Deck 23: Anus,rectum and Prostate

Question 1

The nurse is examining only the rectal area of a woman.In what position should the woman be placed?

A)The lithotomy position
B)Lying in the prone position
C)The left lateral decubitus position
D)Bending over the table while standing

Answer 1

The left lateral decubitus position

Question 2

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

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

Answer 2

Thrombosed hemorrhoid

Question 3

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.This most likely indicates:

A)pinworms.
B)chickenpox.
C)child abuse.
D)bacterial infection.

Answer 3

pinworms.

Question 4

Which of the following statements about the anal canal is true?

A)The anal canal is about 2 cm long in the adult.
B)The anal canal slants backward toward the sacrum.
C)The anal canal contains hair and sebaceous glands.
D)The anal canal is the outlet for the gastrointestinal tract.

Question 5

A 46-year-old man requires assessment of his sigmoid colon.Which of the following is most appropriate for this examination?

A)A proctoscope
B)An ultrasound
C)A colonoscope
D)A rectal exam with an examining finger

Question 6

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)seminal vesicle.

Question 7

A patient who is visiting the clinic complains of having "stomach pains for 2 weeks" and describes his stools as being "soft and black" for about the last 10 days.He denies taking any medications.The nurse is aware that these symptoms are most 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)increase in bile pigment from liver problems.

Question 8

Which of the following statements about the sphincters is true?

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 9

Which of the following techniques is correct for palpation of the rectum?

A)Flex the finger,and insert it slowly toward the umbilicus.
B)First instruct the patient that this will be a painful procedure.
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.

Question 10

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

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 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 baby to have control over the passing of stools are not developed until at least 18 to 24 months of age."

Question 11

After completing an assessment of a 60-year-old man with a family history of colon cancer,the nurse discusses early detection measures for colon cancer with him.The nurse is sure to mention the need for a(n):

A)annual proctoscopy.
B)colonoscopy every 5 years.
C)fecal test for blood every 2 years.
D)digital rectal examination (DRE)every 2 years.

Question 12

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

A)Continue with the exam,and note 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 13

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

A)A jerking of the legs
B)Flexion of the knees
C)A quick contraction of the sphincter
D)Relaxation of the external sphincter

Question 14

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

A)this stool would indicate anal patency.
B)the dark green colour could indicate 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 after birth.

Question 15

A 60-year-old man has just been told he has benign prostatic hypertrophy (BPH).He has a friend who just died from prostate cancer 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 prostate cancer."
D)"The enlargement of your prostate is caused by hormone changes and not cancer."

Question 16

When testing stool for occult blood,the nurse is aware that a false-positive result may occur with:

A)absent bile pigment.
B)increased fat content.
C)increased ingestion of iron medication.
D)a large amount of red meat within the last 3 days.

Question 17

During an examination,the nurse asks the patient to perform the Valsalva manoeuvre and notes that the patient has a moist red doughnut-shaped protrusion from the anus.The nurse knows that this would be consistent with:

A)a rectal polyp.
B)hemorrhoids.
C)a rectal fissure.
D)rectal prolapse.

Question 18

During an assessment of a 20-year-old man,the nurse finds a small,palpable lesion containing a tuft of hair and located directly over the coccyx.The nurse knows that this lesion would most likely be a:

A)polyp.
B)pruritus ani.
C)benign tumour.
D)pilonidal cyst.

Question 19

A 30-year-old woman is visiting the clinic for a complaint of "pain in my bottom when I have a bowel movement." The nurse should assess for which problem?

A)Pinworms
B)Hemorrhoids
C)Food poisoning
D)Fecal incontinence

Question 20

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

A)The rectum is about 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.

Question 21

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

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

Question 22

While assessing a hospitalized,bedridden patient,the nurse notes that the patient has been incontinent of stool.The stool is loose and grey-tan in colour.The nurse recognizes that this finding indicates which of the following?

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

Question 23

A 40-year-old male of African descent is in the office for his annual physical.Which statement is true regarding screening for prostate cancer,according to the Canadian Cancer Society?

A)DRE is more effective than prostate-specific antigen (PSA)in finding prostate cancer.
B)Ancestry is a factor in determining when PSA testing begins.
C)PSA will be done at 50 years of age if there is a family history.
D)BPH increases an individual's risk for prostate cancer.

Question 24

A 62-year-old man is experiencing fever,chills,malaise,and 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 of the following?

A)Prostatitis
B)Urinary tract infection
C)Carcinoma of the prostate
D)BPH

Question 25

During a DRE,the nurse notes 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)Fecal impaction
C)Rectal abscess
D)Rectal prolapse

Question 26

During a health history of a patient who complains of chronic constipation,she asks the nurse about high-fibre foods.The nurse relates that an example of a high-fibre food would be:

A)broccoli.
B)hamburger.
C)iceberg lettuce.
D)white dinner rolls.

Question 27

Which of the following is an abnormal finding upon palpation of the prostate gland through the rectum?

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

Question 28

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

A)The gland is protruding 1 cm into the rectum.
B)The gland is heart-shaped,with a palpable central groove.
C)The gland is flat,with no palpable groove.
D)The gland has a boggy and soft consistency.
E)The gland has a smooth surface and an elastic or rubbery consistency.
F)The gland has fixed mobility.

Question 29

The nurse notes that a patient has had a pale,yellow,greasy stool,or steatorrhea,and recalls that this is caused by:

A)occult bleeding.
B)absent bile pigment.
C)increased fat content.
D)ingestion of bismuth preparations.