1. Assignment: Lab Assignment: Assessing the Genitalia and
Rectum
Photo Credit: Getty Images
Patients are frequently uncomfortable discussing with
healthcare professional’s issues that involve the genitalia and
rectum; however, gathering an adequate history and properly
conducting a physical exam are vital. Examining case studies of
genital and rectal abnormalities can help prepare advanced
practice nurses to accurately assess patients with problems in
these areas.
In this Lab Assignment, you will analyze an Episodic note case
study that describes abnormal findings in patients seen in a
clinical setting. You will consider what history should be
collected from the patients, as well as which physical exams and
diagnostic tests should be conducted. You will also formulate a
differential diagnosis with several possible conditions.
To Prepare
Review the Episodic note case study your instructor provides
you for this week’s Assignment. Please see the “Course
Announcements” section of the classroom for your Episodic
note case study.
Based on the Episodic note case study:
Review this week’s Learning Resources, and consider the
insights they provide about the case study. Refer to Chapter 3 of
the Sullivan resource to guide you as you complete your Lab

2. Assignment.
Search the Walden library or the Internet for evidence-based
resources to support your answers to the questions provided.
Consider what history would be necessary to collect from the
patient in the case study.
Consider what physical exams and diagnostic tests would be
appropriate to gather more information about the patient’s
condition. How would the results be used to make a diagnosis?
Identify
at least five
possible conditions that may be considered in a differential
diagnosis for the patient.
The Lab Assignment
Using evidence-based resources from your search, answer the
following questions and support your answers using current
evidence from the literature.
Analyze the subjective portion of the note. List additional
information that should be included in the documentation.
Analyze the objective portion of the note. List additional
information that should be included in the documentation.
Is the assessment supported by the subjective and objective
information? Why or why not?

3. Would diagnostics be appropriate for this case, and how would
the results be used to make a diagnosis?
Would you reject/accept the current diagnosis? Why or why
not? Identify three possible conditions that may be considered
as a differential diagnosis for this patient. Explain your
reasoning using at least three different references from current
evidence-based literature.
In this Lab Assignment, you will analyze an Episodic note case
study that describes abnormal findings in patients seen in a
clinical setting. You will consider what history should be
collected from the patients, as well as which physical exams and
diagnostic tests should be conducted. You will also formulate a
differential diagnosis with several possible conditions.
1- Review this week’s Learning Resources, and consider the
insights they provide about the case study. Refer to Chapter 3 of
the Sullivan resource to guide you as you complete your Lab
Assignment.
2- Search the Walden library or the Internet for evidence-based
resources to support your answers to the questions provided.
3- Consider what physical exams and diagnostic tests would be
appropriate to gather more information about the patient’s
condition. How would the results be used to make a diagnosis?
4-Identify
at least five
possible conditions that may be considered in a differential
diagnosis for the patient.
Using evidence-based resources from your search, answer the
following questions and support your answers using current

4. evidence from the literature.
Analyze the subjective portion of the note. List additional
information that should be included in the documentation.
Analyze the objective portion of the note. List additional
information that should be included in the documentation.
Is the assessment supported by the subjective and objective
information? Why or why not?
Would diagnostics be appropriate for this case, and how would
the results be used to make a diagnosis?
Would you reject/accept the current diagnosis? Why or why
not? Identify three possible conditions that may be considered
as a differential diagnosis for this patient. Explain your
reasoning using at least three different references from current
evidence-based literature.
Post the assignment By Day 7 of Week 10. Follow the rubric!
We grade by the rubric!
GENITALIA ASSESSMENT
Subjective:
CC: “I have bumps on my bottom that I want to have checked
out.”
HPI: AB, a 21-year-old WF college student reports to your
clinic with external bumps on her genital area. She states the
bumps are painless and feel rough. She states she is sexually

5. active and has had more than one partner during the past year.
Her initial sexual contact occurred at age 18. She reports no
abnormal vaginal discharge. She is unsure how long the bumps
have been there but noticed them about a week ago. Her last Pap
smear exam was 3 years ago, and no dysplasia was found; the
exam results were normal. She reports one sexually transmitted
infection (chlamydia) about 2 years ago. She completed the
treatment for chlamydia as prescribed.
PMH: Asthma
Medications: Symbicort 160/4.5mcg
Allergies: NKDA
FH: No hx of breast or cervical cancer, Father hx HTN, Mother
hx HTN, GERD
Social: Denies tobacco use; occasional ETOH married, 3
children (1 girl, 2 boys)
Objective:
VS: Temp 98.6; BP 120/86; RR 16; P 92; HT 5’10”; WT 169lbs
Heart: RRR, no murmurs
Lungs: CTA, chest wall symmetrical
Genital: Normal female hair pattern distribution; no masses or
swelling. Urethral meatus intact without erythema or discharge.
Perineum intact. Vaginal mucosa pink and moist with rugae
present, pos for firm, round, small, painless ulcer noted on
external labia.

