CORRECT ANSWERS WITH RATIONALES (ALREADY GRADED A+) |
LATEST EXAM | VERIFIED ANSWERS ( 3 LATEST BEST VERSIONS)
Version 1
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 - correct 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?
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. - correct 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 - correct 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.
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?" - correct 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
D. faint - correct 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 - correct 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.
D. It feels like a pencil eraser - correct answer D: . CorrectThe gland should feel like a pencil
eraser—firm, smooth, and slightly movable—and it should be nontender.
What is the best method of verifying anal patency in a newborn?
A. Inserting a lubricated thermometer through the anus and into the rectum
B. Inserting the fifth digit through the anus and into the rectum
C. Checking for the passage of meconium in the first 24 to 48 hours after birth
D. Inspecting the anus for an anal opening - correct answer C: CorrectIf there is no passage of
stool in 24 hours in a newborn, suspect rectal atresia, Hirschsprung disease (congenital
megacolon), or cystic fibrosis.
Mr. Santos is a 67-year-old patient who presents to your office. On examination, you palpate
his prostate, noting that it is hard and irregular. The median sulcus is not palpable. These
findings are consistent with:
A. prostate cancer.
B. benign prostate hypertrophy.
C. prostatitis.
D. a rectal mass. - correct answer A: CorrectWith cancer of the prostate, a hard, irregular
nodule may be palpable on prostate examination.
Mr. Mills, a 38-year-old patient, presents with severe rectal pain and fever. Which condition
might be the cause of the symptoms?
A. An imperforate anus
, B. A perianal abscess
C. Benign prostatic hypertrophy
D. An anorectal fistula - correct answer B: CorrectPerianal abscess is an infection of the soft
tissues surrounding the anal canal, with formation of a discrete abscess cavity. Symptoms
include tenderness, fever, and pain on defecation or with sitting or walking.
"Boggy, enlarged, and tender" on rectal examination is descriptive of which condition?
A. Prostatitis
B. Anorectal abscess
C. Prostatic carcinoma
D. Rectal polyp - correct answer A: CorrectSeminal vesicles are often involved in prostatitis and
may be dilated and tender on palpation; however, the prostate may feel boggy, enlarged, and
tender or have palpable areas of fibrosis that simulate neoplasm.
A newborn does not pass meconium in the first 24 hours after birth. Which problem must be
suspected?
A. Biliary atresia
B. Cystic fibrosis
C. Meckel diverticulum
D. Spinal bifida - correct answer B: CorrectIf there is no passage of stool in 24 hours in a
newborn, suspect rectal atresia, Hirschsprung disease (congenital megacolon), or cystic fibrosis.
Enlargement of the prostate may cause:
A. urinary retention.
B. a forceful urinary stream.
C. infertility.
D. prostate cancer. - correct answer A: CorrectSymptoms of an enlarged prostate relate to
urinary obstruction: hesitancy, decreased force and caliber of stream, dribbling, incomplete
emptying of the bladder, frequency, urgency, nocturia, and dysuria.
The primary function of the rectum is: