NR 509 NR 509 Week 6 physical assessment quiz [100% Cmpltd]

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Chamberlain College of Nursing – NR 509 NR 509 Week 6 physical assessment quiz [100% Cmpltd] Grade Details - All Questions Question 1.Question : During a health history, a patient tells the nur ... se that he has trouble in starting his urine stream. This problem is known as Student Answer: urgency. dribbling. frequency. hesitancy. Instructor Explanation: Hesitancy is trouble in starting the urine stream. Urgency is the feeling that one cannot wait to urinate. Dribbling is the loss of urine before or after the main act of urination. Frequency is urinating more often than usual. Points Received: 2 of 2 Comments: Question 2.Question : Which of these statements is most appropriate when the nurse is obtaining a genitourinary history from an elderly man? Student Answer: “Do you need to get up at night to urinate?” “Do you experience nocturnal emissions, or „wet dreams‟?” “Do you know how to perform a testicular self-examination?” “Has anyone ever touched your genitals when you did not want them to?” Instructor Explanation: The elderly male patient should be asked about the presence of nocturia. This may be due to diuretic medication, fluid retention from mild heart failure or varicose veins, or fluid ingestion 3 hours before bedtime, especially coffee and alcohol. The other questions are more appropriate for younger males. Points Received: 2 of 2 Comments: Question 3.Question : When performing a genitourinary assessment on a 16-year-old boy,the nurse notices a swelling in the scrotum that increases with increased intra-abdominal pressure and decreases when he is lying down. The patient complains of pain when straining. The nurse knows that this description is most consistent with a(n) _____ hernia. Student Answer: femoral incisional direct inguinal indirect inguinal Instructor Explanation: With indirect inguinal hernias, there is pain with straining and a soft swelling that increases with increased intra-abdominal pressure, which may decrease when the patient lies down. These findings do not describe the other hernias. See Table 24-7 for descriptions of femoral and direct inguinal hernias. Points Received: 2 of 2 Comments: Question 4.Question : A 45-year-old mother of two children is seen at the clinic for complaints of “losing my urine when I sneeze.” The nurse documents that she is experiencing Student Answer: urinary frequency. enuresis. stress incontinence. urge incontinence. Instructor Explanation: Stress incontinence is involuntary urine loss with physical strain, sneezing, or coughing that occurs due to weakness of the pelvic floor. Urinary frequency is urinating more times than usual (more than 5 to 6 times per day). Enuresis is involuntary passage of urine at night after age 5 to 6 years (bed wetting). Urge incontinence is involuntary urine loss from overactive detrusor muscle in the bladder. It contracts, causing an urgent need to void. Points Received: 2 of 2 Comments: Question 5.Question : Which of these statements is true regarding the penis? Student Answer: The urethral meatus is located on the ventral side of the penis. The prepuce is the fold of foreskin covering the shaft of the penis. The penis is composed of two cylindrical columns of erectile tissue.The corpus spongiosum expands into a cone of erectile tissue called the glans. Instructor Explanation: At the distal end of the shaft, the corpus spongiosum expands into a cone of erectile tissue, the glans. The penis is composed of three cylindrical columns of erectile tissue. The prepuce is skin that covers the glans of the penis. The urethral meatus forms at the tip of the glans. Points Received: 2 of 2 Comments: Question 6.Question : Which of these statements about the testes is true? Student Answer: The lymphatics of the testes drain into the abdominal lymph nodes. The vas deferens is located along the inferior portion of each testis. The right testis is lower than the left because the right spermatic cord is longer. The cremaster muscle contracts in response to cold and draws the testicles closer to the body. Instructor Explanation: When it is cold, the cremaster muscle contracts, which raises the scrotal sac and brings the testes closer to the body to absorb heat necessary for sperm viability. The lymphatics of the testes drain into the inguinal lymph nodes. The vas deferens is located along the upper portion of each testis. The left testis is lower than the right because the left spermatic cord is longer. Points Received: 2 of 2 Comments: Question 7.Question : The mother of a 10-year-old boy asks the nurse to discuss the recognition of puberty. The nurse should reply by saying Student Answer: “Puberty usually begins at about age fifteen.” “The first sign of puberty is enlargement of the testes.” “Penis size does not increase until about the age of sixteen.” “The development of pubic hair precedes testicular or penis enlargement.” Instructor Explanation: Puberty begins sometime between ages 9 1/2 and 13 1/2 years. The first sign is enlargement of the testes. Next, pubic hair appears