A nurse is collecting data from a patient who has gastroesophageal reflux disease (GERD) and reports experiencing heartburn every night.
Which of the following actions should the nurse identify as a contributing factor to the patient’s heartburn?

Choice A rationale
A 56-year-old who had a colonoscopy 6 years ago does not necessarily need a colonoscopy unless there are other risk factors present.
Choice B rationale
A 45-year-old who has Clostridium difficile does not necessarily need a colonoscopy unless there are other risk factors present.

Choice C rationale
A 32-year-old who has a sister who died of colon cancer is at a higher risk for developing colon cancer and should therefore be scheduled for a colonoscopy.
Choice D rationale
A 34-year-old who reports a new onset of constipation does not necessarily need a colonoscopy unless there are other risk factors present.

Choice A rationale
Jaundice, a common symptom of cholecystitis, is a yellow discoloration of the skin and whites of the eyes (sclera) caused by an excess of bilirubin in the blood. The sclera is often the first place where jaundice is noticeable because the high amount of elastin in the sclera binds to bilirubin, causing a yellowish discoloration.
Choice B rationale
While nail beds can sometimes show signs of certain health issues, they are not typically used to monitor for the presence of jaundice. Jaundice primarily causes yellowing of the skin and the whites of the eyes.
Choice C rationale
The periumbilical area (around the belly button) is not typically used to monitor for the presence of jaundice. Jaundice primarily causes yellowing of the skin and the whites of the eyes.
Choice D rationale

The webbed areas of the fingers are not typically used to monitor for the presence of jaundice. Jaundice primarily causes yellowing of the skin and the whites of the eyes.