Wilkes University NSG 500 Advanced Health Assessment Exam 3
(pdf) | 2026/2027 | Q&A | Health Assessment
1. A nurse is preparing to perform a digital rectal examination to assess the
prostate. Which position is best for this examination?
A) Supine with legs extended
B) Lithotomy position
C) Side-lying with hips and knees flexed
D) Prone
Correct Answer: Side-lying with hips and knees flexed
Rationale: The best position for a prostate exam is side-lying with hips and
knees flexed. Positioning the patient in a side-lying posture with hips and
knees flexed allows for optimal access to the rectal area, facilitating a
smoother examination of the prostate. This positioning can help relax the
pelvic muscles and reduce discomfort during the exam, resulting in a more
reliable assessment.
2. A nurse is palpating a normal prostate gland during a digital rectal
examination. Which description best characterizes the normal prostate?
A) Hard, irregular, and fixed
B) Rubbery, smooth, and round
C) Soft, boggy, and tender
D) Firm, nodular, and asymmetric
Correct Answer: Rubbery, smooth, and round
Rationale: A normal prostate typically feels rubbery, smooth, and round. The
prostate gland should be palpably smooth and firm yet elastic to the touch.
Any irregularities in texture, such as hardness or nodularity, might indicate
,pathological conditions, including benign prostatic hyperplasia or prostate
cancer.
3. A nurse is assessing an older adult male patient. How does the texture of
the prostate typically change with aging?
A) It becomes harder and more nodular
B) It becomes more rubbery
C) It becomes smaller and atrophied
D) It remains unchanged throughout life
Correct Answer: It becomes more rubbery
Rationale: As a man ages, the prostate may feel more rubbery. Aging often
leads to changes in prostate tissue composition, resulting in a rubberier and
softer consistency rather than the firm texture often felt in younger men.
Increased gland size and changes in firmness are normal age-related findings
during examinations.
4. A nurse is performing a rectal examination and notes external
hemorrhoids. Where are external hemorrhoids located?
A) Above the dentate line
B) Below the dentate line
C) Within the anal canal
D) Outside the anal sphincter
Correct Answer: Below the dentate line
Rationale: External hemorrhoids are located below the dentate line. These
hemorrhoids often become thrombosed, resulting in severe pain, and are
,more noticeable externally. They typically appear as perianal swelling and
can cause significant discomfort.
5. A patient reports bright red blood in the stool. The nurse suspects a lower
gastrointestinal bleed. Which condition is a common cause of bright red
rectal bleeding?
A) Peptic ulcer disease
B) Esophageal varices
C) Hemorrhoids
D) Gastritis
Correct Answer: Hemorrhoids
Rationale: Bright red blood in the stool is characteristic of lower
gastrointestinal bleeding, which can be caused by hemorrhoids, anal fissures,
colorectal cancer, or diverticulitis. Hemorrhoids are a common cause of
bright red rectal bleeding. Upper GI bleeding typically presents with dark,
tarry stools (melena).
6. A nurse is assessing a patient with rectal bleeding. Which of the following
is a potential cause of rectal bleeding? (Select all that apply.)
A) Colorectal cancer
B) Hemorrhoids
C) Constipation and straining
D) NSAID use
Correct Answer: A, B, C, D
Rationale: Causes of rectal bleeding include colorectal cancer (which may
present with change in bowel habits, pain, and blood in stool), hemorrhoids,
, constipation/straining, colitis/inflammation or infection of the bowel, anal
fissures, GI bleed, NSAIDs and aspirin use (NOT TYLENOL), and Crohn's
disease.
7. A nurse is assessing a patient with suspected rectal prolapse. Which
finding is characteristic of rectal prolapse?
A) Bright red bleeding from the anus
B) Sliding of the rectum during straining
C) A hard, fixed mass on rectal examination
D) Painful perianal swelling
Correct Answer: Sliding of the rectum during straining
Rationale: Rectal prolapse is characterized by sliding of the rectum, which
occurs during straining. The patient may report a sensation of something
protruding from the anus, especially during bowel movements or with
increased intra-abdominal pressure.
8. A nurse is assessing external hemorrhoids. Which appearance is most
concerning and may indicate a thrombosed hemorrhoid?
A) Pink, beefy small masses
B) Small, pale, skin-colored tags
C) Purple or very dark in color
D) Soft, compressible swellings
Correct Answer: Purple or very dark in color
Rationale: External hemorrhoids typically appear as small masses that are
pink/red and beefy. If the hemorrhoid is purple or very dark in color, this is a
(pdf) | 2026/2027 | Q&A | Health Assessment
1. A nurse is preparing to perform a digital rectal examination to assess the
prostate. Which position is best for this examination?
