ANSWERS (100% CORRECT) | LATEST UPDATE EXAM
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?