Exam View - Chapter 21 PDF

Preview

Summary

Download Exam View - Chapter 21 PDF

Description

Chapter 21: Anus, Rectum, and Prostate Ball: Seidel’s Guide to Physical Examination, 9th Edition MULTIPLE CHOICE 1. Baby Sue is born with an imperforate anus. However, her outward anal appearance is normal. Which sig

healthcare provider that she has a closed anal passageway? a. Development of a scaphoid abdomen b. Vomiting after her first feeding c. Bleeding from the rectum d. Failure to pass meconium stool ANS: D

Failure to pass meconium stool indicates that a newborn has an imperforate anus. DIF: Cognitive Level: Applying (Application) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 2. In males, which surface of the prostate gland is accessible by digital examination? a. Median lobe b. Posterior c. Superior d. Anterior ANS: B

The posterior surface of the prostate gland lies close to the anterior wall of the rectum and is palpable thr examination. DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 3. The prostatic sulcus: a. divides the right and left lateral lobes. b. is the site of the seminal vesicle emergence. c. refers to the anterior aspect of the prostate. d. secretes clear viscous mucus. ANS: A

The prostatic sulcus divides the two lateral lobes and is palpated as a shallow groove. DIF: Cognitive Level: Remembering (Knowledge) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 4. The rectal past medical history of all patients should include inquiry about: a. bowel habits. b. dietary habits. c. hemorrhoid surgery. d. laxative use. ANS: C

Past medical history should include inquiry about hemorrhoids, spinal cord injury, benign prostatic hype colorectal, breast, ovarian, or endometrial cancers, and episiotomies of fourth-degree lacerations during the personal and social history; the use of laxatives is part of the history of the present illness. DIF: Cognitive Level: Applying (Application) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 5. The effects of aging on the gastrointestinal system lead to more frequent experiences of: a. constipation. b. prolonged satiety. c. diarrhea. d. prostate glandular atrophy.

ANS: A

Older adults experience an elevated pressure threshold for the sensation of rectal distention and are there constipation. They also experience early satiety, fecal incontinence, and prostate glandular hypertrophy.

7. The caliber of the urinary stream is routine information in the history of: a. adolescents. b. infants. c. older adults. d. sexually active young men. ANS: C

Routine questions about the caliber of the urinary stream and dribbling are directed toward older men be prostate gradually impedes urine flow. DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 8. Equipment for examination of the anus, rectum, and prostate routinely includes gloves and: a. a hand mirror and gauze. b. a lubricant and penlight. c. slides and normal saline. d. swabs and culture medium. ANS: B

Equipment for the examination includes a penlight, lubricating jelly, gloves, and fecal occult blood testin DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 9. Which is a risk factor for colorectal cancer? a. High-fiber diet b. Diet low in animal fats and proteins c. Irish descent d. Inherited BRAC2 mutation ANS: D

History of intestinal polyps is considered a risk factor for colorectal cancer, as are diets low in fiber and ethnic background of Ashkenazi Jewish descent. DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 10. Nodules found in the peritoneum through the anterior rectal wall: a. are found with bidigital palpation. b. are called shelf lesions. c. are chronic fibrosis. d. are found by having the patient bear down. ANS: B

Because the anterior rectal wall is in contact with the peritoneum, you may be able to detect the tenderne inflammation and the nodularity of peritoneal metastasis. The nodules called shelf lesions are palpable ju males and in the cul-de-sac of females. DIF: Cognitive Level: Applying (Application) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 11. Perianal abscesses, fissures, or pilonidal cysts will cause the patient to experience: a. bulging and wrinkling. b. constipation and pallor. c. diarrhea and redness. d. tenderness and inflammation. ANS: D

Tenderness and inflammation to the perianal area may be related to an abscess, fistula, fissure, pilonidal DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 12. Palpation of the anal ring is done by:

a. b. c.

bidigital palpation with the thumbs. inserting the smallest finger into the anus. pressing a gauze pad over the anus.

13. The posterior surface of the prostate can be located by palpation of the: a. anal canal and perineum. b. anterior wall of the rectum. c. lateral wall of the anus. d. lower abdomen and perineum. ANS: B

Palpation of the rectal anterior wall facilitates posterior prostate location. DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 14. The cervix may be palpated through the: a. anterior rectal wall. b. internal umbilical wall. c. lateral urethral meatus. d. posterior uterine surface. ANS: A

In women, the cervix can be palpated through the anterior rectal wall. It feels like a small, round mass. DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 15. Your patient’s chief complaint is repeated, pencil-like stools. Further examination should include: a. a stool culture. b. parasite testing. c. a digital rectal examination (DRE). d. a prostate examination. ANS: C

Persistent pencil-shaped stools are indicative of stenosis from scarring or pressure from a mass. DRE sh for a mass. DIF: Cognitive Level: Analyzing (Analysis) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 16. Very light tan or gray stools may indicate: a. upper gastrointestinal bleeding. b. obstructive jaundice. c. lower gastrointestinal bleeding. d. polyposis. ANS: B

Very light tan or gray stools suggest obstructive jaundice. DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 17. Tarry black stools should make you suspect: a. internal hemorrhoids. b. rectal fistula. c. upper intestinal tract bleeding. d. prostatic cancer. ANS: C

Upper intestinal tract bleeding results in tarry black stools. DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 18. Prostate-specific antigen (PSA) screening is controversial because: a. there are many false-negative results. b. PSA is produced by many other tissues. c. it is less sensitive than digital rectal examination....