and then penis size increases. Points Received: 2 of 2 Comments:Question 8.Question : A 62-year-old man states that his doctor told him that he has an “inguinal hernia.” He asks the nurse to explain what a hernia is. The nurse should Student Answer: tell him not to worry and that most men his age develop hernias. explain that a hernia is often the result of prenatal growth abnormalities. refer him to his physician for additional consultation because the physician made the initial diagnosis. explain that a hernia is a loop of bowel protruding through a weak spot in the abdominal muscles. Instructor Explanation: A hernia is a loop of bowel protruding through a weak spot in the musculature. The other options are not correct responses to the patient‟s question. Points Received: 2 of 2 Comments: Question 9.Question : During an examination, the nurse notices that a male patient has a red, round, superficial ulcer with a yellowish serous discharge on his penis. On palpation, the nurse finds a nontender base that feels like a small button between the thumb and fingers. At this point, the nurse suspects that this patient has Student Answer: genital warts. a herpes infection. a syphilitic chancre. a carcinoma lesion. Instructor Explanation: This lesion indicates syphilitic chancre, which begins within 2 to 4 weeks of infection. See Table 24-4 for descriptions of the other options. Points Received: 2 of 2 Comments: Question 10.Question : The nurse is performing a genitourinary assessment on a 50-yearold obese male laborer. On examination, the nurse notices a painless round swelling close to the pubis in the area of the internal inguinal ring that is easily reduced when the individual is supine. These findings are most consistent with a(n) _____ hernia. Student Answer: scrotal femoraldirect inguinal indirect inguinal Instructor Explanation: Direct inguinal hernias occur most often in men over the age of 40 years. It is an acquired weakness brought on by heavy lifting, obesity, chronic cough, or ascites. The direct inguinal hernia is usually a painless, round swelling close to the pubis in the area of the internal inguinal ring that is easily reduced when the individual is supine. See Table 24-6 for a description of scrotal hernia. See Table 24-7 for descriptions of femoral hernias and indirect inguinal hernias. Points Received: 2 of 2 Comments: Question 11.Question : The nurse is performing a genital examination on a male patient and notices urethral drainage. When collecting urethral discharge for microscopic examination and culture, the nurse should Student Answer: ask the patient to urinate into a sterile cup. ask the patient to obtain a specimen of semen. insert a cotton-tipped applicator into the urethra. compress the glans between the examiner‟s thumb and forefinger and collect any discharge. Instructor Explanation: If urethral discharge is noticed, then the examiner should collect a smear for microscopic examination and culture by compressing the glans anteroposteriorly between the thumb and forefinger. The other options are not correct actions. Points Received: 2 of 2 Comments: Question 12.Question : A 59-year-old patient has been diagnosed with prostatitis and is being seen at the clinic for complaints of burning and pain during urination. He is experiencing Student Answer: dysuria. nocturia. polyuria. hematuria. Instructor Explanation: Dysuria or burning with urination is common with acute cystitis, prostatitis, and urethritis. Nocturia is voiding during the night. Polyuria is voiding in excessive quantities. Hematuria is voiding with blood in the urine. Points Received: 2 of 2 Comments:Question 13.Question : A 2-month-old uncircumcised infant has been brought to the clinic for a well-baby checkup. How would the nurse proceed with the genital examination? Student Answer: Elicit the cremasteric reflex. Assess the glans for redness or lesions. Avoid retracting the foreskin until the infant is 3 months old. Note any dirt or smegma that has collected under the foreskin. Instructor Explanation: If uncircumcised, then the foreskin is normally tight during the first 3 months and should not be retracted because of the risk of tearing the membrane attaching the foreskin to the shaft. The other options are not correct. Points Received: 2 of 2 Comments: Question 14.Question : 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 Student Answer: broccoli. hamburger. iceberg lettuce. yogurt. Instructor Explanation: High-fiber foods are either soluble type (i.e., beans, prunes, barley, broccoli) and insoluble type (i.e., cereals, wheat germ). The other examples are not considered high-fiber foods. Points Received: 2 of 2 Comments: Question 15.Question : The nurse is examining only the rectal area of a woman and should place the woman in what position? Student Answer: Lithotomy position Prone position Left lateral decubitus position Bending over the table while standing Instructor Explanation: The nurse should place the female patient in lithotomy position if examining genitalia as well; use the left lateral decubitus position for the rectal area alone.Points Received: 2 of 