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Mr. Tucker is a 56-year-old patient who presents to your office with a complaint of
rectal pain. On examination you are palpating the lateral and posterior rectal walls.
What should you expect to feel?
A. A smooth, even, and uninterrupted surface
B. Small nodules from internal hemorrhoids
C. Tissue folds from the valves of Houston
D. Bulging from the bladder wall - 🧠 ANSWER ✔✔A: CorrectThe walls should
feel smooth, even, and uninterrupted.
Mr. Yates is a 62-year-old patient who presents with a chief complaint of rectal
pain. The examiner will focus the history and examination on which known fact?
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,A. Rectal pain is almost always accompanied by an infection.
B. Rectal pain is almost always an indication of local disease.
C. A complaint of rectal pain is usually associated with a serious systemic process.
D. One of the most common causes of rectal pain is prostatic enlargement. - 🧠
ANSWER ✔✔B: CorrectRectal pain is almost always indicative of a local disease.
Mr. Bower is a 78-year-old patient who is unable to assume a standing position for
a routine rectal examination. Which is the best alternative position?
A. Lithotomy position
B. Left lateral position with the knees flexed
C. Knee-chest position
D. Prone position - 🧠 ANSWER ✔✔B: CorrectThe rectal examination can be
performed with the patient in any of these positions: knee-chest; left lateral with
hips and knees flexed; lithotomy, or standing with the hips flexed and the upper
body supported by the examining table.
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,A pregnant woman presents to the emergency department with the complaint of
dark stools. She tells the examiner, "I read in a magazine that this is a sign of
bleeding." Which question by the examiner is most applicable for this situation?
A. "Where did you read that information?"
B. "Have you been giving yourself enemas?"
C. "How much fruit and vegetable intake have you had in the last few days?"
D. "Are you taking prenatal vitamins?" - 🧠 ANSWER ✔✔D: CorrectDuring
pregnancy, the stool color may be dark green or black if the woman is taking iron
supplements.
Mr. Allen is a 56-year-old patient who presents for a routine physical examination.
Before palpating his prostate, you should tell him, "You may feel an urge to
_______."
A. urinate
B. defecate
C. vomit
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, D. faint - 🧠 ANSWER ✔✔A: CorrectIn men, you can palpate the posterior surface
of the prostate gland on the anterior wall. Tell the patient that he may feel the urge
to urinate but that he will not.
How is the anal ring assessed?
A. Inspection of the anus
B. External palpation of the anus
C. Use of a sigmoidoscope
D. Rotation of a finger within the anal sphincter - 🧠 ANSWER ✔✔D:
CorrectRotate your finger to examine the muscular anal ring.
Which example best describes how firm you expect a healthy prostate gland to
feel?
A. It feels like a soft olive or grape.
B. It feels like the topside of a plastic LEGO piece.
C. It feels like a small baseball.
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