Solutions
A 13-year-old girl is visiting the clinic for a sports physical
examination. The nurse should remember to include which of
these tests in the examination?
Testing for occult blood
Valsalva maneuver
Internal palpation of the anus
Inspection of the perianal area Correct Answers D
"Inspect the perianal region of the school-age child and
adolescent during examination of the genitalia."....but there's no
reason given?
(Text, pg 728)
A 14-year-old girl is anxious about not having reached
menarche. When taking the health history, the nurse should
ascertain which of the following? The age that:
The girl began to develop breasts.
Her mother developed breasts.
She began to develop pubic hair.
She began to develop axillary hair. Correct Answers A
"The beginning of breast development precedes menarche
(beginning of menstruation) by about 2 years. Menarche occurs
in breast development stage 3 or 4, usually just after the peak of
the adolescent growth spurt around 12 years of age. This helps
to assess the development of adolescent girls and increases their
knowledge about their own development."
(Text, pg 388)
,A 30-year-old woman is visiting the clinic because of "pain in
my bottom when I have a bowel movement." The nurse should
assess for which problem?
A. Pinworms
B. Hemorrhoids
C. Colon cancer
D. Fecal incontinence Correct Answers B
"These painless, flabby papules are caused by a varicose vein.
An external hemorrhoid starts below the anorectal junction and
is covered by anal skin. When thrombosed, it contains clotted
blood and becomes a painful, swollen, shiny blue mass that
itches and bleeds with defecation. When it resolves, it leaves a
painless, flabby skin sac around the anal orifice."
(Text, pg 732)
A 40-year-old black man is in the office for his annual physical
examination. Which statement regarding the PSA blood test is
true, according to the American Cancer Society? The PSA:
Should be performed with this visit.
Should be performed at age 45 years.
Should be performed at age 50 years.
Is only necessary if a family history of prostate cancer exists.
Correct Answers B
"Men at average risk for PC should receive health information
about benefits and risks of PC tests at 50 years; at higher risk
(African American and positive family history) at 45 years; and
at very high risk (multiple family members with PC) at 40 years.
Screening includes the blood test for prostate-specific antigen
(PSA) and a physical examination (i.e., a digital rectal
examination [DRE]).14"
(Text, pg 723)
, A 46-year-old man requires an assessment of his sigmoid colon.
Which instrument or technique is most appropriate for this
examination?
A. Proctoscope
B. Ultrasound
C. Colonoscope
D. Rectal examination with an examining finger Correct
Answers C
"The sigmoid colon is named from its S-shaped course in the
pelvic cavity. It extends from the iliac flexure of the descending
colon and ends at the rectum. It is 40 cm long and is accessible
to examination only through the colonoscope. The flexible
fiberoptic scope in current use provides a view of the entire
mucosal surface of the sigmoid and the colon."
(Text, pg 722)
A 60-year-old man has just been told that he has benign
prostatic hypertrophy (BPH). He has a friend who just died from
cancer of the prostate. He is concerned this will happen to him.
How should the nurse respond?
A. "The swelling in your prostate is only temporary and will go
away."
B. "We will treat you with chemotherapy so we can control the
cancer."
C. "It would be very unusual for a man your age to have cancer
of the prostate."
D. "The enlargement of your prostate is caused by hormonal
changes, and not cancer." Correct Answers D
"...It is thought that the hypertrophy is caused by hormonal
imbalance that leads to the proliferation of benign adenomas.