Chapter 25, Male Genitourinary System: Findings for Anus, Rectum, Prostate, and Male Genitalia-Sherpath

Question 1 of 15

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The prostate of a healthy patient should have a diameter of __ cm.

• • Your answer: 4Correct answer: 4The prostate should have a diameter of 4 cm (1.57 in.) in a healthy patient.

Question 2 of 15

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Which findings are normal when assessing the prostate gland?

• Correct
  • FirmThe normal prostate gland should be firm on palpation.
• • NodularThe normal prostate gland should not be nodular on palpation.
• Correct
  • Slightly movableThe normal prostate gland should be slightly movable on palpation.
• Correct
  • SmoothThe normal prostate gland should be smooth on palpation.
• • TenderThe normal prostate gland should not be tender on palpation. Tenderness may indicate a problem and should be explored further.

Question 3 of 15

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Which findings should the examiner consider normal when palpating the sacrococcygeal and perianal areas?

• • MassesIdentification of a mass on palpation of the sacrococcygeal and perianal areas is unexpected.
• • NodulesThe examiner should not expect to palpate nodules on the sacrococcygeal and perianal areas.
• • PolypsThe examiner should not expect to palpate polyps on the sacrococcygeal and perianal areas.
• Correct
  • Uninterrupted skinThe examiner should expect the sacrococcygeal and perianal areas to be smooth without irregularities on palpation.

Question 4 of 15

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Which findings should be considered normal when the examiner gently retracts the foreskin of the penis of an uncircumcised patient?

• • Bright red urethral orificeThe urethral orifice is not expected to appear bright red on retraction of the foreskin.
• Correct
  • Cheesy sebaceous matterSmegma is a normal finding in an uncircumcised patient and may appear as cheesy sebaceous matter.
• • Penile dischargeDischarge is an abnormal finding when retracting the foreskin and may indicate an infection.
• Correct
  • Slitlike urethral meatusThe urethral meatus should appear slitlike when retracting the foreskin. A round opening may indicate meatus stenosis.
• Correct
  • Visible dorsal vein on the penisThe dorsal vein is expected to be visible on the penis when retracting the foreskin.

Question 5 of 15

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Which findings should the examiner note as normal on palpation of the flaccid penis?

• • DischargeThe examiner should not expect discharge when palpating the flaccid penis.
• Correct
  • SoftnessOn palpation of the flaccid penis, the examiner should expect the penis to be soft.
• • NodularityThe examiner should not expect the flaccid penis to be nodular on palpation.
• • TendernessThe examiner should not expect the flaccid penis to be tender on palpation.

Question 6 of 15

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Which findings should the examiner note as normal on assessment of the scrotum?

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  • Coarse textureThe examiner should expect the skin of the scrotum to be coarse on palpation.
• • PittingPitting of the scrotum is an unexpected finding.
• • Sebaceous cystsSebaceous cysts are a common but abnormal finding and appear as lumps in the scrotal skin.
• Correct
  • Skin darker than the bodyThe examiner should expect the scrotal skin to be darker than the body.
• Correct
  • Slightly asymmetric shapeThe examiner should expect the scrotum to be slightly asymmetric, because the left testicle has a longer spermatic cord and thus is often lower.

Question 7 of 15

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The testicle of a newborn is typically __ cm in diameter.

• • Your answer: 1Correct answer: 1The testicle of a newborn typically measures 1 cm (0.39 in.) in diameter.

Question 8 of 15

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Which response is expected on a light touch to the anal opening of an infant?

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  • Anal contractionThe anus should contract (also known as an “anal wink”) when lightly touched.
• • Anal dilationAnal contraction, not anal dilation, is expected when lightly touching the anal opening.
• • Anal dischargeAnal contraction, not anal discharge, is expected when lightly touching the anal opening.
• • Anal erythemaAnal contraction, not anal erythema, is expected when lightly touching the anal opening.

Question 9 of 15

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Which finding related to the foreskin of an infant should the examiner consider normal?