2 Comments: Question 16.Question : The nurse notices that a patient has had a pale, yellow, greasy stool, or steatorrhea, and recalls that this is caused by Student Answer: occult bleeding. absent bile pigment. increased fat content. ingestion of bismuth preparations. Instructor Explanation: 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 black stool, and absent bile pigment causes gray, tan stool. Points Received: 2 of 2 Comments: Question 17.Question : The nurse is performing an examination of the anus and rectum. Which of these statements is correct and important to remember during this examination? Student Answer: The rectum is about 8 cm long. The anorectal junction cannot be palpated. Above the anal canal, the rectum turns anteriorly. There are no sensory nerves in the anal canal or rectum. Instructor Explanation: The anal columns are folds of mucosa that extend vertically down from the rectum and end in the anorectal junction. This junction is not palpable, but it is visible on proctoscopy. The rectum is 12 cm long, and just above the anal canal, the rectum dilates and turns posteriorly. Points Received: 2 of 2 Comments: Question 18.Question : 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? Student Answer: Rectal prolapse Internal hemorrhoid External hemorrhoid that has resolvedExternal hemorrhoid that is thrombosed Instructor Explanation: 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. Points Received: 2 of 2 Comments: Question 19.Question : 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) Student Answer: annual proctoscopy. colonoscopy every 10 years. fecal test for blood every 6 months. digital rectal examinations every 2 years. Instructor Explanation: Early detection measures for colon cancer include a digital rectal examination performed annually after age 50 years, a fecal occult blood test annually after age 50 years, sigmoidoscopy every 5 years or colonoscopy every 10 years after age 50 years; and a PSA blood test annually for men over 50 years old, except black men beginning at age 45 years (American Cancer Society, 2006). Points Received: 2 of 2 Comments: Question 20.Question : While performing a rectal examination, the nurse notices a firm, irregularly shaped mass. What should the nurse do next? Student Answer: Continue with the examination and document the finding in the chart. Instruct patient to return for repeat assessment in 1 month. Tell the patient that a mass was felt but it is nothing to worry about. Report the finding and refer the patient to a specialist for further examination. Instructor Explanation: A firm or hard mass with irregular shape or rolled edges may signify carcinoma. Promptly report any mass that is discovered for further examination. The other responses are not correct.Points Received: 2 of 2 Comments: Question 21.Question : 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? Student Answer: Pinworms Hemorrhoids Colon cancer Fecal incontinence Instructor Explanation: Having painful bowel movements, known as dyschezia, may be due to a local condition (hemorrhoid or fissure) or constipation. The other responses are not correct. Points Received: 2 of 2 Comments: Question 22.Question : 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 Student Answer: polyp. pruritus ani. carcinoma. pilonidal cyst. Instructor Explanation: A pilonidal cyst or sinus is a hair-containing cyst or sinus located in the midline over the coccyx or lower sacrum. It often opens as a dimple with a visible tuft of hair and, possibly, an erythematous halo. See Table 25-1 for more information, and also for description of pruritus ani. See Table 25-2 for descriptions of rectal polyps and carcinoma. Points Received: 2 of 2 Comments: Question 23.Question : 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? Student Answer: Proctoscope Ultrasound ColonoscopeRectal exam with an examining finger Instructor Explanation: The sigmoid colon is 40 cm long and is accessible to examination only with the colonoscope. The other responses are not appropriate for examination of the entire sigmoid colon. Points Received: 2 of 2 Comments: Question 24.Question : During an assessment of the newborn, the nurse expects to see which finding when the anal area is slightly stroked? Student Answer: A jerking of the legs Flexion of the knees A quick contraction of the sphincter Relaxation of the external sphincter Instructor Explanation: To assess sphincter tone, the nurse should check the anal reflex by gently stroking the anal area and noticing a quick contraction of the sphincter. The other responses are not correct. Points Received: 2 of 2 Comments: Question 25.Question : 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? Student Answer: Asymmetric, hard, fixed prostate gland Occult blood and perianal pain to palpation Symmetrically enlarged, soft prostate gland A soft nodule protruding from rectal mucosa Instructor Explanation: 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 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. Points Received: 2 of 2 Comments: [Show More]

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