Vol 1 Part 2 p. 137-139

Lewis Medical Surgical Nursing p. 765-766

Practise the full HP CHO -9 October 2022

Attempt every question from this paper in a timed mock, then review the full solution for each one.