Deck 23: Anus, Rectum, and Prostate

Question 1

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.The nurse recognizes that this lesion is likely a:

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

Answer 1

Pilonidal cyst

Question 2

The nurse is caring for a newborn infant.Thirty hours after birth, the infant passes dark green-coloured meconium.The nurse recognizes this is important because the:

A)This type of stool indicates anal patency
B)Dark green coloration indicates occult blood in the stool
C)Meconium can be reflective of distress in the newborn
D)Newborn should have passed the first stool within 12 hours after birth

Answer 2

This type of stool indicates anal patency

Question 3

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

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

Answer 3

Flex the finger and slowly insert it toward the umbilicus

Question 4

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

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

Question 5

After completing an assessment of a 60-year-old man with a family history of colorectal cancer, the nurse discusses with him early detection measures for colorectal cancer.The nurse should discuss the need for a(n):

A)Annual proctoscopy
B)Sigmoidoscopy every 10 years
C)Fecal test for blood every 6 months
D)Digital rectal examinations every 2 years

Question 6

While performing a rectal examination, the advanced practice nurse palpates 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 that it is nothing to worry about
D)Report the finding and refer the patient to a specialist for further examination

Question 7

The nurse is reviewing the functioning of the anal canal with nursing students and states that voluntary closure of the canal is controlled by:

A)The internal sphincter being under voluntary control
B)The external sphincter being under voluntary control
C)Both sphincters remaining slightly relaxed at all times
D)The internal sphincter surrounding the external sphincter

Question 8

The mother of a 5-year-old girl tells the nurse that she has noticed her daughter "scratching at her bottom a lot the past few days." During the assessment, the nurse finds redness and raised skin in the anal area.This finding most likely indicates:

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

Question 9

Which statement concerning the anal canal is true? The anal canal:

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

Question 10

The structure that secretes a thin, milky alkaline fluid to enhance the viability of sperm is the:

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

Question 11

A 13-year-old girl is visiting the clinic for her annual physical examination.As part of the genitalia assessment, the nurse will:

A)Test for occult blood
B)Ask the girl to perform the Valsalva manoeuvre
C)Palpate the internal area of the anus
D)Inspect the perianal area

Question 12

During examination of a 65-year-old female patient, the nurse asks the patient to hold her breath and bear down.The nurse observes that the patient has a moist, red, doughnut-shaped protrusion from the anus and recognizes this finding as a:

A)Rectal polyp
B)Hemorrhoid
C)Rectal fissure
D)Rectal prolapse

Question 13

While performing an assessment of the perianal area of a patient, the nurse notices that the pigmentation of anus is darker than that of 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 would this assessment and history most likely indicate?

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

Question 14

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)Ultrasonography
C)Colonoscope
D)Rectal examination with an examining finger

Question 15

During an assessment of a newborn, the nurse would expect 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 16

A 60-year-old man has just been told that he has benign prostatic hypertrophy (BPH).He has a friend who recently died as a result of cancer of the prostate.He is concerned this will happen to him also.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 that 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, not cancer."

Question 17

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

Question 18

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)No sensory nerves are in the anal canal or rectum.

Question 19

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

A)"Some children are just more difficult to toilet 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 in your baby's development.We'll watch her closely for the next few months."
D)"The nerves that will allow your child to have control over the passing of stools are not developed until at least age 18 to 24 months"

Question 20

A patient who is visiting the clinic complains of having "stomach pains for 2 weeks" and describes his stools as being "sticky looking and black" for approximately the past 10 days.He denies taking any medications.The nurse is aware that these symptoms are mostly indicative of:

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

Question 21

While assessing a hospitalized patient who is bedridden, the nurse notices that the patient has fecal incontinence.The stools are loose and grey-tan in colour, indicating:

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

Question 22

A 35-year-old patient with a history of pancreatitis reports significant weight loss and stools that appear pale, yellow, and greasy.The nurse recognizes that these findings likely indicate:

A)Gastrointestinal bleeding with melena
B)Obstructive jaundice with loss of bile
C)Malabsorption syndrome with steatorrhea
D)Ingestion of bismuth preparations

Question 23

During a discussion with a men's health group, the nurse identifies a number of nonmodifiable risk factors for prostate cancer, including:

A)European descent, obesity
B)Older age, family history, African ancestry
C)Asian ancestry, older age, diet
D)Physical activity, lifestyle

Question 24

A 62-year-old male patient of African descent has come for his annual physical examination.The patient wants to know if he should get the prostate-specific antigen (PSA) test.The nurse will:

A)Recommend that he get the PSA test as he is at high risk for cancer
B)Discuss the benefits and harms of the PSA screening
C)Recommend that he wait until he is 70 years of age before getting the PSA test
D)Tell the patient that there are no benefits to the test and that he does not need it

Question 25

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.The nurse recognizes these symptoms as most consistent with:

A)Prostatitis
B)Polyps
C)Carcinoma of the prostate
D)Benign prostatic hypertrophy

Question 26

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

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

Question 27

During a health history interview with a patient who has chronic constipation, the nurse recommends increasing consumption of high-fibre foods, such as:

A)Broccoli, beans, and cereal
B)Hamburgers and fries
C)Iceberg lettuce and celery
D)Yogurt and ice cream

Question 28

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)Asymmetrical, 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 29

Abdominal palpation of a 78-year-old patient admitted from a long-term care facility, reveals a firm ropelike mass in the left lower quadrant, and percussion of this area of the abdomen is dull.The patient states feeling "full and nauseous," has a distended abdomen, and admits that she has not had a bowel movement "for several days." The nurse recognizes that this is likely:

A)Rectal polyp
B)Fecal impaction
C)An abscess
D)Rectal prolapse

Question 30

During the health history, the patient states, "It really hurts back there, and sometimes it itches, too.I have even seen blood on the toilet tissue after I have had a bowel movement.Is there something there?" Upon inspection of the anus, the nurse will see a(n):

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

Question 31

Which characteristic of the prostate gland would the advance practice nurse recognize as an abnormal finding while palpating the prostate gland through the rectum?

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