NR509 ADVANCED PHYSICAL ASSESSMENT EXAM NEWEST
2025/2026 COMPLETE QUESTIONS AND CORRECT D, Exams of
Nursing
The nurse is performing an examination of the anus and rectum. Which of these
statements is correct and important to remember during this examination?
a. The rectum is approximately 8 cm long.
b. The anorectal junction cannot be palpated.
c. Above the anal canal, the rectum turns anteriorly.
d. No sensory nerves are in the anal canal or rectum. b. The anorectal junction cannot
be palpated.
The structure that secretes a thin, milky alkaline fluid to enhance the viability of sperm is
the:
a. Cowper gland.
b. Prostate gland.
c. Median sulcus.
d. Bulbourethral gland. b. Prostate gland.
A 46-year-old man requires an assessment of his sigmoid colon. Which instrument or
technique is most appropriate for this examination?
a. Proctoscope
b. Ultrasound
c. Colonoscope
d. Rectal examination with an examining finger c. Colonoscope
The nurse is caring for a newborn infant. Thirty hours after birth, the infant passes a dark
green meconium stool. The nurse recognizes this is important because the:
a. Stool indicates anal patency.
b. Dark green color indicates occult blood in the stool.
c. Meconium stool can be reflective of distress in the newborn.
d. Newborn should have passed the first stool within 12 hours after birth. a. Stool
indicates anal patency.
During the assessment of an 18-month-old infant, the mother expresses concern to the
nurse about the infant's inability to toilet train. What would be the nurse's best
response?
a. "Some children are just more difficult to train, so I wouldn't worry about it yet."
1|Page
,b. "Have you considered reading any of the books on toilet training? They can be very
helpful."
c. "This could mean that there is a problem in your baby's development. We'll watch her
closely for the next few months."
d. "The nerves that will allow your baby to have control over the passing of stools are
not developed until at least 18 to 24 months of age." d. "The nerves that will allow your
baby to have control over the passing of stools are not developed until at least 18 to 24
months of age."
A 60-year-old man has just been told that he has benign prostatic hypertrophy (BPH). He
has a friend who just died from cancer of the prostate. He is concerned this will happen
to him. How should the nurse respond?
a. "The swelling in your prostate is only temporary and will go away."
b. "We will treat you with chemotherapy so we can control the cancer."
c. "It would be very unusual for a man your age to have cancer of the prostate."
d. "The enlargement of your prostate is caused by hormonal changes, and not cancer."
d. "The enlargement of your prostate is caused by hormonal changes, and not
cancer."
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?
a. Pinworms
b. Hemorrhoids
c. Colon cancer
d. Fecal incontinence b. Hemorrhoids
A patient who is visiting the clinic complains of having "stomach pains for 2 weeks" and
describes his stools as being "soft and black" for approximately the last 10 days. He
denies taking any medications. The nurse is aware that these symptoms are mostly
indicative of:
a. Excessive fat caused by malabsorption.
b. Increased iron intake, resulting from a change in diet.
c. Occult blood, resulting from gastrointestinal bleeding.
d. Absent bile pigment from liver problems. c. Occult blood, resulting from
gastrointestinal bleeding.
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):
2|Page
,a. Annual proctoscopy.
b. Colonoscopy every 10 years.
c. Fecal test for blood every 6 months.
d. DREs every 2 years. b. Colonoscopy every 10 years.
The mother of a 5-year-old girl tells the nurse that she has noticed her daughter
"scratching at her bottom a lot the last few days." During the assessment, the nurse
finds redness and raised skin in the anal area. This finding most likely indicates:
a. Pinworms.
b. Chickenpox.
c. Constipation.
d. Bacterial infection. a. Pinworms.
The nurse is examining only the rectal area of a woman and should place the woman in
what position?
a. Lithotomy
b. Prone
c. Left lateral decubitus
d. Bending over the table while standing c. Left lateral decubitus
While performing an assessment of the perianal area of a patient, the nurse notices that
the pigmentation of anus is darker than the surrounding skin, the anal opening is closed,
and a skin sac that is shiny and blue is noted. The patient mentioned that he has had
pain with bowel movements and has occasionally noted some spots of blood. What
would this assessment and history most likely indicate?
a. Anal fistula
b. Pilonidal cyst
c. Rectal prolapse
d. Thrombosed hemorrhoid d. Thrombosed hemorrhoid
The nurse is preparing to palpate the rectum and should use which of these techniques?
