Which statement is correct in regard to performing a successful rectal examination?
a. Perform it at the end of the physical examination after a trusting relationship has been established.
b. Perform it at the beginning of the physical examination to minimize the patient's embarrassment.
c. Provide minimal explanations about what will be done to decrease the patient's anxiety.
d. Explain to the patient that you are just as nervous about this as she is.
A
The anorectal examination is usually reserved for the last portion of the physical examination after a trusting relationship has been established. In all likelihood, the patient will experience some degree of embarrassment when a rectal exam is performed; however, if rapport is established prior to the exam, embarrassment can be decreased. A step-by-step explanation, description of expected sensations, reassurance, and a gentle technique can minimize anxiety for the patient. It is inappropriate to tell the patient that you are nervous about performing the exam. This can cause the patient to be concerned about your competency.
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