chap 23
Prostatitis Explanation: The hallmarks of prostatitis are a tender, swollen, firm prostate. Tenderness is not normally present in cases of BPH or prostate cancer.
During DRE, a 46-year-old client cries out in pain as the nurse palpates his swollen, firm prostate. Which of the following problems should the nurse first suspect? Prostatitis Benign prostatic hyperplasia Prostate cancer Rectal cancer
bowel sounds at the bulge. Explanation: Bowel sounds auscultated over the mass indicate the presence of bowel and thus a scrotal hernia.
The nurse suspects that a male client may have a hernia. The nurse should further assess the client for bruising at the site. urinary tract infection. cysts at the spermatic cord. bowel sounds at the bulge.
Testicular torsion Explanation: Any client with scrotal pain should be presumed to have testicular torsion until another diagnosis can be proven.
A client presents at the clinic with severe scrotal pain. What is the presumptive diagnosis? Testicular torsion Priapism Hydrocele Varicocele
Reassure him that it is not unusual to have an erection during the examination Explanation: The nurse should reassure the client that it is not unusual to have an erection during the examination; this will avoid unnecessary embarrassment in the client. The nurse should ask the client to empty the bladder before the examination so that he will be comfortable during the examination. The client should be informed that he may need to stand for most of the examination. The nurse should encourage the client to ask questions during the examination, and, at the same time, ease the client's anxiety by explaining in detail the significance of each portion of the examination.
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? Ask the client to not empty the bladder before the examination Explain that he may need to lie supine Reassure him that it is not unusual to have an erection during the examination Request that the client avoid talking
Hydrocele Explanation: A hydrocele refers to a collection of fluid in the tunica vaginalis of the testes. Cryptorchidism is the most common congenital defect in males; characterized by failure of one or both of the testes to descend into the scrotum. Orchitis is an inflammation of the testes (testicular congestion) caused by pyogenic, viral, spirochetal, parasitic, traumatic, chemical, or unknown factors. Prostatism is an obstructive and irritative symptom complex that includes increased frequency and hesitancy in starting urination, a decrease in the volume and force of the urinary stream, acute urinary retention, and recurrent urinary tract infections.
An adolescent present at the free clinic with a collection of fluid in the tunica vaginalis of the testes. The nurse knows that the term that defines this condition is what? Cryptorchidism Orchitis Hydrocele Prostatism
Hydrocele Explanation: Swelling or masses that contain serous fluid, such as hydrocele or spermatocele, light up with a red glow with transillumination. Swellings or masses that are solid, or filled with blood, such as tumors, hernias, or varicocele, do not transilluminate.
During a client's genitourinary exam, the nurse notes that the client's scrotum is enlarged and easily transilluminates. What should the nurse suspect? Tumor Hernia Varicocele Hydrocele
Rectal prolapse Explanation: Bulges of red mucous membrane or red doughnut like mass with radiation folds suggests a rectal prolapse. A small opening in the skin surrounding the anal opening suggests an anorectal fistula. A thrombosed swollen area would suggest an external hemorrhoid. Soft nodules inside the rectum may suggest polyps.
Upon examination of the rectum, the nurse notes a red, doughnut-like mass with radiating folds. The nurse suspects which of the following? Anorectal fistula Rectal prolapse External hemorrhoid Rectal polyp
Scrotal hernia Explanation: Scrotal hernias occur when the small intestine passes through a weak spot of the inguinal ring. The examiner cannot get a finger above the hernia into the ring. Hernias are often caused by increased abdominal pressure such as in weight lifting. Clients who have a hernia on one side often have another hernia on the opposite side.
A 29-year-old married computer programmer comes to the clinic complaining of "something strange" going on in his scrotum. Last month while he was doing his self-testicular examination he felt a lump in his left testis. He waited a month and felt the area again but the lump was still there. He has had some aching in his left testis but denies any pain with urination or sexual intercourse. He denies any fever, malaise, or night sweats. His past medical history consists of groin surgery when he was a baby and a tonsillectomy as a teenager. He eats a healthy diet and works out at the gym five times a week. He denies any tobacco or illegal drugs and drinks alcohol occasionally. His parents are both healthy. Examination shows a muscular healthy young man with unremarkable vital signs. On visualization the penis is circumcised with no lesions; there is a scar in his right inguinal region. There is no lymphadenopathy. Palpation of his scrotum is unremarkable on the right but has a large mass on the left. While placing a finger through the inguinal ring on the right, the examiner asks the client to bear down. Nothing is felt. The examiner attempts to place a finger through the left inguinal ring but cannot get above the mass. On rectal examination the client's prostate is unremarkable. What disorder of the testes is most likely? Hydrocele Scrotal hernia Scrotal edema Varicocele
Disturbed Sleep Patterns Explanation: The nursing diagnosis of Disturbed Sleep Patterns related to frequent awakenings and frequent voiding meets the major defining characteristics for this nursing diagnosis
A 55 year old male presents to the health care clinic with reports of difficulty starting the urine stream, dribbling frequently, and getting up several times a night to urinate. He has decreased his fluid intake to try to control the nighttime urination. The nurse assesses a temperature of 101.5 °F oral, dry skin and mucous membranes, and suprapubic tenderness. Which nursing diagnosis can the nurse confirm form this data? Disturbed Sleep Patterns Sexual Dysfunction Health Seeking Behaviors Ineffective Health Maintenance
Constipation Ineffective Health Maintenance Risk for Impaired Skin Integrity Explanation: Constipation can be confirmed because of the decreased in bowel elimination and the passage of hard, dry stool. Ineffective Health Maintenance related to insufficient knowledge of stress reducing behaviors. Risk for Impaired Skin Integrity related to the presence of a large hemorrhoid that could cause irritation and skin breakdown if it became thrombosed.
