Ch. 25 - Male Genitourinary System

During the examination of a full-term male newborn, a finding requiring investigation would be: a. An absent testes. b. A meatus centered at the tip of the penis. c. A wrinkled scrotum. d. A penis 2 to 3 cm in length.

a. An absent testes.

A 55-year-old man is in the clinic for a yearly checkup. He is worried because his father died of prostate cancer. The nurse knows which tests should be performed at this time? Select all that apply. a.Blood test for prostate-specific antigen (PSA) b.Urinalysis c.Transrectal ultrasound d.Digital rectal examination (DRE) e.Prostate biopsy

a. Blood test for prostate-specific antigen (PSA) d. Digital rectal examination (DRE)

When performing a genitourinary assessment, the nurse notices that the urethral meatus is ventrally positioned. This finding is: a.Called hypospadias. b.A result of phimosis. c.Probably due to a stricture. d.Often associated with aging.

a. Called hypospadias

Which of these statements is most appropriate when the nurse is obtaining a genitourinary history from an older man? a.Do you need to get up at night to urinate? b.Do you experience nocturnal emissions, or wet dreams? c.Do you know how to perform a testicular self-examination? d.Has anyone ever touched your genitals when you did not want them to?

a. Do you need to get up at night to urinate?

A 59-year-old patient has been diagnosed with prostatitis and is being seen at the clinic for complaints of burning and pain during urination. He is experiencing: a.Dysuria. b.Nocturia. c.Polyuria. d.Hematuria.

a. Dysuria

The congenital displacement of the urethral meatus to the inferior surface of the penis is: a. Hypospadias. b. Epispadias. c. Hypoesthesia. d. Hypophysis.

a. Hypospadias

During a physical examination, the nurse finds that a male patients foreskin is fixed and tight and will not retract over the glans. The nurse recognizes that this condition is: a.Phimosis. b.Epispadias. c.Urethral stricture. d.Peyronie disease.

a. Phimosis

Which of the following would be a normal sensitivity to pressure for the testes? a. Somewhat b. Not at all c. Left more sensitive than right d. Only when inflammation is present

a. Somewhat

A male patient with possible fertility problems asks the nurse where sperm is produced. The nurse knows that sperm production occurs in the: a.Testes. b.Prostate. c.Epididymis. d.Vas deferens.

a. Testes

An older man is concerned about his sexual performance. The nurse knows that in the absence of disease, a withdrawal from sexual activity later in life may be attributable to: a.Side effects of medications. b.Decreased libido with aging. c.Decreased sperm production. d.Decreased pleasure from sexual intercourse.

a. side effects of medications

The nurse is inspecting the scrotum and testes of a 43-year-old man. Which finding would require additional follow-up and evaluation? a.Skin on the scrotum is taut. b.Left testicle hangs lower than the right testicle. c.Scrotal skin has yellowish 1-cm nodules that are firm and nontender. d.Testes move closer to the body in response to cold temperatures.

a. skin on the scrotum is taut

A 16-year-old boy is brought to the clinic for a problem that he refused to let his mother see. The nurse examines him, and finds that he has scrotal swelling on the left side. He had the mumps the previous week, and the nurse suspects that he has orchitis. Which of the following assessment findings support this diagnosis? Select all that apply. a.Swollen testis b.Mass that transilluminates c.Mass that does not transilluminate d.Scrotum that is nontender upon palpation e.Scrotum that is tender upon palpation f.Scrotal skin that is reddened

a.Swollen testis c.Mass that does not transilluminate e.Scrotum that is tender upon palpation f.Scrotal skin that is reddened

A 20-year-old man has indicated that he does not perform a testicular self-examination. One of the facts that should be shared with him is that testicular cancer, although rare, does occur in men: a. Younger than 15 years. b. 15 to 34 years of age. c. 35 to 55 years of age. d. 55 years and older.

b. 15 to 34 years of age.

