An adult male reports urinary frequency and difficulty starting the flow of urine. Which condition is likely?

Pilonidal cyst

Hemorrhoids

Rectal polyp

Enlarged prostate

Answer and Explanation

The Correct Answer is D

A. Pilonidal cyst: This is a localized inflammatory condition or abscess located in the sacrococcygeal region, often containing hair and skin debris. It causes localized pain and drainage at the base of the spine but does not affect the urinary tract. It has no physiological link to urinary hesitancy.

B. Hemorrhoids: These are distended, varicose veins located in the anorectal region that may cause bleeding or discomfort during defecation. While they involve the pelvic floor, they do not obstruct the urethral passage or affect detrusor muscle function. They are a vascular gastrointestinal issue rather than a urological one.

C. Rectal polyp: This is a growth protruding from the mucous membrane of the colon or rectum. Most polyps are asymptomatic or cause occult gastrointestinal bleeding, but they do not compress the bladder neck or the urethra. They are unrelated to the mechanics of micturition in the male patient.

D. Enlarged prostate: Benign prostatic hyperplasia causes the gland to compress the prostatic urethra, leading to obstructive voiding symptoms. These include hesitancy, a weak urinary stream, and frequency as the bladder struggles to empty against resistance. It is the most common cause of these specific urological complaints in adult males.

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Correct Answer is D

Explanation

A. 0/5
This indicates no muscle contraction at all. It would apply if the patient had complete paralysis and could not initiate any movement. Since Marcus can elevate his shoulders, this is not correct.

B. 1/5
This means a trace contraction is palpable or visible, but no movement occurs. Again, Marcus is able to move his shoulders against gravity, so this does not fit.

C. 2/5
This score is given when the patient can move the joint only if gravity is eliminated, but cannot overcome gravity. Marcus can elevate his shoulders against gravity, so this is not accurate.

D. 3/5
This represents full range of motion against gravity but not against resistance. Marcus can elevate his shoulders, but when the nurse applies resistance, he cannot maintain the movement. This matches his presentation.

E. 4/5
This indicates full range of motion against gravity and some resistance, but less than normal strength. If Marcus had been able to elevate his shoulders and withstand the nurse’s pressure partially, this would apply. However, he was unable to resist at all, so 4/5 is not correct.

F. 5/5
This is normal strength, meaning full range of motion against gravity and full resistance. Since Marcus cannot resist the nurse’s pressure, this is not appropriate.

A. Document muscle testing as 4/5 B. Attempt passive ROM to bend the left arm C. Recommend rest, ice, compression, elevation D. Attempt passive ROM to straighten the left arm

Correct Answer is D

Explanation

A. Document muscle testing as 4/5: Manual muscle testing evaluates the strength of a muscle group against resistance or gravity. This procedure is distinct from the assessment of joint mobility and range of motion. It does not address the underlying etiology of the restricted elbow extension.

B. Attempt passive ROM to bend the left arm: This action assesses flexion rather than the extension deficit noted in the clinical stem. Flexion involves decreasing the angle between the humerus and the ulna. The nurse must address the specific limitation identified during the active assessment phase.

C. Recommend rest, ice, compression, elevation: This therapeutic protocol is utilized for managing acute musculoskeletal injuries and inflammation. It represents a clinical intervention rather than a diagnostic assessment step. The nurse must first complete the physical examination before determining the appropriate treatment plan.

D. Attempt passive ROM to straighten the left arm: Passive range of motion helps differentiate between muscle weakness and joint or soft tissue contractures. Straightening the arm specifically evaluates the same plane of movement where the active limitation was observed. This determines the true degree of articular restriction.

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An adult male reports urinary frequency and difficulty starting the flow of urine. Which condition is likely?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The patient is able to elevate his shoulders bilaterally until the nurse presses down on his shoulders. How should the nurse document his muscle strength?

Correct Answer is D

Explanation

The nurse is assessing a patient's active range of motion (ROM) and notices limited extension at the left elbow. What is the next step for the nurse to take?

Correct Answer is D

Explanation

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