A 55-year-old client presents to the health care clinic with reports of decreased bowel movements with the passing of hard, dry stool for the past two (2) weeks. The client states he has noticed a small amount of bleeding from the rectum and on the stool. He states he has had trouble with his bowels all his adult life. Admits to drinking a lot of coffee and works in a high stress job. The nurse observes a large external hemorrhoid upon examination of the anus. Which nursing diagnoses can be confirmed with this data? Select all that apply. Constipation Ineffective Health Maintenance Readiness for Enhanced bowel elimination Acute pain Risk for Impaired Skin Integrity
Benign prostatic hyperplasia (BPH) Explanation: BPH becomes more prevalent during the fifth decade and is often associated with hesitancy in starting a stream, decreased strength of stream, nocturia, and leaking of urine. On examination an enlarged, symmetrical, firm prostate is palpated. The anterior lobe cannot be felt. These clients may also develop UTIs secondary to their obstruction.
A 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) Prostatitis Prostate cancer Anorectal cancer
History of hypertension Explanation: Past history of infection, lack of exercise, and use of vitamins do not contribute to impotence. Vascular problems cause about half the cases of impotence in men older than 50 years.
A 68-year-old man comes to the clinic reporting that he is having difficulty obtaining an erection. When reviewing the client's history what might the nurse note that contributes to impotence? Past history of infection History of hypertension Use of multivitamins Lack of exercise
Prepare the client for surgery. Explanation: For the client with torsion, immediate surgery is necessary to prevent atrophy of the spermatic cord and preserve fertility. Analgesics would be given preoperatively. Postoperatively, a scrotal support is applied and dressings are inspected for drainage. Circumcision is done to relieve phimosis or paraphimosis.
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? Apply scrotal support. Prepare the client for surgery. Apply a dressing over the scrotum. Prepare the client for circumcision.
BPH Explanation: A rubbery or boggy glandular consistency may indicate BPH, a common finding in men older than 60 years of age. The gland may feel soft, tender, and boggy from infection.
A client has undergone a digital rectal examination. This assessment will allow the clinician to diagnose which of the following? Urinary incontinence ED BPH Testicular cancer
Black Explanation: Black stool may indicate upper gastrointestinal bleeding. Red stool may be found with hemorrhoids, polyps, cancer or colitis. Clay-colored stool suggest a biliary obstruction; yellow stool suggests steatorrhea.
A client is being evaluated for upper gastrointestinal bleeding. The nurse would expect to observe stool that is which color? Red Clay Yellow Black
Increased fat content Explanation: Yellow stool suggests increased fat content or steatorrhea. Black stools may indicate gastrointestinal bleeding in this client who has not been receiving iron supplements or taking Pepto-Bismol. Clay-colored stool results from the lack of bile pigment. Cancer of the rectum or colon may be indicated by blood detected in the stool.
A client presents to the health care clinic with reports of yellow stool. Which condition should the nurse most suspect? Gastrointestinal bleeding Lack of bile pigment Increased fat content Cancer of the colon
Penile Explanation: In penile cancer the client is prone to developing phimosis (the foreskin of the penis cannot be pulled back over the glans).
A client with which of the following cancers is prone to developing phimosis? Prostate Leukemia Penile Testicular
Hypospadias Explanation: Hypospadias is a condition in which the urethral meatus is located underneath the glans or on the ventral side. Epispadias is condition in which the urethral meatus is located on top of the glans or on the dorsal side. Paraphimosis is a condition in which the foreskin is so tight that, once retracted, it cannot be returned back over the glans. Phimosis occurs when the foreskin is so tight that it cannot be retracted.
A client's electronic health record reveals that he had surgery as an infant to correct the fact that his urethra was located on the ventral side of his penis. The nurse should recognize that this client had what condition? Epispadias Hypospadias Paraphimosis Phimosis
The exam should be performed after the client takes a warm shower The exam should be performed monthly It is not uncommon for one testicle to be larger than the other Explanation: Testicular self examination should be performed by all men, starting at the age of 14. If an abnormality is found, the client should call to be seen by a physician immediately. It is easier to palpate the testicles after the client has had a warm shower or bath. The exam should be performed monthly. It is not uncommon for one testicle to be larger than the other.
