Hemorrhoids FItz

Question 1

8. Rectal bleeding associated with hemorrhoids is usually described as:

A. streaks of bright red blood on the stool.
B. dark brown to black in color and mixed in with normal-appearing stool.
C. a large amount of brisk red bleeding.
D. significant blood clots and mucus mixed
with stool.

Answer 1

A. streaks of bright red blood on the stool.

Question 2

9. Therapy for hemorrhoids includes all of the following except:

A. weight control.
B. low-fat diet.
C. topical corticosteroids.
D. the use of a stool softener.

Answer 2

B. low-fat diet.

Question 3

10. The nurse practitioner (NP) is advising a 58-year-old woman about the benefits of a high-fiber diet. Which of the following foods provides the highest fiber content?

A. a small banana
B. 1 cup of cooked oatmeal
C. a 1/2-cup serving of brown rice
D. a medium-sized blueberry muffin

Answer 3

B. 1 cup of cooked oatmeal

Question 4

11. A 62-year-old man presents with a 2-month history of noting a “bit of dark blood mixed in with my stool most days.” Physical examination reveals external
    hemorrhoids, no rectal mass, and a small amount of dark brown stool on the examining digit. In-office fecal
    occult blood test is positive, and hemogram reveals a microcytic hypochromic anemia. The next best step in his care is to:

A. perform in-office anoscopy.
B. advise the patient to use sitz baths post–bowel movement.
C. refer to gastroenterology practice for colonoscopy.
D. order a double contrast barium enema.

Answer 4

C. refer to gastroenterology practice for colonoscopy.

Question 5

12. Risk factors for the development of hemorrhoidal symptoms include all of the following except:

A. prolonged sitting.
B. insertive partner in anal intercourse.
C. chronic diarrhea.
D. excessive alcohol use.

Answer 5

B. insertive partner in anal intercourse.

Question 6

13. Which of the following best describes Grade III internal hemorrhoids?

A. The hemorrhoids do not prolapse.
B. The hemorrhoids prolapse upon defecation but reduce spontaneously.
C. The hemorrhoids prolapse upon defecation and must be reduced manually.
D. The hemorrhoids are prolapsed and cannot be reduced manually.

Answer 6

C. The hemorrhoids prolapse upon defecation and must be reduced manually.

Question 7

14. Which of the following patients should be evaluated for possible surgical intervention for hemorrhoids?

A. a 28-year-old woman with symptomatic external hemorrhoids who gave birth 6 days ago
B. a 48-year-old man with Grade II internal hemorrhoids and improvement with standard medical therapy
C. a 44-year-old woman who has internal and external hemorrhoids with recurrent prolapse
D. a 58-year-old man who has Grade I internal hemorrhoids and improvement with psyllium supplements

Answer 7

C. a 44-year-old woman who has internal and external hemorrhoids with recurrent prolapse