The nurse should:
a. Flex the finger, and slowly insert it toward the umbilicus.
b. First instruct the patient that this procedure will be painful.
c. Insert an extended index finger at a right angle to the anus.
d. Place the finger directly into the anus to overcome the tight sphincter. a. Flex the
finger, and slowly insert it toward the umbilicus.
While performing a rectal examination, the nurse notices a firm, irregularly shaped
mass. What should the nurse do next?
3|Page
, a. Continue with the examination, and document the finding in the chart.
b. Instruct the patient to return for a repeat assessment in 1 month.
c. Tell the patient that a mass was felt, but it is nothing to worry about.
d. Report the finding, and refer the patient to a specialist for further examination. d.
Report the finding, and refer the patient to a specialist for further examination.
During an assessment of the newborn, the nurse expects to see which finding when the
anal area is slightly stroked?
a. Jerking of the legs
b. Flexion of the knees
c. Quick contraction of the sphincter
d. Relaxation of the external sphincter c. Quick contraction of the sphincter
A 13-year-old girl is visiting the clinic for a sports physical examination. The nurse should
remember to include which of these tests in the examination?
a. Testing for occult blood
b. Valsalva maneuver
c. Internal palpation of the anus
d. Inspection of the perianal area d. Inspection of the perianal area
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:
a. Rectal polyp.
b. Pruritus ani.
c. Carcinoma.
d. Pilonidal cyst. d. Pilonidal cyst.
During an examination, the nurse asks the patient to perform the Valsalva maneuver and
notices that the patient has a moist, red, doughnut-shaped protrusion from the anus.
The nurse knows that this finding is consistent with a:
a. Rectal polyp.
b. Hemorrhoid.
c. Rectal fissure.
d. Rectal prolapse. d. Rectal prolapse.
A 70-year-old man is visiting the clinic for difficulty in passing urine. In the health history,
he indicates that he has to urinate frequently, especially at night. He has burning when
he urinates and has noticed pain in his back. Considering this history, what might the
nurse expect to find during the physical assessment?
4|Page
2025/2026 COMPLETE QUESTIONS AND CORRECT D, Exams of
Nursing
The nurse is performing an examination of the anus and rectum. Which of these
statements is correct and important to remember during this examination?
a. The rectum is approximately 8 cm long.
b. The anorectal junction cannot be palpated.
c. Above the anal canal, the rectum turns anteriorly.
d. No sensory nerves are in the anal canal or rectum. b. The anorectal junction cannot
be palpated.
The structure that secretes a thin, milky alkaline fluid to enhance the viability of sperm is
the:
a. Cowper gland.
b. Prostate gland.
c. Median sulcus.
d. Bulbourethral gland. b. Prostate gland.
A 46-year-old man requires an assessment of his sigmoid colon. Which instrument or
technique is most appropriate for this examination?
a. Proctoscope
b. Ultrasound
c. Colonoscope
d. Rectal examination with an examining finger c. Colonoscope
The nurse is caring for a newborn infant. Thirty hours after birth, the infant passes a dark
green meconium stool. The nurse recognizes this is important because the:
a. Stool indicates anal patency.
b. Dark green color indicates occult blood in the stool.
c. Meconium stool can be reflective of distress in the newborn.
d. Newborn should have passed the first stool within 12 hours after birth. a. Stool
indicates anal patency.
During the assessment of an 18-month-old infant, the mother expresses concern to the
nurse about the infant's inability to toilet train. What would be the nurse's best
response?
a. "Some children are just more difficult to train, so I wouldn't worry about it yet."
1|Page
,b. "Have you considered reading any of the books on toilet training? They can be very
helpful."
c. "This could mean that there is a problem in your baby's development. We'll watch her
closely for the next few months."
d. "The nerves that will allow your baby to have control over the passing of stools are
not developed until at least 18 to 24 months of age." d. "The nerves that will allow your
baby to have control over the passing of stools are not developed until at least 18 to 24
months of age."