6. Abd: soft, normoactive bowel sounds, neg rebound, neg
murphy’s, neg McBurney
Diagnostics: HSV specimen obtained
Assessment:
Chancre
Learning Resources
Required Readings
(click to expand/reduce)
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., &
Stewart, R. W. (2019).
Seidel's guide to physical examination: An interprofessional
approach
(9th ed.). St. Louis, MO: Elsevier Mosby.
Chapter 17, “Breasts and Axillae”
This chapter focuses on examining the breasts and axillae. The
authors describe the examination procedures and the anatomy
and physiology of breasts.
Chapter 19, “Female Genitalia”
In this chapter, the authors explain how to conduct an

7. examination of female genitalia. The chapter also describes the
form and function of female genitalia.
Chapter 20, “Male Genitalia”
The authors explain the biology of the penis, testicles,
epididymides, scrotum, prostate gland, and seminal vesicles.
Additionally, the chapter explains how to perform an exam of
these areas.
Chapter 21, “Anus, Rectum, and Prostate”
This chapter focuses on performing an exam of the anus,
rectum, and prostate. The authors also explain the anatomy and
physiology of the anus, rectum, and prostate.
Dains, J. E., Baumann, L. C., & Scheibel, P. (2019).
Advanced health assessment and clinical diagnosis in primary
care
(6th ed.). St. Louis, MO: Elsevier Mosby.
Credit Line: Advanced Health Assessment and Clinical
Diagnosis in Primary Care, 6th Edition by Dains, J.E.,
Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby.
Reprinted by permission of Mosby via the Copyright Clearance
Center.
Chapter 5, “Amenorrhea”
Amenorrhea, or the absence of menstruation, is the focus of
this chapter. The authors include key questions to ask patients
when taking histories and explain what to look for in the
physical exam.

8. Chapter 6, “Breast Lumps and Nipple Discharge”
This chapter focuses on the important topic of breast lumps and
nipple discharge. Because breast cancer is the most common
type of cancer in women, it is important to get an accurate
diagnosis. Information in the chapter includes key questions to
ask and what to look for in the physical exam.
Chapter 7, “Breast Pain”
Determining the cause of breast pain can be difficult. This
chapter examines how to determine the likely cause of the pain
through diagnostic tests, physical examination, and careful
analysis of a patient’s health history.
Chapter 27, “Penile Discharge”
The focus of this chapter is on how to diagnose the causes of
penile discharge. The authors include specific questions to ask
when gathering a patient’s history to narrow down the likely
diagnosis. They also give advice on performing a focused
physical exam.
Chapter 36, “Vaginal Bleeding”
In this chapter, the causes of vaginal bleeding are explored.
The authors focus on symptoms outside the regular menstrual
cycle. The authors discuss key questions to ask the patient as
well as specific physical examination procedures and laboratory
studies that may be useful in reaching a diagnosis.
Chapter 37, “Vaginal Discharge and Itching”
This chapter examines the process of identifying causes of
vaginal discharge and itching. The authors include questions on
the characteristics of the discharge, the possibility of the issues

9. being the result of a sexually transmitted infection, and how
often the discharge occurs. A chart highlights potential
diagnoses based on patient history, physical findings, and
diagnostic studies.
Sullivan, D. D. (2019).
Guide to clinical documentation
(3rd ed.). Philadelphia, PA: F. A. Davis.
Chapter 3, "SOAP Notes" (Previously read in Week 8)
Cucci, E., Santoro, A., DiGesu, C., DiCerce, R., & Sallustio, G.
(2015). Sclerosing adenosis of the breast: Report of two cases
and review of the literature.
Polish Journal of Radiology, 80
, 122–127. doi:10.12659/PJR.892706. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4356184/
Sabbagh , C., Mauvis, F., Vecten, A., Ainseba, N., Cosse, C.,
Diouf, M., & Regimbeau, J. M. (2014). What is the best position
for analyzing the lower and middle rectum and sphincter
function in a digital rectal examination? A randomized,
controlled study in men.
Digestive and Liver Disease, 46
(12), 1082–1085. doi:10.1016/j.dld.2014.08.045
Westhoff , C. L., Jones, H. E., & Guiahi, M. (2011). Do new
guidelines and technology make the routine pelvic examination
obsolete?
Journal of Women’s Health, 20
(1), 5–10.
This article describes the benefits of new technology and
guidelines for pelvic exams. The authors also detail which
guidelines and technology may become obsolete.