During an examination of an aging man, the nurse recognizes that normal changes to expect would be: a.Change in scrotal color. b.Decrease in the size of the penis. c.Enlargement of the testes and scrotum. d.Increase in the number of rugae over the scrotal sac.

b. Decrease in the size of the penis

A 55-year-old man is experiencing severe pain of sudden onset in the scrotal area. It is somewhat relieved by elevation. On examination the nurse notices an enlarged, red scrotum that is very tender to palpation. Distinguishing the epididymis from the testis is difficult, and the scrotal skin is thick and edematous. This description is consistent with which of these? a.Varicocele b.Epididymitis c.Spermatocele d.Testicular torsion

b. Epididymitis

A patient has soft, moist, fleshy, painless papules around the anus. The examiner suspects this condition is: a. HSV-2. b. HPV. c. Gonorrhea. d. Peyronie disease.

b. HPV

The nurse is describing how to perform a testicular self-examination to a patient. Which statement is most appropriate? a.A good time to examine your testicles is just before you take a shower. b.If you notice an enlarged testicle or a painless lump, call your health care provider. c.The testicle is egg shaped and movable. It feels firm and has a lumpy consistency. d.Perform a testicular examination at least once a week to detect the early stages of testicular cancer.

b. If you notice and enlarged testicle or a painless lump, call your heath care provider

An adhesion of the prepuce to the head of the penis, making it impossible to retract, is: a. Paraphimosis. b. Phimosis. c. Smegma. d. Dyschezia.

b. Phimosis

The external male genital structures include the: a.Testis. b.Scrotum. c.Epididymis. d.Vas deferens.

b. Scrotum

When assessing the scrotum of a male patient, the nurse notices the presence of multiple firm, nontender, yellow 1-cm nodules. The nurse knows that these nodules are most likely: a.From urethritis. b.Sebaceous cysts. c.Subcutaneous plaques. d.From an inflammation of the epididymis.

b. Sebaceous cysts

When performing a scrotal assessment, the nurse notices that the scrotal contents show a red glow with transillumination. On the basis of this finding the nurse would: a.Assess the patient for the presence of a hernia. b.Suspect the presence of serous fluid in the scrotum. c.Consider this finding normal, and proceed with the examination. d.Refer the patient for evaluation of a mass in the scrotum.

b. Suspect the presence of serous fluid in the scrotum

The mother of a 10-year-old boy asks the nurse to discuss the recognition of puberty. The nurse should reply by saying: a.Puberty usually begins around 15 years of age. b.The first sign of puberty is an enlargement of the testes. c.The penis size does not increase until about 16 years of age. d.The development of pubic hair precedes testicular or penis enlargement.

b. The first sign of puberty is an enlargement of the testes

When performing a genital examination on a 25-year-old man, the nurse notices deeply pigmented, wrinkled scrotal skin with large sebaceous follicles. On the basis of this information, the nurse would: a.Squeeze the glans to check for the presence of discharge. b.Consider this finding as normal, and proceed with the examination. c.Assess the testicles for the presence of masses or painless lumps. d.Obtain a more detailed history, focusing on any scrotal abnormalities the patient has noticed.

b.Consider this finding as normal, and proceed with the examination.

A 2-year-old boy has been diagnosed with physiologic cryptorchidism. Considering this diagnosis, during assessment the nurse will most likely observe: a.Testes that are hard and painful to palpation. b.Atrophic scrotum and a bilateral absence of the testis. c.Absence of the testis in the scrotum, but the testis can be milked down. d.Testes that migrate into the abdomen when the child squats or sits cross-legged.

c. Absence of the testis in the scrotum, bit the testis can be milked down

During an examination of an aging man, the nurse recognizes that normal changes to expect would be: a.Enlarged scrotal sac. b.Increased pubic hair. c.Decreased penis size. d.Increased rugae over the scrotum.

c. Decreased penis size

The nurse is performing a genitourinary assessment on a 50-year-old obese male laborer. On examination, the nurse notices a painless round swelling close to the pubis in the area of the internal inguinal ring that is easily reduced when the individual is supine. These findings are most consistent with a(n) ______ hernia. a.Scrotal b.Femoral c.Direct inguinal d.Indirect inguinal

c. Direct inguinal

During a genital examination, the nurse notices that a male patient has clusters of small vesicles on the glans, surrounded by erythema. The nurse recognizes that these lesions are: a.Peyronie disease. b.Genital warts. c.Genital herpes. d.Syphilitic cancer.

c. Genital herpes

A 64-year-old man has come for a health examination. A normal age-related change in the scrotum would be: a. Testicular atrophy. b. Testicular hypertrophy. c. Pendulous scrotum. d. Increase in scrotal rugae.

c. Pendulous scrotum.

