Chapter 26- Practice Questions

Question 1

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.

Answer 1

d. Is the outlet for the gastrointestinal tract.

Question 2

Which statement concerning 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 2

b. The external sphincter is under voluntary control.

Question 3

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.

Answer 3

b. The anorectal junction cannot be palpated.

Question 4

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

a. Cowper gland.
b. Prostate gland.
c. Median sulcus.
d. Bulbourethral gland.

Answer 4

b. Prostate gland.

Question 5

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. Ultrasound
c. Colonoscope
d. Rectal examination with an examining finger

Answer 5

c. Colonoscope

Question 6

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

Answer 6

d. The enlargement of your prostate is caused by hormonal changes, and not cancer.

Question 7

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 7

b. Hemorrhoids

Question 8

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 approximately the last 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.

Answer 8

c. Occult blood, resulting from gastrointestinal bleeding.

Question 9

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. DREs every 2 years.

Answer 9

b. Colonoscopy every 10 years.

Question 10

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

Answer 10

c. Left lateral decubitus

Question 11

While performing an assessment of the perianal area of a patient, the nurse notices that the pigmentation of anus is darker than 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

Answer 11

d. Thrombosed hemorrhoid

Question 12

The 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 12

a. Flex the finger, and slowly insert it toward the umbilicus.

Question 13

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 the patient to return for a 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 13

d. Report the finding, and refer the patient to a specialist for further examination.

Question 14

During an assessment of the newborn, the nurse expects to see 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

Answer 14

c. Quick contraction of the sphincter

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. Rectal 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 finding is consistent with a:

a. Rectal polyp.
b. Hemorrhoid.
c. 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 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. Asymmetric, 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

Answer 17

a. Asymmetric, hard, and fixed prostate gland

Question 18

A 40-year-old black man is in the office for his annual physical examination. Which statement regarding
the PSA blood test is true, according to the American Cancer Society? The PSA:

a. Should be performed with this visit.
b. Should be performed at age 45 years.
c. Should be performed at age 50 years.
d. Is only necessary if a family history of prostate cancer exists.

Answer 18

b. Should be performed 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 condition?

a. Prostatitis
b. Polyps
c. Carcinoma of the prostate
d. BPH

Answer 19

a. Prostatitis

Question 20

During a discussion for a mens health group, the nurse relates that the group with the highest incidence of prostate cancer is:

a. Asian Americans.
b. Blacks.
c. American Indians.
d. Hispanics.

Answer 20

b. Blacks.

Question 21

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

a. Palpable central groove
b. Tenderness to palpation
c. Heart shaped
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 patient who is hospitalized and bedridden, 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 the taking of a health 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

Question 27

The nurse is performing a digital examination of a patients prostate gland and notices that a normal prostate gland includes which of the following characteristics? Select all that apply.

a. 1 cm protrusion into the rectum
b. Heart-shaped 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

Answer 27

a. 1 cm protrusion into the rectum
b. Heart-shaped with a palpable central groove
e. Smooth surface, elastic, and rubbery consistency