Chapter 25

Question 0

Which of these statements about the anal canal is true? The anal canal:

A) is about 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

Answer 0

D) is the outlet for the gastrointestinal tract

Question 1

Which of these statements about 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.

Answer 1

B) The external sphincter is under voluntary control.

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 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

Answer 2

B) The anorectal junction cannot be palpated

Question 3

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)mbulbourethral gland.

Answer 3

B) prostate gland.

Question 4

A 46-year-old man requires assessment of his sigmoid colon. The nurse is aware that which of these is most appropriate for this examination?

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

Answer 4

C) Colonoscope

Question 5

A 60-year-old man has just been told he has benign prostatic hypertrophy. He has a friend who just died from cancer of the prostate, and he 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 hormone changes and not cancer.”

Answer 5

D) “The enlargement of your prostate is caused by hormone changes and not cancer.”

Question 6

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 6

B) Hemorrhoids

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) absent bile pigment from liver problems.

Answer 7

C) occult blood resulting from gastrointestinal bleeding.

Question 8

After completing an assessment of a 60-year-old man with a family history of colon cancer, the nurse discusses with him early detection measures for colon cancer. The nurse should mention the need for a(n):
A) annual proctoscopy.
B) colonoscopy every 10 years.
C) fecal test for blood every 6 months.
D) digital rectal examinations every 2 years.

Answer 8

B) colonoscopy every 10 years

Question 9

The nurse is examining only the rectal area of a woman and should place the woman in what position?
A) Lithotomy position
B) Prone position
C) Left lateral decubitus position
D) Bending over the table while standing

Answer 9

C) Left lateral decubitus position

Question 10

While doing an assessment of the perianal area of a patient, the nurse notices that the pigmentation of anus is darker than surrounding skin, the anal opening is closed, and there is a skin sac that is shiny and blue. The patient mentioned that he has had pain with bowel movements and has noted some spots of blood occasionally. What would this assessment and history be most likely to indicate?
A) Anal fistula
B) Pilonidal cyst
C) Rectal prolapse
D) Thrombosed hemorrhoid

Answer 10

D) Thrombosed hemorrhoid

Question 11

The nurse is preparing to palpate the rectum and should use which of these techniques?
A) Flex the finger and insert slowly toward the umbilicus.
B) Instruct the patient first that this will be a painful procedure.
C)mInsert 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 11

A) Flex the finger and insert slowly toward the umbilicus.

Question 12

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 patient to return for 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.

Answer 12

D) Report the finding and refer the patient to a specialist for further examination.

Question 13

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.

Answer 13

D) a large amount of red meat within the last 3 days.

Question 14

A 13-year-old girl is visiting the clinic for a sports physical. The nurse should remember to include which of these tests in the examination?
A) Test for occult blood
B) The Valsalva maneuver
C) Internal palpation of the anus
D) Inspection of the perianal area

Answer 14

D) Inspection of the perianal area

Question 15

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 knows that this lesion would most likely be a:
A) polyp.
B) pruritus ani.
C) carcinoma.
D) pilonidal cyst.

Answer 15

D) pilonidal cyst

Question 16

During an examination, the nurse asks the patient to perform the Valsalva maneuver and notices 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.

Answer 16

D) rectal prolapse.

Question 17

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

Answer 17

A) Asymmetric, hard, fixed prostate gland

Question 18

A 40-year-old black man is in the office for his annual physical. Which statement regarding the prostate-specific antigen (PSA) blood test is true, according to the American Cancer Society? The PSA:
A) should be done with this visit.
B) should be done at age 45 years.
C) should be done at age 50 years.
D) is only necessary if there is a family history of prostate cancer.

Answer 18

B) should be done at age 45 years

Question 19

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 of the following?
A) Prostatitis
B) A polyp
C) Carcinoma of the prostate
D) Benign prostatic hypertrophy (BPH)

Answer 19

A) Prostatitis

Question 20

During a discussion for a men’s health group, the nurse relates that the group with the highest incidence of prostate cancer is:
A) Asian Americans.
B) African-Americans.
C) American Indians.
D) Hispanics.

Answer 20

B) African-Americans

Question 21

The nurse is palpating the prostate gland through the rectum and notices an abnormal finding if which of these is present?
A) Palpable central groove
B) Tenderness to palpation
C) Heart shape
D) Elastic and rubbery consistency

Answer 21

B) Tenderness to palpation

Question 22

The nurse notices 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.

Answer 22

C) increased fat content.

Question 23

During a health history of a patient who complains of chronic constipation, the patient asks the nurse about high-fiber foods. The nurse relates that an example of a high-fiber food would be:
A) broccoli.
B) hamburger.
C) iceberg lettuce.
D) yogurt.

Answer 23

A) broccoli

Question 24

While assessing a hospitalized, bedridden patient, the nurse notices that the patient has been incontinent of stool. The stool is loose and gray-tan in color. 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

Answer 24

C) Absent bile pigment

Question 25

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) Fecal impaction
C) Rectal abscess
D) Rectal prolapse

Answer 25

B) Fecal impaction

Question 26

During a 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

Answer 26

D) External hemorrhoid that is thrombosed