An accessory glandular structure for the male genital organs is the: a.Testis. b.Scrotum. c.Prostate. d.Vas deferens.

c. Prostate

A 2-month-old uncircumcised infant has been brought to the clinic for a well-baby checkup. How would the nurse proceed with the genital examination? a.Eliciting the cremasteric reflex is recommended. b.The glans is assessed for redness or lesions. c.Retracting the foreskin should be avoided until the infant is 3 months old. d.Any dirt or smegma that has collected under the foreskin should be noted.

c. Retracting the foreskin should be avoided until the infant is 3 months old

Prostatic hypertrophy occurs frequently in older men. The symptoms that may indicate this problem are: a. Polyuria and urgency. b. Dysuria and oliguria. c. Straining, loss of force, and sense of residual urine. d. Foul-smelling urine and dysuria.

c. Straining, loss of force, and sense of residual urine.

A 45-year-old mother of two children is seen at the clinic for complaints of losing my urine when I sneeze. The nurse documents that she is experiencing: a.Urinary frequency. b.Enuresis. c.Stress incontinence. d.Urge incontinence.

c. Stress incontinence

During an examination, the nurse notices that a male patient has a red, round, superficial ulcer with a yellowish serous discharge on his penis. On palpation, the nurse finds a nontender base that feels like a small button between the thumb and fingers. At this point the nurse suspects that this patient has: a.Genital warts. b.Herpes infection. c.Syphilitic chancre. d.Carcinoma lesion.

c. Syphilitic chancre

When the nurse is performing a testicular examination on a 25-year-old man, which finding is considered normal? a.Nontender subcutaneous plaques b.Scrotal area that is dry, scaly, and nodular c.Testes that feel oval and movable and are slightly sensitive to compression d.Single, hard, circumscribed, movable mass, less than 1 cm under the surface of the testes

c. Testes that feel oval and moveable and are slightly sensitive to compression

During examination of the scrotum, a normal finding would be that: a. The left testicle is firmer to palpation than the right. b. The left testicle is larger than the right. c. The left testicle hangs lower than the right. d. The left testicle is more tender to palpation than the right.

c. The left testicle hangs lower than the right.

The nurse is aware of which statement to be true regarding the incidence of testicular cancer? a.Testicular cancer is the most common cancer in men aged 30 to 50 years. b.The early symptoms of testicular cancer are pain and induration. c.Men with a history of cryptorchidism are at the greatest risk for the development of testicular cancer. d.The cure rate for testicular cancer is low.

c.Men with a history of cryptorchidism are at the greatest risk for the development of testicular cancer.

The examiner is going to inspect and palpate for a hernia. during this examination, the man is instructed to: a. hold his breath during palpation b. cough after the examiner has gently inserted the examination finger into the rectum c.bear down when the examiners finger is at the inguinal canal d. relax in a supine position while the examination finger is inserted into the canal

c.bear down when the examiners finger is at the inguinal canal

A 62-year-old man states that his physician told him that he has an inguinal hernia. He asks the nurse to explain what a hernia is. The nurse should: a.Tell him not to worry and that most men his age develop hernias. b.Explain that a hernia is often the result of prenatal growth abnormalities. c.Refer him to his physician for additional consultation because the physician made the initial diagnosis. d.Explain that a hernia is a loop of bowel protruding through a weak spot in the abdominal muscles.

d. Explain that a hernia is a loop of bowel protruding through a weak spot in the abdominal muscle

During palpation of the testes, the normal finding would be: a. Firm to hard and rough. b. Nodular. c. 2 to 3 cm long by 2 cm wide and firm. d. Firm, rubbery, and smooth.

d. Firm, rubbery, and smooth.

When performing a genital assessment on a middle-aged man, the nurse notices multiple soft, moist, painless papules in the shape of cauliflower-like patches scattered across the shaft of the penis. These lesions are characteristic of: a.Carcinoma. b.Syphilitic chancres. c.Genital herpes. d.Genital warts.

d. Genital warts

When the nurse is performing a genital examination on a male patient, which action is correct? a.Auscultating for the presence of a bruit over the scrotum b.Palpating for the vertical chain of lymph nodes along the groin, inferior to the inguinal ligament c.Palpating the inguinal canal only if a bulge is present in the inguinal region during inspection d.Having the patient shift his weight onto the left (unexamined) leg when palpating for a hernia on the right side

d. Having the patient shift his weight onto the left (unexamined) leg when palpating for a hernia on the right side

During a health history, a patient tells the nurse that he has trouble in starting his urine stream. This problem is known as: a.Urgency. b.Dribbling. c.Frequency. d.Hesitancy.

d. Hesitancy

During transillumination of a scrotum, you note a nontender mass that transilluminates with a red glow. This finding is suggestive of: a. Scrotal hernia. b. Scrotal edema. c. Orchitis. d. Hydrocele.

d. Hydrocele.