A 60-year-old man has just been told that he has benign prostatic hypertrophy (BPH). He
has a friend who just died from cancer of the prostate. He is concerned this will happen
to him. How should the nurse respond?
a. "The swelling in your prostate is only temporary and will go away."
b. "We will treat you with chemotherapy so we can control the cancer."
c. "It would be very unusual for a man your age to have cancer of the prostate."
d. "The enlargement of your prostate is caused by hormonal changes, and not cancer."
d. "The enlargement of your prostate is caused by hormonal changes, and not
cancer."
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?
a. Pinworms
b. Hemorrhoids
c. Colon cancer
d. Fecal incontinence b. Hemorrhoids
A patient who is visiting the clinic complains of having "stomach pains for 2 weeks" and
describes his stools as being "soft and black" for approximately the last 10 days. He
denies taking any medications. The nurse is aware that these symptoms are mostly
indicative of:
a. Excessive fat caused by malabsorption.
b. Increased iron intake, resulting from a change in diet.
c. Occult blood, resulting from gastrointestinal bleeding.
d. Absent bile pigment from liver problems. c. Occult blood, resulting from
gastrointestinal bleeding.
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):
2|Page
,a. Annual proctoscopy.
b. Colonoscopy every 10 years.
c. Fecal test for blood every 6 months.
d. DREs every 2 years. b. Colonoscopy every 10 years.
The mother of a 5-year-old girl tells the nurse that she has noticed her daughter
"scratching at her bottom a lot the last few days." During the assessment, the nurse
finds redness and raised skin in the anal area. This finding most likely indicates:
a. Pinworms.
b. Chickenpox.
c. Constipation.
d. Bacterial infection. a. Pinworms.
The nurse is examining only the rectal area of a woman and should place the woman in
what position?
a. Lithotomy
b. Prone
c. Left lateral decubitus
d. Bending over the table while standing c. Left lateral decubitus
While performing an assessment of the perianal area of a patient, the nurse notices that
the pigmentation of anus is darker than the surrounding skin, the anal opening is closed,
and a skin sac that is shiny and blue is noted. The patient mentioned that he has had
pain with bowel movements and has occasionally noted some spots of blood. What
would this assessment and history most likely indicate?
a. Anal fistula
b. Pilonidal cyst
c. Rectal prolapse
d. Thrombosed hemorrhoid d. Thrombosed hemorrhoid
The nurse is preparing to palpate the rectum and should use which of these techniques?
The nurse should:
a. Flex the finger, and slowly insert it toward the umbilicus.
b. First instruct the patient that this procedure will be painful.
c. Insert an extended index finger at a right angle to the anus.
d. Place the finger directly into the anus to overcome the tight sphincter. a. Flex the
finger, and slowly insert it toward the umbilicus.
While performing a rectal examination, the nurse notices a firm, irregularly shaped
mass. What should the nurse do next?
3|Page
, a. Continue with the examination, and document the finding in the chart.
b. Instruct the patient to return for a repeat assessment in 1 month.
c. Tell the patient that a mass was felt, but it is nothing to worry about.
d. Report the finding, and refer the patient to a specialist for further examination. d.
Report the finding, and refer the patient to a specialist for further examination.
During an assessment of the newborn, the nurse expects to see which finding when the
anal area is slightly stroked?
a. Jerking of the legs
b. Flexion of the knees
c. Quick contraction of the sphincter
d. Relaxation of the external sphincter c. Quick contraction of the sphincter
A 13-year-old girl is visiting the clinic for a sports physical examination. The nurse should
remember to include which of these tests in the examination?
a. Testing for occult blood
b. Valsalva maneuver
c. Internal palpation of the anus
d. Inspection of the perianal area d. Inspection of the perianal area
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:
a. Rectal polyp.
b. Pruritus ani.
c. Carcinoma.
d. Pilonidal cyst. d. Pilonidal cyst.
During an examination, the nurse asks the patient to perform the Valsalva maneuver and
notices that the patient has a moist, red, doughnut-shaped protrusion from the anus.
The nurse knows that this finding is consistent with a:
a. Rectal polyp.
b. Hemorrhoid.
c. Rectal fissure.
d. Rectal prolapse. d. Rectal prolapse.
A 70-year-old man is visiting the clinic for difficulty in passing urine. In the health history,
he indicates that he has to urinate frequently, especially at night. He has burning when
he urinates and has noticed pain in his back. Considering this history, what might the
nurse expect to find during the physical assessment?
4|Page
