NURSING HEALTH ASSESSMENT APEA EXAM QUESTIONS AND ANSWERS
WITH RATIONALES TEST BANK 2 – EXAM QUESTIONS & ANSWERS
Question:
What is the recommendation of American Cancer Society for initial
screening of an African-American male for prostate cancer?
Digital rectal exam starting at age 40 yearsPSA starting at age 45
yearsDiscussions starting at age 40-45 years CorrectHe should be screened
starting at age 50 years.
Explanation:
American Cancer Society guidelines recommend beginning screening
discussion at age 40-45 years for males at high risk for developing prostate
cancer (e.g. a first degree relative with prostate cancer before age 65 or
African American race). The reason for “screening discussions” is to keep
males involved in individual decision making. The PSA threshold is 4.0
ng/mL. Testing is discouraged for males with less than a 10 year expected
survival. US Preventive Services Task Force does not recommend
screening.
,Question:
What is American Cancer Society’s recommendation for prostate screening in a 70 year-ol
male?
He should be screened annually with PSA only.He should be screened
annually with PSA and DRE.He should be screened until he has a life
expectancy of less than 10 years. CorrectScreening can stop at age 75 years.
Explanation:
Prostate cancer screening at age 70 years includes both prostate specific
antigen measurement (PSA) and digital rectal exam (DRE). Prostate cancer
is typically a slow growing tumor, thus if life expectancy is < 10 years,
screening is not cost-effective.
Question:
A 70 year-old male presents to your clinic with a lump in his breast. How
should this be evaluated? Palpation and ultrasound IncorrectMammogram
and ultrasound CorrectUltrasound onlyMammogram only
Explanation:
This patient has a lump identified in the breast. Since males can develop
breast cancer, it must be evaluated in the same means that a female breast
lump would be evaluated. He should have a clinical breast exam to identify
the position of the lump, and any other abnormal findings such as nodes or
other lumps. Then, he should have mammogram and ultrasound to help
evaluate the lump. If the findings were suspicious for a malignancy, the
patient would be referred to a surgeon.
Question:
A 22 year-old male who is otherwise healthy complains of scrotal pain. His
pain has developed over the past 4 days. He is diagnosed with epididymitis.
What is the most likely reason?
His ageInfection with Chlamydia CorrectUnderlying hydroceleUrinary tract infection
Explanation:
Several factors predispose males to epididymitis. In men under age 35, the
most common cause of epididymitis is infection with Chlamydia
trachomatis. In older men, urinary tract pathogens are more typical. In pre-
pubertal boys, bicycle riding and heavy physical exertion are most
common. In pre-pubertal boys, consideration should be given to congenital
,abnormalities.
Question:
Digital rectal exam may be performed to assess the prostate gland. Which
term does NOT describe a prostate gland that may have a tumor?
NodularAsymmetricalBoggy CorrectIndurated
Explanation:
A boggy prostate describes a gland that is edematous and tender, such as is
seen in a patient with bacterial prostatitis. The other terms indicate an
abnormality that could represent a prostate gland tumor.
Question:
A male patient has epididymitis. His most likely complaint will be:
burning with urination.testicular pain.scrotal pain. Correctpenile discharge.
Explanation:
The most common complaint is scrotal pain. It usually develops over a
period of days. Occasionally, it develops acutely and will be accompanied
by fever, chills, and a very ill-appearing patient. Burning with urination is
possible if the underlying cause is a urinary tract infection, but, this is not
usual. This presentation is seen more commonly in older males. Testicular
pain is not a common complaint with epididymitis. Penile discharge would
not indicate an infection in the epididymis since the epididymis is a tightly
coiled tubular structure located on the testis.
Question:
What is the recommendation of American Cancer Society for screening an
average risk 40 year-old Caucasian male for prostate cancer?
Digital rectal examSerum prostate specific antigen (PSA)Digital rectal
exam and PSAHe should be screened starting at age 50 years. Correct
Explanation:
American Cancer Society recommends initial prostate screening of an
average risk male at age 50 years with PSA testing with or without digital
rectal exam. If the initial PSA is < 2.5 ng/mL, the screen can be repeated in
, 2 years. If the PSA is > 2.5, annual screening should take place.
Question:
Which of the following results in a clinically insignificant increase in the
prostate specific antigen (PSA)? Digital rectal exam
CorrectEjaculationProstatitis IncorrectProstate biopsy
Explanation:
Digital rectal exam (DRE) leads to a clinically insignificant increase of
0.26-0.4 ng/ml for about 48-72 hours afterwards. Prostate biopsy increases
the PSA about 8 ng/ml for up to 4 weeks following biopsy. Prostate
infection and ejaculation both can increase the PSA levels.
Question:
Hesselbach’s triangle forms the landmark for:
inguinal hernia. Correctfemoral hernia.abdominal hernia.umbilical hernia.
Explanation:
Direct inguinal hernias occur through Hesselbach’s triangle. The inguinal
ligament, the rectus muscle, and the epigastric vessels form the triangle.
When there is a weakness in the floor of the inguinal canal, a hernia can
result. Inguinal hernias are the most common groin hernias in men and
women. Repair of this is the most common surgical procedure performed in
the US.
Question:
Which of the following medications should be avoided in a 65 year-old
male with benign prostatic hyperplasia (BPH)?
Doxazosin IncorrectCiprofloxacinPseudoephedrine CorrectPropanolol
Explanation:
Nasal decongestants like pseudoephedrine should be avoided in men with
BPH. These will increase the urge to urinate. Urinary frequency is a
bothersome symptom of males with BPH. Medications that are known to
impair urination are muscle relaxants, narcotics, tricyclic antidepressants
such as amitriptyline, and medications with anticholinergic properties such
as antihistamines.
