NURS5220 Exam #2 2025
Questions and Correct Answers
Graded A+
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.
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.
Questions and Correct Answers
Graded A+
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.
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.
