NSG500 / NSG 500 Exam 3 (Latest 2024 /
2025): Advanced Health Assessment |
Questions and Verified Answers | 100% Correct | Grade A - Wilkes Prositioning for rectal/prostate exam -knee/chest -lithotomy -left lateral with hips and knees flexed and upper body supported by exam table -adult males: lithotomy/left lateral for adequate visualization o the perianal and sacrococcygeal areas
-in women: lithotomy is preferred
Normal prostate exam findings -Palpated the posterior surface on the anterior wall -may feel urge to urinate
-Should feel: Firm, smooth, and slightly moveable, nontender
-4cm with less than 1 cm protrusion into the rectum -Prostatic lobes should be symmetric -Seminal vesicles not palpable unless inflamed Exam findings for rectal prolapse Protruding rectal mucosa. Thick concentric mucosal ring. Sulcus noted between anal canal and rectum.
Exam findings: hemorrhoids (internal vs external)
-internal hemorrhoids not felt unless thrombosed -usually not visible at rest -thrombosed appear blue/shiny mass 1 / 2
Internal: soft swellings not palpable on examination and not visible unless
prolapsed through anus Causes of rectal bleeding -anal fissures, anaphylactoid purpura, aspirin-containing medications, bleeding/coagulation disorders, colitis, dysentery, esophageal varices, trauma, hemorrhoids, intususpeption, iron positing, meckel diverticulum, neoplasms, oral steroids, peptic ulcers, polyps, regional enteritis, strangulated hernia, swallowed blood, thrombocytopenia, volvulus Sequence of MS exam inspect, palpate, range of motion, muscle tone, muscle strength MS changes associated with aging -bone loss -boney prominences more apparent -deteriorating cartilage around joints -tendon less elastic -reduced total muscle mass, tone and strength -progressive decrease in reaction time, speed of movement, agility and endurance occur Muscle strength and grading No evidence of movement = 0 Trace movement = 1 Full range of motion but not against gravity = 2 Full range of motion against gravity but not resistance = 3 Full range of motion against gravity but some resistance but weak = 4 Full range of motion against gravity, full resistance = 5 Shoulder evaluation Shrug shoulders, raise both arms forward and straight over head (expect flexion of 180 degrees), extend and stretch arms behind back (expect hyperextension of 50 degrees), lift both arms laterally and straight over head, swing in front of body Osteoarthritis
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