Nursing: Health assessment & Promotion: Chapter 23: Male Genitalia and Rectum

The nurse is reviewing lifestyle changes with a client who is attempting to reduce the risk for colon and prostate cancer. Which statement by the client requires further follow-up by the nurse?

"I am on a high-protein diet that includes red meats."

After teaching a client about measures to reduce his risk for colon cancer, the nurse determines that the teaching was successful when the client states which of the following?

"I should eat a half-cup of raisins every day."

A 17-year-old male client expresses concern about feeling lumps on his testicles. What response by the nurse would best address the client's concerns?

"The normal testicle contains internal structures that cause lumps on the surface."

A male client suffers from urinary retention. Which instructions are best to teach the client?

"Try voiding, then resting a few minutes, before going again."

What ethnic group has a significantly higher incidence rate of prostate cancer?

African American

The nurse is preparing an instructional session for male clients about preventing penile cancer. Which non-modifiable risk factor should the nurse include in the teaching?

Age 60 years or older

60-year-old coach comes to the clinic complaining of difficulty starting to urinate for the last several months. He believes the problem is steadily getting worse. When asked he says he has a very weak stream, and it feels like it takes 10 minutes to empty his bladder. He also has the urge to go to the bathroom more often than he used to. He denies any blood or sediment in his urine and any pain with urination. He has had no fever, weight gain, weight loss, or night sweats. His medical history includes type 2 diabetes and high blood pressure treated with medications. He does not smoke but drinks a six pack of beer weekly. He has been married for 35 years. His mother died of a myocardial infarction in her 70s, and the client's father is currently in his 80s with high blood pressure and arthritis. Examination reveals a mildly obese alert and cooperative man. His blood pressure is 130/70 with a heart rate of 80. He is afebrile, and his cardiac, lung, and abdominal examinations are normal. Visualization of the anus shows no inflammation, masses, or fissures. Digital rectal examination reveals a smooth, enlarged prostate. No discrete masses are felt. There is no blood on the glove. An analysis of the urine shows no red blood cells, white blood cells, or bacteria. What disorder of the anus, rectum, or prostate is most likely?

Benign prostatic hyperplasia (BPH)

nurse is assessing a client who is uncircumcised. The nurse understands that this client is at greater risk for which of the following conditions? Select all that apply.

Cancer of the glans penis HIV/AIDS

A nurse examining a client's external genitalia notices that his scrotum and testes draw up and he shivers. This phenomenon is known as which of the following?

Cremasteric reflex

Which of the following would the nurse expect to be done to assess the size of the prostate?

Digital rectal examination

A nurse examines the anal area of a client and observes the presence of a varicose vein. How should the nurse document this finding?

External hemorrhoid

A nurse is planning to palpate for a urethral discharge in a male client. Which technique would be best for the nurse to use?

Gently squeeze the glans between the thumb and index finger.

The nurse is assessing male genitalia and finds clusters of pimple-like clear vesicles. The nurse recognizes this as what?

Herpes

Upon observation, the nurse documents that a male child's urethral meatus is located on the underside of his penis. What is the term for this structural abnormality?

Hypospadias

A nurse recognizes that which finding is normal upon palpation of the prostate?

Nontender and rubbery

While assessing the scrotum of an adult client, the nurse notes thin and rugated scrotal skin with little hair dispersion. How would the nurse document this finding?

Normal findings

Palpation of a male client's urethra produces a yellowish-white discharge. What is the nurse's best action?

Obtain a sample of the discharge for culture.

An uncircumcised, 78 year-old male has presented at the clinic complaining that he cannot retract his foreskin over his glans. On examination it is noted that the foreskin is very constricted. What is this condition called?

Phimosis

When performing the physical assessment of a client, the nurse notes the presence of a small cyst that contains hair, which is located midline in the sacrococcygeal area and has a palpable sinus tract. How should the nurse document this finding?

Pilonidal cyst

A nurse is a preparing to assess a male client's anus and rectum. How should the nurse best prepare the client for this assessment?

Position the client in a left side-lying position.

A client comes to the Emergency Department complaining of sudden sharp testicular pain. Further examination reveals torsion of the spermatic cord. Which of the following would the nurse expect to do next?

Prepare the client for surgery.

On palpation of a client's prostate, a nurse detects hard, fixed, and irregular nodules on the prostate. Which condition should the nurse most suspect in this client?

Prostate cancer

A nurse prepares a male client for a physical assessment of the external genitalia. Which instruction is appropriate for the nurse to give the client before the examination?

Reassure him that it is not unusual to have an erection during the examination

When the nurse is examining a male client's genitalia, the client experiences an erection. What would be most appropriate for the nurse to do?

Reassure the client that this is not unusual.

The client tells the nurse that he has little or no interest in sex. He says he is concerned and he knows his wife is unhappy with his lack of libido. What can the nurse tell the client often causes lack of libido?

Side effects of medications

During the physical assessment of a client's genitalia, the nurse notes an abnormal mass or swelling. The nurse performs transillumination by shining a light from the back of the scrotum through the mass. In which condition should the nurse see a red glow?

Spermatocele

The nurse is beginning the physical exam of a male client's genitals. The nurse is sitting on a stool in front of the client. In which position would be best to place the client?

Standing

During the assessment of a client, the nurse recognizes that which of the client's lifestyle practices may predispose to the development of an inguinal hernia?

Strenuous activity

A 23 year old male comes to the clinic complaining of sudden and severe pain in his scrotum. The nurse would suspect what?

Torsion of the spermatic cord

The nurse suspects that a male client may have a hernia. The nurse should further assess the client for

bowel sounds at the bulge.

The nurse is assessing the genitalia of an adult male client when he tells the nurse that his testes are swollen and painful. The nurse should refer the client to a physician for possible

epididymitis.

A nurse observes that the mucosa of the rectum and the rectal wall of a female client protrudes out through the anal opening. It appears as a red, doughnut-like mass with radiating folds. How should the nurse document this condition of the rectum?

prolapse

During assessment of an elderly male client, the client tells the nurse that he has had difficulty urinating for the past few weeks. The nurse should refer the client to the physician for possible

prostate enlargement.

The nurse identifies a cheesy white material that has accumulated under a male client's foreskin of the penis. What does this finding suggest to the nurse?

smegma