10. Centers for Disease Control and Prevention. (2019).
Sexually transmitted diseases (STDs).
Retrieved from http://www.cdc.gov/std/#
This section of the CDC website provides a range of
information on sexually transmitted diseases (STDs). The
website includes reports on STDs, related projects and
initiatives, treatment information, and program tools.
Document:
Final Exam Review (Word document)
Optional Resource
LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2014).
DeGowin’s diagnostic examination
(10th ed.). New York, NY: McGraw Hill Medical.
Chapter 8, “The Chest: Chest Wall, Pulmonary, and
Cardiovascular Systems; The Breasts” (Section 2, “The
Breasts,” pp. 434–444)
Section 2 of this chapter focuses on the anatomy and physiology
of breasts. The section provides descriptions of breast
examinations and common breast conditions.
Chapter 11, “The Female Genitalia and Reproductive System”
(pp. 541–562)
In this chapter, the authors provide an overview of the female

11. reproductive system. The authors also describe symptoms of
disorders in the reproductive system.
Chapter 12, “The Male Genitalia and Reproductive System” (pp.
563–584)
The authors of this chapter detail the anatomy of the male
reproductive system. Additionally, the authors describe how to
conduct an exam of the male reproductive system.
Review of Chapter 9, “The Abdomen, Perineum, Anus, and
Rectosigmoid” (pp. 445–527)
Required Media
(click to expand/reduce)
Special Examinations - Breast, Genital, Prostate, and Rectal -
Week 10
(14m)
Accessible player --Downloads--Download Video
w/CCDownload AudioDownload Transcript
Online media for
Seidel's Guide to Physical Examination
It is highly recommended that you access and view the
resources included with the course text,
Seidel's Guide to Physical Examination
. Focus on the videos and animations in Chapters 16 and 18–20
that relate to special examinations, including breast, genital,
prostate, and rectal. Refer to the Week 4 Learning Resources
area for access instructions on
https://evolve.elsevier.com/

12. Rubric Detail
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Name:
NURS_6512_Week_10_Assignment_Rubric
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ExcellentGoodFairPoorWith regard to the SOAP note case study
provided and using evidence-based resources from your search,
answer the following questions and support your answers using
current evidence from the literature:
· Analyze the subjective portion of the note. List additional
information that should be included in the documentation.
10 (10%) - 12 (12%)The response clearly, accurately, and
thoroughly analyzes the subjective portion of the SOAP note
and lists detailed additional information to be included in the
documentation.7 (7%) - 9 (9%)The response accurately analyzes
the subjective portion of the SOAP note and lists additional
information to be included in the documentation.4 (4%) - 6

13. (6%)The response vaguely analyzes the subjective portion of the
SOAP note and vaguely and/or inaccurately lists additional
information to be included in the documentation.0 (0%) - 3
(3%)The response inaccurately analyzes the subjective portion
of the SOAP note, with inaccurate and/or missing additional
information included in the documentation.
· Analyze the objective portion of the note. List additional
information that should be included in the documentation.
10 (10%) - 12 (12%)The response clearly, accurately, and
thoroughly analyzes the objective portion of the SOAP note and
lists detailed additional information to be included in the
documentation.7 (7%) - 9 (9%)The response accurately analyzes
the objective portion of the SOAP note and lists additional
information to be included in the documentation.4 (4%) - 6
(6%)The response vaguely analyzes the objective portion of the
SOAP note and vaguely and/or inaccurately lists additional
information to be included in the documentation.0 (0%) - 3
(3%)The response inaccurately analyzes the objective portion of
the SOAP note, with inaccurate and/or missing additional
information included in the documentation.
· Is the assessment supported by the subjective and objective
information? Why or why not?
14 (14%) - 16 (16%)The response clearly and accurately
identifies whether or not the assessment is supported by the
subjective and/or objective information, with a thorough and
detailed explanation.11 (11%) - 13 (13%)The response
accurately identifies whether or not the assessment is supported
by the subjective and/or objective information, with a clear
explanation.8 (8%) - 10 (10%)The response vaguely identifies
whether or not the assessment is supported by the subjective
and/or objective information, with a vague explanation.0 (0%) -
7 (7%)The response inaccurately identifies whether or not the
assessment is supported by the subjective and/or objective
information, with an inaccurate or missing explanation.
· What diagnostic tests would be appropriate for this case, and
how would the results be used to make a diagnosis?

