Deck 20: Anus, Rectum, and Prostate

Question 1

The prostatic sulcus

A)divides the prostate into anterior and posterior lobes.
B)is the site of the seminal vesicle emergence.
C)refers to the anterior aspect of the prostate.
D)secretes clear viscous mucus.
E)divides the prostate into right and left lateral lobes.

Answer 1

divides the prostate into right and left lateral lobes.

Question 2

Caliber of urinary stream is routine information in the history of

A)adolescents.
B)infants.
C)older men.
D)sexually active men.
E)pregnant women.

Answer 2

older men.

Question 3

The initial digital approach to the rectal examination should be

A)at a right angle to the anus.
B)with direct horizontal pressure of fingertip.
C)with the finger pad pressed against anal verge.
D)during sphincter tightening.
E)bidigital palpation with thumbs.

Answer 3

at a right angle to the anus.

Question 4

The urge to defecate is caused by

A)constriction of the internal sphincter.
B)the rectum filling with feces.
C)cognitive processes.
D)fluid volume in the stomach.
E)relaxation of the external sphincter.

Question 5

Perianal abscesses, fissures, or pilonidal cysts will cause the patient to experience

A)bulging and wrinkling.
B)constipation and pallor.
C)urinary symptoms.
D)tenderness and inflammation.
E)diarrhea and redness.

Question 6

Which of the following conditions is most commonly seen in adults with diabetes?

A)Pinworms
B)Pilonidal cysts
C)Perianal fistula
D)Pruritus ani
E)Anorectal fissure

Question 7

Factors associated with increased risk of prostate cancer include

A)African American descent.
B)cigarette smoking.
C)low-fat diet.
D)alcoholism.
E)obesity.

Question 8

To make visualization of polyps in the anorectal area easier, you should

A)apply clear jelly around the anal orifice.
B)ask the patient to bear down.
C)ask the patient to relax the sphincter.
D)rotate your finger inside the anal canal.
E)have the patient contract the external sphincter.

Question 9

Palpation of the anal ring is done by

A)bidigital palpation with thumbs.
B)inserting the smallest finger into the anus.
C)pressing a gauze pad over the anus.
D)rotation of the forefinger inside the anus.
E)rotation of the forefinger outside the anus.

Question 10

Which of the following is a risk factor for anal cancer?

A)White race
B)Diet low in animal fats and proteins
C)Physical inactivity
D)Infection with high risk HPV
E)Low body fat

Question 11

The mother of a 1-week-old breastfed baby tells you that she is concerned because her baby has a small bowel movement each time he feeds. You should let the mother know that

A)this is normal.
B)she should feed the baby less.
C)this usually indicates a congenital abnormality.
D)she needs to change the baby to formula.
E)the baby's internal sphincter is underdeveloped.

Question 12

Equipment for examination of the anus, rectum, and prostate routinely includes gloves and

A)an anoscope.
B)lubricant and penlight.
C)slides and normal saline.
D)swabs and culture medium.
E)a hand mirror and gauze.

Question 13

When the practitioner is inquiring about the patient's lower GI tract history, the inquiry should include

A)bowel habits.
B)dietary habits.
C)hemorrhoid surgery.
D)laxative use.
E)recent travel.

Question 14

The adult internal rectal sphincter is controlled by the

A)autonomic nervous system.
B)central nervous system.
C)peripheral nervous system.
D)lumbar spinal reflexes.
E)sacral spinal reflexes.

Question 15

When performing a rectal examination in a man, in which position is the patient generally placed?

A)Lithotomy
B)Prone
C)Trendelenburg
D)Left lateral
E)Supine

Question 16

A healthy prostate protrudes into the rectal wall a distance of _____ cm.

A)less than 1
B)1 to 2
C)2 to 3
D)3 to 4
E)more than 4

Question 17

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.
E)urges to defecate.

Question 18

The proximal end of the rectum is continuous with the

A)transverse colon.
B)duodenum.
C)ileum.
D)internal rectal sphincter.
E)sigmoid colon.

Question 19

The posterior surface of the prostate can be located by palpation of the

A)posterior wall of the rectum.
B)anterior wall of the rectum.
C)lateral wall of the anus.
D)lower abdomen and perineum.
E)anal canal and perineum.

Question 20

In males, which surface of the prostate gland is accessible by digital examination?

A)Median lobe
B)Posterior
C)Superior
D)Anterior
E)Lateral

Question 21

Tarry black stool should make you suspect

A)internal hemorrhoids.
B)rectal fistula.
C)upper intestinal bleeding.
D)prostatic cancer.
E)lower intestinal bleeding.

Question 22

Baby Sue is born with an imperforate anus. However, her outward anal appearance is normal. When is it likely that her closed anal passageway will be suspected by her health care providers?

A)After she develops a scaphoid abdomen
B)During her first feeding when she vomits
C)When she bleeds from the rectum
D)When she fails to pass meconium stool
E)When the rectum prolapses

Question 23

Very light tan or gray stool may indicate

A)Hirschsprung disease.
B)obstructive jaundice.
C)lower gastrointestinal bleeding.
D)polyposis.
E)upper gastrointestinal bleeding.

Question 24

Prostate-specific antigen (PSA) screening is controversial because

A)there are few false-negative results.
B)PSA is produced by many other tissues.
C)it is less sensitive than digital rectal examination.
D)there are associated harms of false-positive test results.
E)it detects prostate cancer only in its late stage.

Question 25

Cellulose tape test is used for the detection of

A)imperforate anus.
B)condyloma.
C)anal fissure.
D)steatorrhea.
E)enterobiasis.

Question 26

Prostate examination findings of a hard, irregular, painless nodule with obliteration of the median sulcus are signs of

A)benign prostatic hypertrophy.
B)cancer of the prostate.
C)longstanding prostatitis.
D)swelling caused by aging.
E)acute prostatitis.

Question 27

A lower spinal cord lesion may be indicated by which finding?

A)Lack of an "anal wink"
B)Anorectal fissure
C)Anal fistula
D)Passage of meconium
E)Small flaps of anal skin

Question 28

An infant with constipation and a consistently empty rectum may need evaluation for

A)sexual abuse.
B)Hirschsprung disease.
C)pilonidal cyst.
D)intestinal parasites.
E)rectal abscess.

Question 29

Palpation of a normal prostate in an older adult is likely to feel

A)cool.
B)grainy.
C)polypoid.
D)rubbery.
E)hard.

Question 30

Pinworms and Candida may both cause

A)shrunken buttocks.
B)hemorrhoids.
C)perirectal irritation.
D)perirectal protrusion.
E)constipation.

Question 31

A common cause of dark green or black stool color during pregnancy is indicative of

A)consumption of iron preparations.
B)consumption of vitamins.
C)intestinal parasites.
D)slow bleeding of hemorrhoids.
E)slow intestinal bleeding.

Question 32

An expected anal or rectal finding late in pregnancy is the presence of

A)cysts.
B)rectal prolapse.
C)skin tags.
D)polyps.
E)hemorrhoids.

Question 33

The cervix may normally be palpated through the

A)anterior rectal wall.
B)left lateral rectal wall.
C)right lateral rectal wall.
D)posterior uterine surface.
E)posterior rectal wall.

Question 34

Thrombosed hemorrhoids are

A)flabby skin sacs.
B)red, inflamed, and painful.
C)fluctuant soft papules.
D)blue, shiny painful masses.
E)pink to whitish.

Question 35

Your patient's chief complaint is repeated pencil-like stools. Further examination should include

A)stool culture.
B)parasite testing.
C)digital rectal examination (DRE).
D)prostate examination.
E)cellulose tape test.