Question 1

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

Accepted Answer

The size of a normal prostate gland should be 2.5 cm long by 4 cm wide and should not protrude more than 1 cm into the rectum.The prostate should be heart-shaped,with a palpable central groove,a smooth surface,and elastic with a rubbery consistency.Abnormal findings include a flat shape with no palpable groove,boggy with a soft consistency,and fixed mobility.

Question 2

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

Accepted Answer

According to the American Cancer Society (2010),black men have a higher rate of prostate cancer than other racial groups.

Question 3

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:

Accepted Answer

High-fiber foods are either soluble type (e.g.,beans,prunes,barley,broccoli)or insoluble type (e.g.,cereals,wheat germ).The other examples are not considered high-fiber foods.

Question 4

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:

Accepted Answer

According to the American Cancer Society (2006),the PSA blood test should be performed annually for black men beginning at age 45 years and annually for all other men over age 50 years.

Question 5

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?

Accepted Answer

A fecal impaction is a collection of hard,desiccated feces in the rectum.The obstruction often results from decreased bowel motility,in which more water is reabsorbed from the stool.(See Table 25-2 for the descriptions of rectal polyps and abscesses; See Table 25-1 for a description of rectal prolapse.)

Question 6

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?

Accepted Answer

These symptoms are consistent with an external hemorrhoid.An external hemorrhoid,when thrombosed,contains clotted blood and becomes a painful,swollen,shiny blue mass that itches and bleeds with defecation.When the external hemorrhoid resolves,it leaves a flabby,painless skin sac around the anal orifice.An internal hemorrhoid is not palpable but may appear as a red mucosal mass when the person performs a Valsalva maneuver.A rectal prolapse appears as a moist,red doughnut with radiating lines.

Question 7

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?

Accepted Answer

Subjective symptoms of carcinoma of the prostate include frequency,nocturia,hematuria,weak stream,hesitancy,pain or burning on urination,and continuous pain in lower back,pelvis,and thighs.Objective symptoms of carcinoma of the prostate include a malignant neoplasm that often starts as a single hard nodule on the posterior surface,producing asymmetry and a change in consistency.As it invades normal tissue,multiple hard nodules appear,or the entire gland feels stone hard and fixed.

Question 8

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?

Accepted Answer

The presence of gray-tan stool indicates absent bile pigment,which can occur with obstructive jaundice.The ingestion of iron preparations and the presence of occult blood turns the stools to a black color.Jellylike mucus shreds mixed in the stool would indicate inflammation.

Question 9

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

Accepted Answer

The normal prostate gland should feel smooth,elastic,and rubbery; slightly movable; heart-shaped with a palpable central groove; and not be tender to palpation.

Question 10

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?

Accepted Answer

The common presenting symptoms of prostatitis are fever,chills,malaise,and urinary frequency and urgency.The individual may also have dysuria,urethral discharge,and a dull aching pain in the perineal and rectal area.These symptoms are not consistent with polyps.(See Table 25-3 for the descriptions of carcinoma of the prostate and BPH.)

Question 11

The nurse notices that a patient has had a pale,yellow,greasy stool,or steatorrhea,and recalls that this is caused by:

Accepted Answer

Steatorrhea (pale,yellow,greasy stool)is caused by increased fat content in the stools,as in malabsorption syndrome.Occult bleeding and ingestion of bismuth products cause a black stool,and absent bile pigment causes a gray-tan stool.

Quiz 25: Anus,Rectum,and Prostate