Deck 18: Assessing the Anus and Rectum

Question 1

The rectum is the lower part of the sigmoid colon that contains which of the following vasculature? Select all that apply.

A) Arteries
B) Lymph nodes
C) Veins
D) Visceral nerves
E) Hemorrhoids
F) Sweat glands

Answer 1

Arteries
Veins
Hemorrhoids

Question 2

You are performing a focused health history on a patient's pattern of bowel elimination. Which of the following questions would you ask? Select all that apply.

A) What is your normal bowel movement pattern?
B) Do you feel bloated?
C) Have you noticed any change in the size and diameter of your stools?
D) Are you constipated?
E) Do you have any diarrhea?
F) Do you have irritable bowel syndrome?

Answer 2

What is your normal bowel movement pattern?
Have you noticed any change in the size and diameter of your stools?
Are you constipated?
Do you have any diarrhea?

Question 3

The ROME III Diagnostic Criteria for Functional Constipation must include which two or more of the following? Select all that apply.

A) Straining while having a bowel movement
B) Bouts of diarrhea
C) Hard or lumpy stools
D) Sensation of incomplete evacuation
E) Manual removal of stool from the rectum
F) Fewer than five bowel movements per week

Answer 3

Straining while having a bowel movement
Hard or lumpy stools
Sensation of incomplete evacuation
Manual removal of stool from the rectum

Question 4

You are about to inspect the anus. How would the male patient be positioned? Select all that apply.

A) Fowler's
B) Supine
C) Prone
D) Side-lying
E) Lithotomy

Question 5

You are about to inspect the anus of a patient complaining of soreness in the rectal area. Which supplies are needed to perform an inspection? Select all that apply.

A) Gown
B) Gloves
C) Mask
D) Shoe covers
E) Water-soluble lubricant

Question 6

You are inspecting the anus and perianal area. Which of the following are normal findings? Select all that apply.

A) Anus is tightly closed.
B) Skin is moist and darkly pigmented.
C) Erythema and tenderness are present.
D) No lesions or ulcerations are present.
E) Small, dilated protrusions are present.

Question 7

You are going to be performing a digital rectal examination. Identify the positions that the patient can choose to be in for this assessment. Select all that apply.

A) Lateral decubitus
B) Prone
C) Lithotomy
D) Standing, bending over, and holding onto the examining table
E) Standing, putting the hands on the knees, and bending over

Question 8

You are performing a digital rectal examination and assessing the prostate gland. What will you assess for? Select all that apply.

A) Shape
B) Size
C) Smoothness
D) Lumps
E) Tenderness

Question 9

What helps to propel waste materials from the rectum into the anal canal?

A) Intraabdominal pressure
B) Transverse folds
C) Sympathetic nerves
D) Pressure of fecal waste products

Question 10

The main function of the glands in the anal canal is to:

A) Lubricate the anal canal.
B) Provide blood supply to the rectum.
C) Allow the anal tissue to contract.
D) Allow nerve impulses to travel to the rectum.

Question 11

Which culture has the highest rates of colorectal cancer?

A) Caucasian
B) Asian
C) Chinese
D) African American

Question 12

During a health history, a 48-year-old woman reports that she has been noticing that her stools look like "pencils." What should be your next question?

A) "Do you think that you are constipated and need a laxative?"
B) "Have you ever had a bowel disease or a bowel obstruction?"
C) "I do not understand what you mean by 'look like pencils.' Can you explain?"
D) "Tell me the amount of fluids you drink and types of foods that you eat."

Question 13

You are caring for a patient who has been on intravenous antibiotic therapy for 7 days. He has now developed watery, nonbloody, foul-smelling diarrhea. You suspect the organism causing this diarrhea is:

A) Staphylococcus.
B) Streptococcus.
C) Clostridium difficile.
D) A virus.

Question 14

A patient comes to the urgent care center stating that today he noticed bright red blood in his stool. He denies abdominal pain, nausea, or vomiting. He states that he had a similar episode that occurred last week. Bright red blood usually indicates:

A) Upper gastrointestinal bleeding.
B) Bleeding low in the colon or rectum.
C) Bleeding higher in the colon.
D) Bleeding caused by digestion of blood.

Question 15

You are performing a focused history on a patient who is complaining of rectal pain and itching. He reports small amounts of blood on the toilet paper after having a bowel movement. You inspect the anal area and note a large, red, soft protrusion next to the anus. This is called a(n):

A) Internal hemorrhoid.
B) External hemorrhoid.
C) Rectal polyp.
D) Anal fistula.

Question 16

The patient reports that he has not had a bowel movement in 7 days. He has had several doses of a laxative without any results. The nurse is going to assess for fecal impaction by performing a digital rectal examination. What instruction should the nurse give to the patient prior to the assessment?

A) "Drink 8 ounces of water in the next hour to help soften the stool."
B) "Tell me if you are feeling any discomfort or pain."
C) "You cannot move at all during this assessment or serious injury will occur."
D) "Hold your breath and push as I insert my finger in your rectum."

Question 17

You are performing a digital rectal assessment and want to assess the anal sphincter muscle tone. As you are gently inserting your finger into the rectum, what instructions will you give to the patient?

A) "Push against my finger."
B) "Take a deep breath in."
C) "Hold your breath and push."
D) "Relax and breathe in and out."

Question 18

The health-care provider reviewed a patient's recent blood work and noted the patient to be anemic. A fecal occult blood test (FOBT) was ordered. You have obtained a stool sample. Put the steps in order to test the stool for occult blood (1-8). (Enter the number of each step in the proper sequence. Do not use punctuation or spaces. Example: 1234.)
____1. Close the specimen-side FOBT slide.
____2. Set up the FOBT by opening up the side for the sample application.
____3. Apply a sample specimen to both of the FOBT windows.
____4. Observe the specimen site's color.
____5. Put on gloves.
____6. Remove and discard gloves.
____7. Open the opposite side of the FOBT slide.
____8. Drop one or two drops on each window as directed.

Question 19

The rectum partially or fully intussuscepts and comes out through the anus. This condition is called ____________________ ____________________ .

Question 20

The nurse has performed a digital rectal examination and found the following findings that are seen in this picture. What is the name of the condition? ____________________ ____________________ ____________________