Deck 26: Anus, Rectum, and Prostate

Question 1

Which statement concerning the anal canal is true?

A) Slants backward toward the sacrum
B) Contains hair and sebaceous glands
C) Approximately 2 cm long in the adult
D) The outlet for the gastrointestinal tract

Answer 1

The outlet for the gastrointestinal tract

Question 2

The nurse is performing an examination of the anus and rectum. Which of these statements is correct and important to remember during this examination?

A) The rectum is approximately 8 cm long.
B) The anorectal junction cannot be palpated.
C) Above the anal canal, the rectum turns anteriorly.
D) There are no sensory nerves in the anal canal or rectum.

Answer 2

The anorectal junction cannot be palpated.

Question 3

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

Answer 3

Hemorrhoids

Question 4

What structure secretes a thin, milky alkaline fluid to enhance the viability of sperm?

A) Cowper gland
B) Median sulcus
C) Prostate gland
D) Bulbourethral gland

Question 5

The nurse is preparing to palpate the rectum and should use which of these techniques?

A) Flex the finger, and slowly insert it toward the umbilicus.
B) Insert an extended index finger at a right angle to the anus.
C) First instruct the patient that this procedure will be painful.
D) Place the finger directly into the anus to overcome the tight sphincter.

Question 6

The nurse is caring for a newborn infant. Thirty hours after birth, the infant passes a dark green meconium stool. What is the importance of this finding?

A) The stool indicates anal patency.
B) The dark green color indicates occult blood in the stool.
C) Meconium stool can be reflective of distress in the newborn.
D) The newborn should have passed the first stool within 12 hours of birth.

Question 7

During an assessment of a 20-year-old man, the nurse finds a small palpable lesion with a tuft of hair located directly over the coccyx. What does this finding indicate?

A) Carcinoma
B) Rectal polyp
C) Pruritus ani
D) Pilonidal cyst

Question 8

During the assessment of an 18-month-old infant, the mother expresses concern to the nurse about the infant's inability to toilet train. What would be the best response by the nurse?

A) "Some children are just more difficult to train, so I wouldn't worry about it yet."
B) "Have you considered reading any of the books on toilet training? They can be very helpful."
C) "This could mean that there is a problem with your baby's development. We'll watch her closely for the next few months."
D) "The nerves that allow your baby to have control over the passing of stools are not developed until at least 18 to 24 months of age."

Question 9

The mother of a 5-year-old girl tells the nurse that she has noticed her daughter "scratching at her bottom a lot the last few days." During the assessment, the nurse finds redness and raised skin in the anal area. What does this finding likely indicate?

A) Pinworms
B) Chickenpox
C) Constipation
D) Bacterial infection

Question 10

A patient who is visiting the clinic reports having "stomach pains for 2 weeks" and describes his stools as being "soft and black" for approximately the last 10 days. He denies taking any medications. What do these symptoms suggest?

A) Excessive fat caused by malabsorption
B) Absent bile pigment from liver problems
C) Increased iron intake, resulting from a change in diet
D) Occult blood, resulting from gastrointestinal bleeding

Question 11

The nurse is examining only the rectal area of a woman and should place the woman in what position?

A) Prone
B) Lithotomy
C) Left lateral decubitus
D) Bending over the table while standing

Question 12

Which statement concerning the sphincters is correct?

A) The internal sphincter is under voluntary control.
B) The external sphincter is under voluntary control.
C) Both sphincters remain slightly relaxed at all times.
D) The internal sphincter surrounds the external sphincter.

Question 13

While performing an assessment of the perianal area of a patient, the nurse notices that the pigmentation of the anus is darker than the surrounding skin, the anal opening is closed, and a skin sac that is shiny and blue is noted. The patient mentioned that he has had pain with bowel movements and has occasionally noted some spots of blood. What does this assessment and history most likely indicate?

A) Anal fistula
B) Pilonidal cyst
C) Rectal prolapse
D) Thrombosed hemorrhoid

Question 14

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 and 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."

Question 15

After completing an assessment of a 60-year-old white male with a family history of colon cancer, the nurse discusses with him early detection measures for colon cancer. What should the nurse include in the instructions?

A) Annual proctoscopy
B) Annual PSA blood test
C) Colonoscopy every 10 years
D) Fecal occult blood test every 6 months

Question 16

While performing a rectal examination, the nurse notices a firm, irregularly shaped mass. What should the nurse do next?

