Digital Rectal Examination Flashcards, test questions and answers

Question 1

Which procedure is a highly reliable way to diagnose testicular cancer? a. Scrotal ultrasound b. Fluoroscopy c. Blood testing d. Tomography e. Digital rectal examination

Answer

a. Scrotal ultrasound
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Question 2

“A 43-year-old black client without a family history of prostate cancer asks the nurse when he should have a prostate-specific antigen (PSA) test and a digital rectal examination (DRE) performed. Which response by the nurse is appropriate?

Answer

You should start undergoing prostate cancer screening at age 45.
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Question 3

When a resident in the nursing home complains of constipation, the nurse performs a digital rectal examination and finds a hard fecal mass. This is an example of

Answer

assessment.
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Question 4

Have a digital rectal examination and prostate-specific antigen (PSA) test done yearly.

Answer

What should a male client older than age 50 do to help ensure early identification of prostate cancer?
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Question 5

Which hypothesis is nondirectional? Answers: A. Hospitals with an infection-control nurse will have fewer instances of sepsis among inpatients than hospitals without an infection-control nurse. B. There will be a greater weight loss among dieting patients who receive a weekly supportive telephone call from a dietitian than among dieting patients who do not receive a weekly supportive phone call. C. There will be a difference in stage of disease for prostate cancer among men who had an abnormal prostate-specific antigen (PSA) screening compared with men who had an abnormal digital rectal examination (DRE) screening. D. Children who receive weekly counseling for one year after the death of a parent will perform better in school than children who do not receive weekly counseling after the death of a parent. Quiz # 1

Answer

Correct C: This example includes a nondirectional hypothesis; there is no expected direction evident.
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Question 6

A 58-year-old male patient is being seen by the health care provider for an annual physical. According to the American Cancer Society, which cancer screenings should be recommended every year for asymptomatic men? (Select all that apply.) A. A fecal occult blood stool test B. A prostate-specific antigen test C. A Papanicolaou test D. A digital rectal examination E. A pelvic examination F. A colonoscopy

Answer

A. A fecal occult blood stool test B. A prostate-specific antigen test D. A digital rectal examination Evidence supports that proactive and timely cancer screening reduces the likelihood of developing cancer. Cancer diagnosed at a lower stage has a greater likelihood of cure. A fecal occult blood stool test and a prostate-specific antigen test are recommended annually. The digital rectal examination is recommended annually. The Papanicolaou test and pelvic examination are tests for women’s health. A colonoscopy is recommended every 10 years for low-risk patients.
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Question 7

What should a male client older than age 50 do to help ensure early identification of prostate cancer? Have a digital rectal examination and prostate-specific antigen (PSA) test done yearly. Have a complete blood count (CBC) and blood urea nitrogen (BUN) and creatinine levels checked yearly. Have a transrectal ultrasound every 5 years. Perform monthly testicular self-examinations, especially after age 50.

Answer

Have a digital rectal examination and prostate-specific antigen (PSA) test done yearly. Explanation: The incidence of prostate cancer increases after age 50. The digital rectal examination, which identifies enlargement or irregularity of the prostate, and PSA test, a tumor marker for prostate cancer, are effective diagnostic measures that should be done yearly. Testicular self-examinations won’t identify changes in the prostate gland because of its location in the body. A transrectal ultrasound, CBC, and BUN and creatinine levels are usually done after diagnosis to identify the extent of the disease and potential metastasis.
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Question 8

To accurately monitor progression of a symptom of decreased urinary stream, the nurse should encourage the patient to have which primary screening measure done on a regular basis? A. Uroflowmetry B. Transrectal ultrasound C. Digital rectal examination (DRE) D. Prostate-specific antigen (PSA) monitoring

Answer

C. Digital rectal examination (DRE) Digital rectal examination is part of a regular physical examination and is a primary means of assessing symptoms of decreased urinary stream, which is often caused by benign prostatic hyperplasia in men over 50 years of age. The uroflowmetry helps determine the extent of urethral blockage and the type of treatment needed but is not done on a regular basis. Transrectal ultrasound is indicated with an abnormal DRE and elevated PSA to differentiate between BPH and prostate cancer. The PSA monitoring is done to rule out prostate cancer, although levels may be slightly elevated in patients with BPH.
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Question 9

Which of the following would be recommended for the patient described? (Mark all that are true.) Carcinoembryonic antigen testing for a 65-year-old breast cancer survivor 6 months after her breast cancer diagnosis and treatment Breast cancer screening for a 25-year-old female Hodgkin’s disease survivor who was treated with chest irradiation Depression screening for a 25-year-old survivor of leukemia Follow-up carcinoembryonic antigen testing for a 65-year-old male colon cancer survivor Digital rectal examination and monitoring of prostate-specific antigen levels every 6 months for a 72-year-old prostate cancer survivor

Answer

B, C, D, & E. Breast cancer patients should be counseled that intensive surveillance using laboratory and imaging tests does not improve overall survival or quality of life. However, monthly breast self-examination, annual mammography of preserved breast tissue, and a careful history and physical examination every 6 months for 5 years are recommended (SOR C). A Cochrane review, based on two randomized, controlled trials, found that less-intensive follow-up strategies based on periodic clinical examinations and annual mammography seem as effective as more-intense surveillance schemes. Any positive findings on the history and physical examination would certainly warrant further investigation. Female Hodgkin’s disease survivors treated with chest irradiation are at increased risk of developing breast cancer; surveillance should be started at 25 years of age (SOR C). The U.S. Preventive Services Task Force recommends routine screening for depression all adult patients, but only if staff-assisted depression care supports are in place to ensure accurate diagnosis, effective treatment, and follow-up care (USPSTF B recommendation). Survivors of childhood cancers are at increased risk for depression, and should be screened and treated as appropriate (SOR C). Use of carcinoembryonic antigen testing and CT for follow-up of colorectal cancer patients yields a survival advantage of about 19% (SOR A). However, there is insufficient evidence to support any optimal combination of tests or frequency of clinical follow-up. Expert recommendations suggest that prostate cancer survivors should receive annual digital rectal examinations, plus monitoring of prostate-specific antigen levels every 6 months for 5 years, and then annually (SOR C).
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Question 10

Mr. smith is seen in his primary care physicians office for his annual physical examination. He has a digital rectal examination and is given three small cards to take home and return with fecal samples to screen for colorectal cancer. Assign the cpt code to report this occult blood sampling. a. 82270 b. 82271 c. 82273 d. 82274

Answer

a. 82270
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