Advanced Health Assessment NSG 625 Quiz 4
Updated Top Solution
Risk factors for prostate cancer - ✔✔✔ - Age!
Smoking
+FHx
Hormones
Dietary/environmental factors
Infectious agents
Rare in individuals under 40
Black population is at highest risk
Poor health literacy causes patient to be more likely to present with advanced stages
Most common position for rectal exam of male and female - ✔✔✔ - male commonly standing
Females commonly on supine in order to do recto-vaginal exam
Palpation of prostate gland - ✔✔✔ - size, shape, surface, consistency, mobility, sensitivity
Normal prostate feels like a hard rubber ball, smooth, and firm, heart shaped with apex
pointed to anus
Lubricate gloved finger and insert into anus
Finger should be inserted up to 4 inches
Palpate where the prostate lies which is the anterior wall of the rectum
Asymmetry is associated with cancer
BPH presents as symmetrical, enlarged, soft gland protruding into the rectal lumen
What to ask in sexual history - ✔✔✔ - sexual health
Risk and function
Are you sexually active in last year
,Sex with men women trans
How many partners in the past year
Have you maintained an interest in sex
Are you able to maintain an erection
Protection
hx of STDs
Trauma/violence
Pregnancy
Function and satisfaction
What type of sex do you engage in
Describe the process of palpation of the penis - ✔✔✔ - have the patient in the standing
position and put on gloves
Inspect the penis, scrotum, and perineum for skin changes (erythema, rash, lesions) along
with masses and swelling
Palpate the inguinal lymph nodes
Palpate the penis by retracting the foreskin if present and examine for abnormalities such as
adhesions, discharge, and lesions
Open the urethral meatus to check patency and then replace the foreskin
Describe the process of inspection and palpation of the scrotum and its contents - ✔✔✔ -
palpate the scrotum and testicles
Palpate each testicle individually
Use your thumb and index finger to gently palpate the entire testicle on each side
If unable to locate the testicle, palpate along the inguinal ligament for an undescended
testicle
Palpate the epididymis by palpating along the posterior aspect of the testicle
Check for the spermatic cord posteriorly
,Epididymitis - ✔✔✔ - inflammation of the epididymis that is frequently caused by the spread
of infection from the urethra or the bladder
Pain and tenderness when palpating the epididymis by palpating along the posterior aspect
of the testicle
Hematuria in a female patient - ✔✔✔ - 40 - 60 yo - UTI, kidney stone, bladder tumor
Older than 60 yo Bladder tumor, UTI
Hematuria in a male patient - ✔✔✔ - <20 yo: congenital urinary tract anomaly, acute
glomerulonephritis, UTI
20 - 60 yo: UTI, kidney stone, bladder tumor
>60 yo: prostatic disorder, bladder tumor, UTI
Stress incontinence - ✔✔✔ - the inability to control the voiding of urine under physical stress
such as running, sneezing, laughing, or coughing
Incontinence characterized by urine leakage resulting from increased intra-abdominal
pressure
Risk factors for stress incontinence - ✔✔✔ - Female
Age
Hysterectomy
Pelvic floor surgery or injury
Multiple vaginal births
Obesity
Urge incontinence - ✔✔✔ - state in which a person experiences involuntary passage of urine
that occurs soon after a strong sense of urgency to void
Detrusor muscles involuntarily contracting and creating need to void
Commonly seen in BPH
, Overflow incontinence - ✔✔✔ - involuntary loss of urine associated with overdistention and
overflow of the bladder
Strong outlet resistance. The outlet resistance leads to urinary retention and eventually the
pressure from the urine in the bladder exceeds the outflow resistance.
Commonly seen in BPH
How to assess hernia - ✔✔✔ - protrusion of abdominal viscera through a weak area of the
abdominal wall often seen as a bulge upon inspection
Palpate the inguinal ring by placing the index finger on the scrotum anterior to the testicle
and palpate up into the inguinal ring - ask the patient to cough and the hernia will feel like a
sudden impulse on the index finger
Inspection of a rectal exam - ✔✔✔ - have patient empty bladder and bowel
Use gloved right hand to examine anus and surrounding tissue while left gloved hand
spreads the buttocks - inspecting for hemorrhoids, fissures, inflammation, or nodules
Palpation of rectal exam - ✔✔✔ - lubricate right gloved index finger and explain procedure
Left hand spreads the buttocks, right index finger is placed on the anal verge, relaxing the
sphincter with the palmar surface of the finger
As the patient takes a deep breath the index finger is inserted into the anal canal as far as
possible
The examiner palpates for polyps, tenderness, or any other abnormalities
For males the prostate gland should also be palpated for abnormalities
Exam concludes with examiner withdrawing their finger
Leopold's Maneuvers - ✔✔✔ - A series of four maneuvers designed to provide a systematic
approach whereby the examiner may determine fetal presentation and position.
