QUESTIONS AND VERIFIED ANSWERS
/GRADED A
A 62-year-old male who is undergoing evaluation for possible
prostate cancer strongly declines a rectal examination, stating
that, "Some trainee once did that and it hurt badly." Which of
the following is true about the innervation of the anus and
rectum that may explain this patient's experience of
discomfort?
The anal canal has a rich somatosensory innervation, making
poorly directed examinations painful in this area.
A 54-year-old male with a strong family history of breast and
prostate cancer presents to his primary care provider to
discuss prostate screening. His father died at age 73 years
from prostate cancer that was not detected on routine digital
rectal examinations (DREs), and he would like to minimize
his chance of a similar occurrence. Which of the following is
true regarding the anatomy and screening of the prostate by
DRE?
The median lobe of the prostate is located anterior to the
urethra and is not palpable on DRE.
,A clinician is meeting the mother of a 5-year-old with asthma
for the first time. The mother notes that the asthma has been
poorly controlled and that the child has had multiple
hospitalizations. The clinician inquires about family stressors
and finds that the parents are divorced, the mother recently
lost her job, and the child spent 2 months living with her
grandparents who both smoke. Which of the following is the
best example of the role of health promotion with this family?
Develop a health promotion plan that includes more frequent
visits and guidance to assist family with stressors and improve
the child's asthma symptoms.
A clinician is reading the chart of a full-term newborn whose
mother had an uneventful pregnancy in the hospital for the
first time on the day of birth. In reviewing the infant's chart,
the clinician notes that, in the delivery room, at 5 minutes, the
infant had a heart rate >100, strong respiratory effort, was
crying vigorously, moving actively, and had good color
except for some acrocyanosis of the hands and feet. This
infant's APGAR score is closest to which of the following?
9
A newborn who is floppy and limp, blue in color, with a heart
rate of 60, and minimal respiratory effort has just been
delivered. The infant has no grimace and only a very weak
,cry. What is the best immediate response to the infant in this
situation?
Begin neonatal resuscitation.
An infant is born 4 weeks preterm to a mother with a history
of hypertension, severe diabetes, and alcohol abuse. The
infant is noted to be small for gestational age (SGA),
weighing just 1,500 g. Which of the following is the most
important reason for assessing both gestational age and birth
weight for any infant?
These two factors help to anticipate certain medical and
developmental problems.
A clinician arrives at the hospital several hours after the birth
of a full-term infant. The infant is rooming in with her parents
and appears to be doing well. There were no problems with
the pregnancy, labor, or delivery. The nurse asks if the baby
should be taken back to the nursery for examination. What is
the best response to the nurse?
State that the infant should be examined in the presence of the
parents so they can be taught about what their newborn can
do.
, The nurse in the newborn nursery reports that she is
concerned about Baby Boy Jones, who was born full-term by
cesarean section for failure to progress. The pregnancy was
complicated only by a maternal urinary tract infection in the
first trimester. He had APGARs of 9 and 10 at 1 and 5
minutes, respectively, and had been doing well. However,
now, on the fourth day of life, the infant has developed a
tremor. Which of the following factors would cause the most
concern about the tremor?
The infant also has asymmetric limb movements.
A mother brings her 9-month-old son to the practice for the
first time, concerned that he is not yet sitting by himself. After
taking a careful history, the physician notes that the infant has
good head control and can grasp a rattle but is unable to roll
over, crawl, or pull to stand. What should the clinician explain
to the mother?
The delay in his physical motor skills is concerning and
warrants a more complete developmental history and possible
referral for early intervention.
A 42-year-old school teacher with a history of irregular
periods who underwent successful intrauterine insemination
(IUI) on January 25th presents to the clinic for care on March
19th. Her last menstrual period (LMP) was November 11th of