ATI Health Assess 2.0: Rectum and Genitourinary Post Quiz

A nurse is collecting a health history from a client. Which the following client statements requires further investigation? a.) I urinate a lot when I get up int he morning b.) I have a bowel movement every morning after breakfast c.) I have noticed that it burns when I urinate d.) I empty my bladder several times a day

- "I have noticed that it burns when I urinate." A burning sensation when voiding can be an indication of a urinary tract infection (UTI). Other manifestations of a UTI can include an urgent sensation to void and changes in the appearance of the urine, such as blood, cloudiness, or a foul odor.

A nurse is providing teaching about the prevention of sexually transmitted infections (STIs) to a 19 year old client who is sexually active and reports having multiple partners. Which of the following client responses demonstrates an understanding of the teaching? a.) I should plan on getting tested each year for sexually transmitted infections b.) Taking my birth control pills will prevent me from getting an infection c.) Because I am at a low risk for HIV, I only need to get tested every other year d.) Since I got Hepatitis B vaccine, I am protected from sexually transmitted infections.

- "I should plan on getting tested each year for sexually transmitted infections." It is recommended that all sexually active females who are under the age of 25 receive a yearly screening for chlamydia, gonorrhea, and syphilis infections.

A nurse is providing education to a male client about health promotion screenings. Which of the following information should the nurse include in the teaching? a.) a digital rectal examination can detect enlargement of the prostate gland. b.) the prostate-specific antigen (PSA) test evaluates semen for the presence of cancer cells c.) testicular self-examination should be performed when the client is sitting in a cool environment d.) a client who has an average risk for colorectal cancer should have a colonoscopy every 2 years.

- A digital rectal examination can detect enlargement of the prostate gland. A digital rectal examination can assess the size of the prostate gland and the presence of any tenderness or nodules.

A nurse is providing education to a young adult about the human papillomavirus (HPV) vaccine. Which of the following information should the nurse include in the teaching? a.) the HPV vaccine is only recommended for female clients b.) an HPV infection can lead to the development of cancer c.) the HPV vaccine should be administered before age 18 to be effective d.) immunization to prevent an HPV infection requires a single injection

- An HPV infection can lead to the development of cancer. HPV infections are associated with the development of genital, rectal, and oropharyngeal cancers.

A nurse is inserting a urinary catheter for a female adolescent. Which of the following findings should the nurse report to the provider? a.) a membrane at the vaginal opening b.) an area of tenderness on the labia majora c.) lack of pubic hair on the medial thigh d.) labia minora is a darker skin tone than overall coloring

- An area of tenderness on the labia majora A palpable, fluid-filled area with swelling, tenderness, or other manifestations of inflammation on the labia majora could be a Bartholin gland abscess and should be reported to the provider.

A nurse is providing a bed bath for an older adult client who is immobile. Which of the following findings should the nurse report to the provider? a.) a pendulous scrotal sac b.) an inability to retract the foreskin c.) sparse pubic hair d.) left testicle is positioned lower than the right one

- An inability to retract the foreskin The prepuce, or foreskin, should be retractable in an uncircumcised male. Phimosis, a narrowed opening of the foreskin, is an unexpected finding and should be reported to the provider.

A nurse is preparing to assess a client for the presence of a hernia. Which of the following areas should nurse plan to inspect? (select all that apply) a.) femoral area b.) inguinal area c.) rectal area d.) length of the shaft e.) the circumference of the glans

- Femoral area is correct. The nurse should inspect the bilateral areas of the femoral canal for the presence of any bulges, swelling, or asymmetry that can indicate the occurrence of a femoral hernia. A femoral hernia occurs when loops of bowel descend through the femoral canal; it can present a surgical emergency. - Inguinal area is correct. The nurse should inspect the bilateral areas below the symphysis pubis, on either side of the penile shaft, for the presence of any bulges, swelling, or asymmetry that can indicate the occurrence of an inguinal hernia. An inguinal hernia occurs when loops of bowel descend through the inguinal canal.

A nurse is caring for a male client who reports the presence of yellow discharge from the meatus and burning with urination. Which of the following infections should the nurse suspect? a.) Human papillomavirus (HPV) b.) Urinary tract infection (UTI) c.) Syphillis d.) gonorrhea

- Gonorrhea The reported manifestation of yellow discharge from the meatus and dysuria are associated with a gonorrhea infection. The edges of the meatus can also appear inflamed and edematous.