When is the Leopold manuever preformed - ✔✔✔ - 20 weeks of gestation until the baby is
term to find out important assessment info about the fetus
Updated Top Solution
Risk factors for prostate cancer - ✔✔✔ - Age!
Smoking
+FHx
Hormones
Dietary/environmental factors
Infectious agents
Rare in individuals under 40
Black population is at highest risk
Poor health literacy causes patient to be more likely to present with advanced stages
Most common position for rectal exam of male and female - ✔✔✔ - male commonly standing
Females commonly on supine in order to do recto-vaginal exam
Palpation of prostate gland - ✔✔✔ - size, shape, surface, consistency, mobility, sensitivity
Normal prostate feels like a hard rubber ball, smooth, and firm, heart shaped with apex
pointed to anus
Lubricate gloved finger and insert into anus
Finger should be inserted up to 4 inches
Palpate where the prostate lies which is the anterior wall of the rectum
Asymmetry is associated with cancer
BPH presents as symmetrical, enlarged, soft gland protruding into the rectal lumen
What to ask in sexual history - ✔✔✔ - sexual health
Risk and function
Are you sexually active in last year
,Sex with men women trans
How many partners in the past year
Have you maintained an interest in sex
Are you able to maintain an erection
Protection
hx of STDs
Trauma/violence
Pregnancy
Function and satisfaction
What type of sex do you engage in
Describe the process of palpation of the penis - ✔✔✔ - have the patient in the standing
position and put on gloves
Inspect the penis, scrotum, and perineum for skin changes (erythema, rash, lesions) along
with masses and swelling
Palpate the inguinal lymph nodes
Palpate the penis by retracting the foreskin if present and examine for abnormalities such as
adhesions, discharge, and lesions
Open the urethral meatus to check patency and then replace the foreskin
Describe the process of inspection and palpation of the scrotum and its contents - ✔✔✔ -
palpate the scrotum and testicles
Palpate each testicle individually
Use your thumb and index finger to gently palpate the entire testicle on each side
If unable to locate the testicle, palpate along the inguinal ligament for an undescended
testicle
Palpate the epididymis by palpating along the posterior aspect of the testicle
Check for the spermatic cord posteriorly
,Epididymitis - ✔✔✔ - inflammation of the epididymis that is frequently caused by the spread
of infection from the urethra or the bladder
Pain and tenderness when palpating the epididymis by palpating along the posterior aspect
of the testicle
Hematuria in a female patient - ✔✔✔ - 40 - 60 yo - UTI, kidney stone, bladder tumor
Older than 60 yo Bladder tumor, UTI
Hematuria in a male patient - ✔✔✔ - <20 yo: congenital urinary tract anomaly, acute
glomerulonephritis, UTI
20 - 60 yo: UTI, kidney stone, bladder tumor
>60 yo: prostatic disorder, bladder tumor, UTI
Stress incontinence - ✔✔✔ - the inability to control the voiding of urine under physical stress
such as running, sneezing, laughing, or coughing
Incontinence characterized by urine leakage resulting from increased intra-abdominal
pressure
Risk factors for stress incontinence - ✔✔✔ - Female
Age
Hysterectomy
Pelvic floor surgery or injury
Multiple vaginal births
Obesity
Urge incontinence - ✔✔✔ - state in which a person experiences involuntary passage of urine
that occurs soon after a strong sense of urgency to void
Detrusor muscles involuntarily contracting and creating need to void
Commonly seen in BPH
, Overflow incontinence - ✔✔✔ - involuntary loss of urine associated with overdistention and
overflow of the bladder
Strong outlet resistance. The outlet resistance leads to urinary retention and eventually the
pressure from the urine in the bladder exceeds the outflow resistance.
Commonly seen in BPH
How to assess hernia - ✔✔✔ - protrusion of abdominal viscera through a weak area of the
abdominal wall often seen as a bulge upon inspection
Palpate the inguinal ring by placing the index finger on the scrotum anterior to the testicle
and palpate up into the inguinal ring - ask the patient to cough and the hernia will feel like a
sudden impulse on the index finger
Inspection of a rectal exam - ✔✔✔ - have patient empty bladder and bowel
Use gloved right hand to examine anus and surrounding tissue while left gloved hand
spreads the buttocks - inspecting for hemorrhoids, fissures, inflammation, or nodules
Palpation of rectal exam - ✔✔✔ - lubricate right gloved index finger and explain procedure
Left hand spreads the buttocks, right index finger is placed on the anal verge, relaxing the
sphincter with the palmar surface of the finger
As the patient takes a deep breath the index finger is inserted into the anal canal as far as
possible
The examiner palpates for polyps, tenderness, or any other abnormalities
For males the prostate gland should also be palpated for abnormalities
Exam concludes with examiner withdrawing their finger
Leopold's Maneuvers - ✔✔✔ - A series of four maneuvers designed to provide a systematic
approach whereby the examiner may determine fetal presentation and position.
When is the Leopold manuever preformed - ✔✔✔ - 20 weeks of gestation until the baby is
term to find out important assessment info about the fetus