A) Continue with the examination, and document the finding in the chart.
B) Instruct the patient to return for a repeat assessment in 1 month.
C) Tell the patient that a mass was felt, but it is nothing to worry about.
D) Report the finding, and refer the patient to a specialist for further examination.

Question 17

A 70-year-old man is visiting the clinic for difficulty in passing urine. In the health history, he indicates that he has to urinate frequently, especially at night. He has burning when he urinates and has noticed pain in his back. Considering this history, what might the nurse expect to find during the physical assessment?

A) Asymmetric, hard, and fixed prostate gland
B) Occult blood and perianal pain to palpation
C) Symmetrically enlarged, soft prostate gland
D) Soft nodule protruding from the rectal mucosa

Question 18

A 46-year-old man requires an assessment of his sigmoid colon. Which instrument or technique is most appropriate for this examination?

A) Ultrasound
B) Proctoscope
C) Colonoscope
D) Rectal examination with an examining finger

Question 19

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?

A) Valsalva maneuver
B) Testing for occult blood
C) Internal palpation of the anus
D) Inspection of the perianal area

Question 20

During an assessment of the newborn, the nurse expects to see which finding when the anal area is slightly stroked?

A) Jerking of the legs
B) Flexion of the knees
C) Quick contraction of the sphincter
D) Relaxation of the external sphincter

Question 21

The nurse notices that a patient has had a pale, yellow, greasy stool, or steatorrhea. What is the cause of this finding?

A) Occult bleeding
B) Absent bile pigment
C) Increased fat content
D) Ingestion of bismuth preparations

Question 22

A 62-year-old man is experiencing fever, chills, malaise, urinary frequency, and urgency. He also reports urethral discharge and a dull aching pain in the perineal and rectal area. These symptoms are most consistent with which condition?

A) BPH
B) Polyps
C) Prostatitis
D) Carcinoma of the prostate

Question 23

The nurse is performing a digital examination of a patient's prostate gland and notices that a normal prostate gland includes which of the following characteristics? (Select all that apply.)

A) Fixed mobility
B) Boggy with a soft consistency
C) 1 cm protrusion into the rectum
D) Flat shape with no palpable groove
E) Heart-shaped with a palpable central groove
F) Smooth surface, elastic, and rubbery consistency

Question 24

During the health history of a patient who reports chronic constipation, the patient asks the nurse about foods to eat to avoid constipation. What should the nurse include as an example of an appropriate food?

A) Yogurt
B) Broccoli
C) Ground beef
D) Iceberg lettuce

Question 25

While palpating the prostate gland through the rectum, which finding would the nurse recognize as abnormal?

A) Heart shaped
B) Palpable central groove
C) Tenderness to palpation
D) Elastic and rubbery consistency

Question 26

A 40-year-old black man is in the office for his annual physical examination. Which statement regarding the PSA blood test is true?

A) Should be performed at age 50 years.
B) Should be performed with this visit.
C) Should be performed at age 45 years.
D) Is only necessary if a family history of prostate cancer exists.

Question 27

During a digital examination of the rectum, the nurse notices that the patient has hard feces in the rectum. The patient complains of feeling "full," has a distended abdomen, and states that she has not had a bowel movement "for several days." The nurse suspects which condition?

A) Rectal polyp
B) Rectal abscess
C) Fecal impaction
D) Fecal incontinence

Question 28

As the nurse is taking the health history, the patient states, "It really hurts back there, and sometimes it itches, too. I have even seen blood on the tissue when I have a bowel movement. Is there something there?" The nurse should expect to see which of these upon examination of the anus?

A) Rectal prolapse
B) Internal hemorrhoid
C) External hemorrhoid that has resolved
D) External hemorrhoid that is thrombosed

Question 29

During a group discussion on men's health, what group should the nurse inform them has the highest incidence of prostate cancer?

A) Blacks
B) Hispanics
C) Asian Americans
D) American Indians

Question 30

While assessing a hospitalized patient who is jaundiced, the nurse notices that the patient has been incontinent of stool. The stool is loose and gray-tan in color. What does this finding indicate?

A) Occult blood
B) Inflammation
C) Absent bile pigment
D) Ingestion of iron preparations