NURS5220 EXAM #2 STUDY
QUESTIONS AND ANSWERS
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?
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.
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
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.
D. It feels like a pencil eraser - 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 - 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. - 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 - 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 - 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 - 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.
QUESTIONS AND ANSWERS
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?
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.
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
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.
D. It feels like a pencil eraser - 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 - 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. - 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 - 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 - 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 - 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.
