CH 25 - Male Genitourinary System
Which condition would a 20-year-old Caucasian male with a history of cryptorchidism be at high risk for developing? Varicocele Bladder cancer Testicular cancer Sexually transmitted infections
A history of undescended testes (cryptorchidism) is the most important risk factor for testicular cancer. Testicular cancer is also more common in Caucasian males between the ages of 18 and 35. Cryptorchidism is not a risk factor for a varicocele. A varicocele is a dilation of varicose veins in the spermatic cord, and occurs in 15% by age 15 years. Undescended testes are not a risk factor for bladder cancer; smoking and certain occupations are risk factors for bladder cancer. Sexually transmitted infections can occur in a sexually active patient who practices unsafe sex but is not associated with cryptorchidism.
Upon palpation, how would a normal epididymis feel in a male patient? Rough Tender Firm and rubbery Softer than the testes
A normal epididymis is softer than the testis and feels discrete. The epididymis is not rough but feels smooth on palpation. Although the testes may be slightly tender with palpation, the epididymis is nontender. The testes will feel firm and rubbery, but the epididymis will not.
Which question would be most important for the nurse to ask a patient to assess for stress incontinence? "Are you urinating more often than usual?" "Are you having any difficulty controlling your urine?" "Do you have any trouble starting the urine stream?" "Do you accidentally urinate when you laugh or bear down?"
"Do you accidentally urinate when you laugh or bear down?" The nurse would ask, "Do you accidentally urinate when you laugh or bear down?" Stress incontinence refers to the involuntary loss of urine during physical strain (bear down) or laughing. The nurse would also ask about sneezing and coughing, which can lead to a loss of urine during stress incontinence. Stress incontinence is caused by weakness of the pelvic floor muscles. Although the nurse could ask about urinating more often than usual for stress incontinence, it is not the most important because this question is more specific for polyuria or oliguria. Asking about any difficulty controlling urine would help assess for stress incontinence, but it is not the most important because incontinence and urge incontinence can be identified with this question; it is not specific for stress incontinence like the question that asks about laughing or bearing down. Trouble starting the urine stream assesses for hesitancy, which is a reflection of possible obstruction; it is not an important question to ask for stress incontinence.
Which patient would be at risk for developing bladder cancer? A 64-year-old Caucasian patient who smokes and works in a textile factory A 70-year-old Asian patient with a history of hypertension and diabetes A 45-year-old Hispanic patient with a decreased glomerular filtration rate (GFR) A 28-year-old African-American patient who had an undescended testicle surgically corrected
A 64-year-old Caucasian patient who smokes and works in a textile factory The 64-year-old Caucasian patient who smokes and works in a textile factory is at risk for bladder cancer. Risk factors for developing bladder cancer include being Caucasian, smoking, and working with aniline dyes and other chemicals used in the textile, paint, plastic, printing, and rubber industries. A history of hypertension and diabetes are risk factors for chronic kidney disease and end-stage renal disease, not for bladder cancer. A patient with a decreased GFR is at risk for renal and kidney problems, but GFR is not a recommended indicator for bladder cancer. A patient with an undescended testicle that was surgically corrected is at risk for testicular cancer, not bladder cancer. Caucasians are more susceptible to testicular cancer than African Americans.
A patient with a diffuse testicular tumor reports having a hard nodule in the left scrotum. Which additional finding would the nurse monitor for in the patient? Testis transilluminates Misshapen testis Tender swelling of testis Firm palpation does not produce discomfort
Firm palpation does not produce discomfort Firm palpation does not cause usual sickening discomfort as with normal testis in a patient with a diffuse testicular tumor. In a diffuse testicular tumor, the testis does not transilluminate. The diffuse tumor maintains the shape of the testis, and it is not misshapen. Nontender swelling of the testis occurs with a diffuse testicular tumor.
Which medical condition would cause a patient's scrotum to have a red glow of serous fluid upon transillumination? Hernia Hydrocele Orchitis Testicular tumor
Hydrocele If the serous fluid transilluminates and shows a red glow, it indicates the patient has a hydrocele. Transillumination is performed by shining a strong flashlight from behind the scrotal contents. The absence of transillumination of the scrotal contents is normal. Blood and solid tissue do not transilluminate. Therefore transillumination does not occur in other conditions such as hernia, orchitis, and testicular tumor.
Which symptom would the nurse expect patients having acute cystitis, prostatitis, or urethritis to have in common? Dysuria Polyuria Nocturia Oliguria
In conditions such as acute cystitis, prostatitis, and urethritis, there is inflammation of the urinary tract that results in dysuria. Thus the nurse would expect dysuria to be common among patients with acute cystitis, prostatitis, or urethritis. Dysuria refers to pain, burning, and discomfort during urination. Polyuria refers to an increased frequency of urination because of the excessive production of urine, which may occur in patients with diabetes mellitus. Nocturia is not a common symptom among patients with acute cystitis, prostatitis, or urethritis. Nocturia refers to the urgency and increased frequency of urination during night hours from diuretic medication, certain urinary tract disorders, and cardiovascular diseases. Oliguria is not a common symptom among patients with acute cystitis, prostatitis, or urethritis. Oliguria refers to a diminished quantity of urine because of decreased fluid intake or renal failure.
A patient with a varicocele reports a dragging sensation in the scrotal area. Which additional assessment finding would the nurse monitor for upon palpation? Solitary nodule on testicle Scrotal "bag of worms" Extremely tender scrotum Absence of testis
Scrotal "bag of worms" Varicocele refers to the dilation of the varicose veins in the spermatic cord, which feels like a "bag of worms" on palpation. A solitary nodule on a testicle is testicular cancer, not a varicocele. An extremely tender scrotum occurs in epididymitis, not varicocele. Absence of testis is cryptorchidism, not varicocele.
Which laboratory result would the nurse monitor to best determine a patient's kidney function? Presence of urine glucose Blood urea nitrogen (BUN) Serum creatinine White blood cells in urine
Serum creatinine is the best measurement of kidney function because its levels are fairly constant from day to day, and it is a reflection of the glomerular filtration rate. The presence of urine glucose indicates glycosuria, suggesting hyperglycemia occurring with diabetes, but it is not as specific for detecting kidney functioning. BUN is not as specific as creatinine for kidney functioning because BUN rises with dehydration or an increase in protein intake. White blood cells in urine are not as specific to indicate kidney functioning but can suggest a urinary tract infection. A high count of white blood cells in the urine is associated with urinary tract infections.
Which initial finding indicates the male has entered puberty? Pubic hair appears. Penis size increases. Testes enlarge. Vellus hair grows.
The first sign of puberty is enlargement of the testes. Next pubic hair appears, and then penis size increases. Vellus hair, the fine body hair on the abdomen, is a sign of prepuberty, not puberty.
Which condition would be caused by hyperactivity of the detrusor muscle? Direct inguinal hernia Pendulous scrotum Urge incontinence Testicular torsion
Urge incontinence Urge incontinence is caused by a hyperactive detrusor muscle. The overactive detrusor muscle causes an urge to urinate, which may in turn result in the involuntary leakage of urine. This condition is referred to as urge incontinence. A direct inguinal hernia can be caused by muscle atrophy, not from a hyperactive detrusor muscle. A pendulous scrotum results in the older adult male because of decreased tone of the dartos muscle, not from an overactive detrusor muscle. Testicular torsion occurs from faulty anchoring of testis on the wall of the scrotum, not from a hyperactive detrusor muscle.