When performing a genitourinary assessment on a 16-year-old male adolescent, the nurse notices a swelling in the scrotum that increases with increased intra-abdominal pressure and decreases when he is lying down. The patient complains of pain when straining. The nurse knows that this description is most consistent with a(n) ______ hernia. a.Femoral b.Incisional c.Direct inguinal d.Indirect inguinal

d. Indirect inguinal

The nurse knows that a common assessment finding in a boy younger than 2 years old is: a.Inflamed and tender spermatic cord. b.Presence of a hernia in the scrotum. c.Penis that looks large in relation to the scrotum. d.Presence of a hydrocele, or fluid in the scrotum.

d. Presence of a hydrocele, or fluid in the scrotum

The nurse is providing patient teaching about an erectile dysfunction drug. One of the drugs potential side effects is prolonged, painful erection of the penis without sexual stimulation, which is known as: a.Orchitis. b.Stricture. c.Phimosis. d.Priapism.

d. Priapism

When the nurse is performing a genital examination on a male patient, the patient has an erection. The nurses most appropriate action or response is to: a.Ask the patient if he would like someone else to examine him. b.Continue with the examination as though nothing has happened. c.Stop the examination, leave the room while stating that the examination will resume at a later time. d.Reassure the patient that this is a normal response and continue with the examination.

d. Reassure the patient that this is a normal response and continue with the examination

The nurse is examining the glans and knows which finding is normal for this area? a.The meatus may have a slight discharge when the glans is compressed. b.Hair is without pest inhabitants. c.The skin is wrinkled and without lesions. d.Smegma may be present under the foreskin of an uncircumcised male.

d. Smegma may be present under the foreskin of an uncircumcised male

An older man asks if he is able to father children. In the aging male, when does infertility occur? a. At age 60, with the sudden decline in sperm production b. At approximately age 55 to 60, when testosterone levels are lower c. When the male is no longer able to achieve an erection d. There is no specific age; men may be fertile into their 80s and 90s.

d. There is no specific age; men may be fertile into their 80s and 90s.

A 15-year-old boy is seen in the clinic for complaints of dull pain and pulling in the scrotal area. On examination, the nurse palpates a soft, irregular mass posterior to and above the testis on the left. This mass collapses when the patient is supine and refills when he is upright. This description is consistent with: a.Epididymitis. b.Spermatocele. c.Testicular torsion. d.Varicocele.

d. Varicocele

The nurse is performing a genital examination on a male patient and notices urethral drainage. When collecting urethral discharge for microscopic examination and culture, the nurse should: a.Ask the patient to urinate into a sterile cup. b.Ask the patient to obtain a specimen of semen. c.Insert a cotton-tipped applicator into the urethra. d.Compress the glans between the examiners thumb and forefinger, and collect any discharge.

d. compress the glans between the examiners thumb and forefinger, and collect any discharge

H.T. has come to the clinic for a follow-up visit. Six months ago, he was started on a new medication that may cause impotence as a side effect; therefore medication classes explored by the nurse are: a. Antipyretics. b. Bronchodilators. c. Corticosteroids. d. Antihypertensives.

d.Antihypertensives.

When the nurse is conducting sexual history from a male adolescent, which statement would be most appropriate to use at the beginning of the interview? a.Do you use condoms? b.You dont masturbate, do you? c.Have you had sex in the last 6 months? d.Often adolescents your age have questions about sexual activity.

d.Often adolescents your age have questions about sexual activity.

Which of these statements is true regarding the penis? a.The urethral meatus is located on the ventral side of the penis. b.The prepuce is the fold of foreskin covering the shaft of the penis. c.The penis is made up of two cylindrical columns of erectile tissue. d.The corpus spongiosum expands into a cone of erectile tissue called the glans.

d.The corpus spongiosum expands into a cone of erectile tissue called the glans.

Which statement concerning the testes is true? a.The lymphatic vessels of the testes drain into the abdominal lymph nodes. b.The vas deferens is located along the inferior portion of each testis. c.The right testis is lower than the left because the right spermatic cord is longer. d.The cremaster muscle contracts in response to cold and draws the testicles closer to the body.

d.The cremaster muscle contracts in response to cold and draws the testicles closer to the body.

You are assessing an adolescent boy. The first physical sign of puberty is: a. Height spurt b. Penis lengthening c. Sperm production d. Pubic hair development e. Testes enlargement

e. Testes enlargement