WITH RATIONALES TEST BANK 2 – EXAM QUESTIONS & ANSWERS
Question:
What is the recommendation of American Cancer Society for initial
screening of an African-American male for prostate cancer?
Digital rectal exam starting at age 40 yearsPSA starting at age 45
yearsDiscussions starting at age 40-45 years CorrectHe should be screened
starting at age 50 years.
Explanation:
American Cancer Society guidelines recommend beginning screening
discussion at age 40-45 years for males at high risk for developing prostate
cancer (e.g. a first degree relative with prostate cancer before age 65 or
African American race). The reason for “screening discussions” is to keep
males involved in individual decision making. The PSA threshold is 4.0
ng/mL. Testing is discouraged for males with less than a 10 year expected
survival. US Preventive Services Task Force does not recommend
screening.
,Question:
What is American Cancer Society’s recommendation for prostate screening in a 70 year-ol
male?
He should be screened annually with PSA only.He should be screened
annually with PSA and DRE.He should be screened until he has a life
expectancy of less than 10 years. CorrectScreening can stop at age 75 years.
Explanation:
Prostate cancer screening at age 70 years includes both prostate specific
antigen measurement (PSA) and digital rectal exam (DRE). Prostate cancer
is typically a slow growing tumor, thus if life expectancy is < 10 years,
screening is not cost-effective.
Question:
A 70 year-old male presents to your clinic with a lump in his breast. How
should this be evaluated? Palpation and ultrasound IncorrectMammogram
and ultrasound CorrectUltrasound onlyMammogram only
Explanation:
This patient has a lump identified in the breast. Since males can develop
breast cancer, it must be evaluated in the same means that a female breast
lump would be evaluated. He should have a clinical breast exam to identify
the position of the lump, and any other abnormal findings such as nodes or
other lumps. Then, he should have mammogram and ultrasound to help
evaluate the lump. If the findings were suspicious for a malignancy, the
patient would be referred to a surgeon.
Question:
A 22 year-old male who is otherwise healthy complains of scrotal pain. His
pain has developed over the past 4 days. He is diagnosed with epididymitis.
What is the most likely reason?
His ageInfection with Chlamydia CorrectUnderlying hydroceleUrinary tract infection
Explanation:
Several factors predispose males to epididymitis. In men under age 35, the
most common cause of epididymitis is infection with Chlamydia
trachomatis. In older men, urinary tract pathogens are more typical. In pre-
pubertal boys, bicycle riding and heavy physical exertion are most
common. In pre-pubertal boys, consideration should be given to congenital
,abnormalities.
Question:
Digital rectal exam may be performed to assess the prostate gland. Which
term does NOT describe a prostate gland that may have a tumor?
NodularAsymmetricalBoggy CorrectIndurated
Explanation:
A boggy prostate describes a gland that is edematous and tender, such as is
seen in a patient with bacterial prostatitis. The other terms indicate an
abnormality that could represent a prostate gland tumor.
Question:
A male patient has epididymitis. His most likely complaint will be:
burning with urination.testicular pain.scrotal pain. Correctpenile discharge.
Explanation:
The most common complaint is scrotal pain. It usually develops over a
period of days. Occasionally, it develops acutely and will be accompanied
by fever, chills, and a very ill-appearing patient. Burning with urination is
possible if the underlying cause is a urinary tract infection, but, this is not
usual. This presentation is seen more commonly in older males. Testicular
pain is not a common complaint with epididymitis. Penile discharge would
not indicate an infection in the epididymis since the epididymis is a tightly
coiled tubular structure located on the testis.
Question:
What is the recommendation of American Cancer Society for screening an
average risk 40 year-old Caucasian male for prostate cancer?
Digital rectal examSerum prostate specific antigen (PSA)Digital rectal
exam and PSAHe should be screened starting at age 50 years. Correct
Explanation:
American Cancer Society recommends initial prostate screening of an
average risk male at age 50 years with PSA testing with or without digital
rectal exam. If the initial PSA is < 2.5 ng/mL, the screen can be repeated in
, 2 years. If the PSA is > 2.5, annual screening should take place.
Question:
Which of the following results in a clinically insignificant increase in the
prostate specific antigen (PSA)? Digital rectal exam
CorrectEjaculationProstatitis IncorrectProstate biopsy
Explanation:
Digital rectal exam (DRE) leads to a clinically insignificant increase of
0.26-0.4 ng/ml for about 48-72 hours afterwards. Prostate biopsy increases
the PSA about 8 ng/ml for up to 4 weeks following biopsy. Prostate
infection and ejaculation both can increase the PSA levels.
Question:
Hesselbach’s triangle forms the landmark for:
inguinal hernia. Correctfemoral hernia.abdominal hernia.umbilical hernia.
Explanation:
Direct inguinal hernias occur through Hesselbach’s triangle. The inguinal
ligament, the rectus muscle, and the epigastric vessels form the triangle.
When there is a weakness in the floor of the inguinal canal, a hernia can
result. Inguinal hernias are the most common groin hernias in men and
women. Repair of this is the most common surgical procedure performed in
the US.
Question:
Which of the following medications should be avoided in a 65 year-old
male with benign prostatic hyperplasia (BPH)?
Doxazosin IncorrectCiprofloxacinPseudoephedrine CorrectPropanolol
Explanation:
Nasal decongestants like pseudoephedrine should be avoided in men with
BPH. These will increase the urge to urinate. Urinary frequency is a
bothersome symptom of males with BPH. Medications that are known to
impair urination are muscle relaxants, narcotics, tricyclic antidepressants
such as amitriptyline, and medications with anticholinergic properties such
as antihistamines.