A) Supine with legs extended
B) Lithotomy position
C) Side-lying with hips and knees flexed
D) Prone
Correct Answer: Side-lying with hips and knees flexed
Rationale: The best position for a prostate exam is side-lying with hips and
knees flexed. Positioning the patient in a side-lying posture with hips and
knees flexed allows for optimal access to the rectal area, facilitating a
smoother examination of the prostate. This positioning can help relax the
pelvic muscles and reduce discomfort during the exam, resulting in a more
reliable assessment.
2. A nurse is palpating a normal prostate gland during a digital rectal
examination. Which description best characterizes the normal prostate?
A) Hard, irregular, and fixed
B) Rubbery, smooth, and round
C) Soft, boggy, and tender
D) Firm, nodular, and asymmetric
Correct Answer: Rubbery, smooth, and round
Rationale: A normal prostate typically feels rubbery, smooth, and round. The
prostate gland should be palpably smooth and firm yet elastic to the touch.
Any irregularities in texture, such as hardness or nodularity, might indicate
,pathological conditions, including benign prostatic hyperplasia or prostate
cancer.
3. A nurse is assessing an older adult male patient. How does the texture of
the prostate typically change with aging?
A) It becomes harder and more nodular
B) It becomes more rubbery
C) It becomes smaller and atrophied
D) It remains unchanged throughout life
Correct Answer: It becomes more rubbery
Rationale: As a man ages, the prostate may feel more rubbery. Aging often
leads to changes in prostate tissue composition, resulting in a rubberier and
softer consistency rather than the firm texture often felt in younger men.
Increased gland size and changes in firmness are normal age-related findings
during examinations.
4. A nurse is performing a rectal examination and notes external
hemorrhoids. Where are external hemorrhoids located?
A) Above the dentate line
B) Below the dentate line
C) Within the anal canal
D) Outside the anal sphincter
Correct Answer: Below the dentate line
Rationale: External hemorrhoids are located below the dentate line. These
hemorrhoids often become thrombosed, resulting in severe pain, and are
,more noticeable externally. They typically appear as perianal swelling and
can cause significant discomfort.
5. A patient reports bright red blood in the stool. The nurse suspects a lower
gastrointestinal bleed. Which condition is a common cause of bright red
rectal bleeding?
A) Peptic ulcer disease
B) Esophageal varices
C) Hemorrhoids
D) Gastritis
Correct Answer: Hemorrhoids
Rationale: Bright red blood in the stool is characteristic of lower
gastrointestinal bleeding, which can be caused by hemorrhoids, anal fissures,
colorectal cancer, or diverticulitis. Hemorrhoids are a common cause of
bright red rectal bleeding. Upper GI bleeding typically presents with dark,
tarry stools (melena).
6. A nurse is assessing a patient with rectal bleeding. Which of the following
is a potential cause of rectal bleeding? (Select all that apply.)
A) Colorectal cancer
B) Hemorrhoids
C) Constipation and straining
D) NSAID use
Correct Answer: A, B, C, D
Rationale: Causes of rectal bleeding include colorectal cancer (which may
present with change in bowel habits, pain, and blood in stool), hemorrhoids,
, constipation/straining, colitis/inflammation or infection of the bowel, anal
fissures, GI bleed, NSAIDs and aspirin use (NOT TYLENOL), and Crohn's
disease.
7. A nurse is assessing a patient with suspected rectal prolapse. Which
finding is characteristic of rectal prolapse?
A) Bright red bleeding from the anus
B) Sliding of the rectum during straining
C) A hard, fixed mass on rectal examination
D) Painful perianal swelling
Correct Answer: Sliding of the rectum during straining
Rationale: Rectal prolapse is characterized by sliding of the rectum, which
occurs during straining. The patient may report a sensation of something
protruding from the anus, especially during bowel movements or with
increased intra-abdominal pressure.
8. A nurse is assessing external hemorrhoids. Which appearance is most
concerning and may indicate a thrombosed hemorrhoid?
A) Pink, beefy small masses
B) Small, pale, skin-colored tags
C) Purple or very dark in color
D) Soft, compressible swellings
Correct Answer: Purple or very dark in color
Rationale: External hemorrhoids typically appear as small masses that are
pink/red and beefy. If the hemorrhoid is purple or very dark in color, this is a