A nurse is caring for an older adult client who has an enlarged prostate and reports difficulty voiding. Which of the following actions should the nurse take? (select all that apply) a.) perform a bladder scan within 60 minutes of the client voiding b.) ensure that the client's intake is significantly greater than output c.) inspect the client's suprapubic area for distention d.) notify the provider if the bladder scan residual volume is greater than 100ml e.) ask the client if they are experiencing pain or a burning sensation when voiding

- Inspect the client's suprapubic area for distention is correct. Clients who have an enlarged prostate can experience difficulty or an inability to pass urine due to an obstruction at the bladder outlet. A full bladder can be noted by inspecting the suprapubic area for distention and when the client reports lower abdominal discomfort. - Notify the provider if the bladder scan residual volume is greater than 100 mL is correct. A post-void residual is expected to be less than 100 mL. The nurse should notify the provider if the volume is greater than 100 mL. - Ask the client if they are experiencing pain or a burning sensation when voiding is correct. Clients who have difficulty emptying their bladder can develop a urinary tract infection (UTI) due to urinary stasis. Manifestations of a UTI can include a burning sensation when voiding, frequent voiding of small volumes, urgency, suprapubic pain, fever, and bloody urine.

A nurse is inspecting the genitalia of an older adult female client. For which of the following findings should the nurse notify the provider? a.) sparse pubic hair b.) atrophy of the mons pubis c.) dry vaginal membranes d.) labial ulcerations

- Labial ulceration Redness, swelling, or ulcerations in the genital area are always unexpected findings and should be reported to the provider.

A nurse is preparing to assist with a prostate examination. Which of the following actions should the nurse plan to take? a.) supply sterile gloves for the provider b.) provide the supplies for a specimen culture c.) position the client standing, facing the examination table d.) darken the lighting in the room.

- Position the client standing, facing the examination table. An ambulatory client can be positioned standing with the examination table supporting their upper body. Alternately, the provider might prefer the client to be positioned on their left side with the hip and knee flexed to stabilize their position and enable adequate visualization of the area.

A nurse is preparing to assist the provider with an assessment of a female client's genitourinary system. Which of the following actions should the nurse plan to take? a.) position the client supine with the head of the bed elevated b.) avoid conversation while the provider is performing the assessment c.) instruct the client to position their knees inward d.) position the client's arms above their head

- Position the client supine with the head of the bed elevated. The client should be positioned supine with the head of the bed elevated 45° or with their head on a pillow so that the provider can maintain eye contact with the client throughout the examination.

A nurse is conducting a healthy interview with a client about their urinary system. The nurse should recognize that which of the following client reports could indicate the presence of declining kidney function? (select all that apply) a.) recent weight gain b.) hematuria c.) shortness of breath d.) swelling in the ankles e.) difficulty starting a urine system

- Recent weight gain is correct. If kidney function declines, the body is less able to excrete fluid, leading to extracellular volume overload. This alteration in fluid balance can result in weight gain, edema, and shortness of breath. - Shortness of breath is correct. If kidney function declines, the body is less able to excrete fluid, leading to extracellular volume overload. This alteration in fluid balance can result in weight gain, edema, and shortness of breath. - Swelling in the ankles is correct. If kidney function declines, the body is less able to excrete fluid, leading to extracellular volume overload. This alteration in fluid balance can result in weight gain, edema, and shortness of breath.

A nurse is inspecting a client's rectal area and noted the presence of bulging red tissue that encompasses the entire anal opening. Which of the following should the nurse suspect? a.) anal fissure b.) rectal prolapse c.) external hemorrhoid d.) pilondial sinus

- Rectal prolapse A rectal prolapse appears as a moist, red, circular protrusion of the rectal mucus membranes through the anal opening. This can occur due to straining if the client has weak pelvic muscular support.

A nurse is preparing to assess a client's genitalia. Which of the following actions should the nurse plan to take? a.) ensure the client has a full bladder b.) use a firm, deliberate touch when palpating c.) apply sterile gloves prior to touching the genitalia d.) remove the drape from the lower half of the cleint's body.

- Use a firm, deliberate touch when palpating. The nurse should use a gentle, firm, deliberate touch when palpating a client's genitals.

A nurse is inspecting the genitals of an adult male client. Which of the following should the nurse identify as expected findings? (select all that apply) a.) visible dorsal vein on the underside of the penile shaft b.) bilateral pea-sized (1cm), soft testes c.) Meatus located on the dorsal side of the glans d.) absence of public hair on the penile shaft e.) testes that are easily moveable during palpation

- Visible dorsal vein on the underside of the penile shaft is correct. The dorsal vein might be visible on the penile shaft. This is an expected finding. - Absence of pubic hair on the penile shaft is correct. Pubic hair is expected to be present only at the base of the penis. This is an expected finding. - Testes that are easily movable during palpation is correct. It is an expected finding that the testes are freely movable. Testes that are not movable should be reported to the provider.

A nurse is providing education to a female client who has expressed a desire to use a natural method of contraception. Which of the following methods should the nurse recommend? (select all that apply) a.) condoms b.) withdrawal c.) fertility track with periodic abstinence d.) spermicidal sponge e.) tubal ligation

- Withdrawal is correct. Withdrawing the penis from the vagina prior to ejaculation is considered a natural method of contraception. - Fertility tracking with periodic abstinence is correct. Fertility tracking involves an understanding of the reproductive cycle and monitoring for subtle clues that are present during fertile times. This is a natural method of contraception.