14. 18 (18%) - 20 (20%)The response thoroughly and accurately
describes appropriate diagnostic tests for the case and explains
clearly, thoroughly, and accurately how the test results would
be used to make a diagnosis.15 (15%) - 17 (17%)The response
accurately describes appropriate diagnostic tests for the case
and explains how the test results would be used to make a
diagnosis.12 (12%) - 14 (14%)The response vaguely and/or with
some inaccuracy describes appropriate diagnostic tests for the
case and vaguely and/or with some inaccuracy explains how the
test results would be used to make a diagnosis.0 (0%) - 11
(11%)The response inaccurately describes appropriate
diagnostic tests for the case, with an inaccurate or missing
explanation of how the test results would be used to make a
diagnosis.
· Would you reject or accept the current diagnosis? Why or
why not?
· Identify three possible conditions that may be considered as
a differenial diagnosis for this patient. Explain your reasoning
using at least three different references from current evidence-
based literature.
23 (23%) - 25 (25%)The response states clearly whether to
accept or reject the current diagnosis, with a thorough, accurate,
and detailed explanation of sound reasoning. The response
clearly, thoroughly, and accurately identifies three conditions as
a differential diagnosis, with reasoning that is explained clearly,
accurately, and thoroughly using three or more different
references from current evidence-based literature.20 (20%) - 22
(22%)The response states whether to accept or reject the current
diagnosis, with an accurate explanation of sound reasoning. The
response accurately identifies three conditions as a differential
diagnosis, with reasoning that is explained using three different
references from current evidence-based literature.17 (17%) - 19
(19%)The response states whether to accept or reject the current
diagnosis, with a vague explanation of the reasoning. The
response identifies two to three conditions as a differential

15. diagnosis, with reasoning that is explained vaguely and/or
inaccurately using three or fewer references from current
evidence-based literature.0 (0%) - 16 (16%)The response
inaccurately states or is missing a statement of whether to
accept or reject the current diagnosis, with an explanation that
is inaccurate and/or missing. The response identifies three or
fewer conditions as a differential diagnosis, with reasoning that
is missing or explained inaccurately using two or fewer
references from current evidence-based literature.
Written Expression and Formatting - Paragraph Development
and Organization:
Paragraphs make clear points that support well-developed ideas,
flow logically, and demonstrate continuity of ideas. Sentences
are carefully focused--neither long and rambling nor short and
lacking substance. A clear and comprehensive purpose
statement and introduction are provided that delineate all
required criteria.
5 (5%) - 5 (5%)Paragraphs and sentences follow writing
standards for flow, continuity, and clarity. A clear and
comprehensive purpose statement, introduction, and conclusion
are provided that delineate all required criteria.4 (4%) - 4
(4%)Paragraphs and sentences follow writing standards for
flow, continuity, and clarity 80% of the time. Purpose,
introduction, and conclusion of the assignment are stated, yet
are brief and not descriptive.3 (3%) - 3 (3%)Paragraphs and
sentences follow writing standards for flow, continuity, and
clarity 60%–79% of the time. Purpose, introduction, and
conclusion of the assignment are vague or off topic.0 (0%) - 2
(2%)Paragraphs and sentences follow writing standards for
flow, continuity, and clarity < 60% of the time. No purpose
statement, introduction, or conclusion were provided.
Written Expression and Formatting - English writing standards:
Correct grammar, mechanics, and proper punctuation
5 (5%) - 5 (5%)Uses correct grammar, spelling, and punctuation

16. with no errors.4 (4%) - 4 (4%)Contains a few (1 or 2) grammar,
spelling, and punctuation errors.3 (3%) - 3 (3%)Contains
several (3 or 4) grammar, spelling, and punctuation errors.0
(0%) - 2 (2%)Contains many (≥ 5) grammar, spelling, and
punctuation errors that interfere with the reader’s
understanding.
Written Expression and Formatting - The paper follows correct
APA format for title page, headings, font, spacing, margins,
indentations, page numbers, running heads, parenthetical/in-text
citations, and reference list.
5 (5%) - 5 (5%)Uses correct APA format with no errors.4 (4%) -
4 (4%)Contains a few (1 or 2) APA format errors.3 (3%) - 3
(3%)Contains several (3 or 4) APA format errors.0 (0%) - 2
(2%)Contains many (≥ 5) APA format errors.
Total Points: 100
Name:
NURS_6512_Week_10_Assignment_Rubric