• Correct
  • Adherence to the prepuce of the glansIn an infant, the foreskin may adhere to the glans and should not be forced to retract.
• • InflammationThe foreskin of an infant is not expected to be inflamed.
• • NodularityThe foreskin of an infant is expected to be smooth, not nodular.
• • RednessThe foreskin of an infant is not expected to be red. An erythematous foreskin may indicate infection.

Question 10 of 15

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Which findings are abnormal when assessing the sacrococcygeal and perianal areas?

• Correct
  • Anal fissureAn anal fissure is a tear in the anal mucosa and is an abnormal finding. Fissures occur most often in the posterior midline.
• • Coarse anal skinCoarse anal skin that is darker than the surrounding skin is a normal finding.
• Correct
  • External hemorrhoidsExternal hemorrhoids are an abnormal finding. When visible, they appear as soft swellings of the veins in the lower portion of the rectum or anus.
• Correct
  • Redness around the anal openingRedness is an abnormal finding and may indicate inflammation or infection.
• • Smooth, uninterrupted skinSmooth, uninterrupted skin is a normal finding.

Question 11 of 15

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Which finding would you consider abnormal when palpating the rectum?

• • Patient urge to defecateThe patient urge to defecate is a normal finding as the external sphincter is opened when the examining finger enters the rectum.
• Correct
  • Rough, lumpy rectal wallsRough, lumpy rectal walls are an abnormal finding. The rectal walls should be smooth, even, and uninterrupted.
• • Smooth anal ringA smooth anal ring is a normal finding.
• • Sphincter that tightens evenly around your fingerA sphincter that tightens evenly around your finger is a normal finding.

Question 12 of 15

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Which findings are abnormal when palpating the prostate?

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  • Left lobe larger than right lobeThe lateral lobes should be symmetric, so having one lobe that is larger than the other is an abnormal finding.
• • Palpable median sulcusA palpable median sulcus is a normal finding.
• Correct
  • Protrusion >0.39 in. (>1 cm) into the rectumProtrusion ≤0.39 in. (≤1 cm) into the rectum is a normal finding. Protrusion >0.39 in. (>1 cm) is an abnormal finding that indicates prostate enlargement.
• Correct
  • Soft bumps on the prostate lobesBumps of any consistency are an abnormal finding. The surface of the prostate should be smooth, with no nodules or masses.
• Correct
  • Soft, rubbery consistencyA soft consistency is abnormal. The consistency of the prostate should be firm, not soft.

Question 13 of 15

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Which findings are abnormal when palpating the inguinal area?

• • Oval external ringThe external ring of the inguinal canal is expected to be oval.
• Correct
  • Palpable lymph nodesThe lymph nodes are not expected to be palpable in the inguinal area. Palpable nodes may indicate an infection.
• Correct
  • SwellingSwelling in the inguinal area is an abnormal finding and may indicate an infection.
• Correct
  • TendernessTenderness of the inguinal area is an abnormal finding and may indicate infection or hernia.
• Correct
  • Viscous on the examining fingerThe presence of a Viscous against the examining finger when the patient coughs is abnormal and suggests an inguinal hernia.

Question 14 of 15

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Which findings are considered abnormal when palpating the inguinal canal for a hernia?

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  • Bulge in the inguinal areaA bulge in the inguinal area is abnormal and may indicate a hernia.
• • Oval external ringThe presence of an oval external ring on palpation is a normal finding; it does not indicate a hernia.
• Correct
  • Swelling of the internal ringSwelling of the internal ring is abnormal and may indicate a hernia.
• Correct
  • TendernessTenderness on palpation is an abnormal finding and may indicate a hernia.
• Correct
  • Viscous on coughThe feeling of a Viscous against the examining finger on coughing is abnormal and may indicate a hernia.

Question 15 of 15

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Which findings should be considered abnormal when palpating the shaft of the penis?

• Correct
  • IndurationInduration is an abnormal finding on palpation of the penile shaft.
• Correct
  • NodularityNodularity is an abnormal finding on palpation of the penile shaft.
• Correct
  • PriapismPriapism, or prolonged erection, is an abnormal finding on palpation of the penile shaft.
• • SoftnessThe penile shaft should feel soft to the touch on palpation.
• Correct
  • TendernessTenderness is an abnormal finding on palpation of the penile shaft.