A college-aged male client is being seen in the college health clinic by the nurse practitioner. During the assessment, the nurse practitioner asks the client if he is aware of the importance of testicular self examination. The nurse would include the following information when sharing with the client. Select all that apply. The exam should be performed routinely by the client by the age of 21 The exam should be performed after the client takes a warm shower The exam should be performed monthly If an abnormality is found by the client, he should be seen within six months by a healthcare provider It is not uncommon for one testicle to be larger than the other
hernia Explanation: A noticeable bulge in the inguinal area when standing strongly suggests that the male client has a hernia. Hypospadias is a displacement of the urinary meatus. Testicular torsion would be suspected if the scrotum were edematous and painful. An epidermoid cyst is a painless mobile mass in the scrotum. It would not be observed while the client is standing
A male client has a distinctive bulge in the right inguinal area when standing. What should the nurse suspect is occurring with this client? hernia hypospadias testicular torsion epidermoid cysts
Gonorrhea Explanation: Gonorrhea symptoms include pain with urination, rectal pain and urethral discharge. Chlamydia is generally asymptomatic. Scabies is associated with papules, vesicles, pustules and itching. Syphilis has five stages but is exhibited by a genital lesion.
A male client is complaining of pain with urination, rectal pain and urethral discharge. The nurse suspects this is what? Gonorrhea Chlamydia Scabies Syphilis
inguinal hernia. Explanation: Strenuous activity and heavy lifting may predispose the client to development of an inguinal hernia.
A male client tells the nurse that his occupation requires heavy lifting and a great deal of strenuous activity. The nurse should assess the client for signs and symptoms of prostate enlargement. erectile dysfunction. inguinal hernia. urinary tract infection.
External hemorrhoid Explanation: Hemorrhoids are usually painless papules caused by varicose veins, either external or internal. If the hemorrhoid becomes thrombosed is can become painful and swollen. A perianal abscess is a cavity of pus caused by infection in the skin around the anal opening. An anal fissure is a split in the tissue of the anal canal caused by trauma. An anorectal fistula is a small, round opening in the skin that surrounds the anal opening. It suggests an inflammatory tract from the anus or rectum out to the skin.
A nurse examines the anal area of a client and observes the presence of a varicose vein. How should the nurse document this finding? Perianal abscess Anal fissure Anorectal fistula External hemorrhoid
External hemorrhoid Explanation: Hemorrhoids are usually painless papules caused by varicose veins, either external or internal. If the hemorrhoid becomes thrombosed is can become painful and swollen. A perianal abscess is a cavity of pus caused by infection in the skin around the anal opening. An anal fissure is a split in the tissue of the anal canal caused by trauma. An anorectal fistula is a small, round opening in the skin that surrounds the anal opening. It suggests an inflammatory tract from the anus or rectum out to the skin.
A nurse examines the anal area of a client and observes the presence of a varicose vein. How should the nurse document this finding? Perianal abscess Anal fissure Anorectal fistula E xternal hemorrhoid
Position the client in a left side-lying position. Explanation: The most frequently used position for inspection and palpation of the anus, rectum, and prostate is the left lateral position. This position allows adequate inspection and palpation of the anus, rectum, and prostate (in men) and is usually more comfortable for the client. Pain control should not be necessary. Some men may be anxious or fearful during this exam, but the nurse would not normally raise this possibility unless he or she had reason to believe that the client felt this way.
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? Ask the client if he is feeling anxious or fearful about the exam. Assist the client into the supine position. Administer a dose of analgesia 15 minutes before the exam. Position the client in a left side-lying position.
Acute prostatitis Explanation: The prostate is normally nontender and rubbery. A swollen and tender prostate that is firm and warm to the touch may indicate acute prostatitis. An enlarged smooth, firm, slightly elastic prostate that may not have a median sulcus suggests benign prostatic hypertrophy. A hard area on the prostate or hard, fixed, irregular nodules on the prostate suggest cancer. Hydrocele is a painless swelling of the scrotum
A nurse is palpating the prostate of a client and finds it to be swollen, tender, firm, and warm to the touch. Which condition should the nurse most suspect? Acute prostatitis Hydrocele Benign prostatic hypertrophy Prostate cancer
Gently squeeze the glans between the thumb and index finger. Explanation: To palpate for urethral discharge, the nurse would gently squeeze the glans between the thumb and index finger. Having the client hold the penis, observing the glans, or inspecting the scrotal skin would be insufficient because discharge in the urethra cannot be visualized.
A nurse is planning to assess a male client for urethral discharge. Which technique would be best for the nurse to use? Have the client hold the penis while the examiner looks for discharge. Gently squeeze the glans between the thumb and index finger. Inspect the scrotal skin while holding the penis aside. Observe the glans of the penis for signs of abnormal discharge.
Gently squeeze the glans between the thumb and index finger. Explanation: To palpate for urethral discharge, the nurse would gently squeeze the glans between the thumb and index finger. Having the client hold the penis, observing the glans, or inspecting the scrotal skin would be inappropriate.
A nurse is planning to palpate for a urethral discharge in a male client. Which technique would be best for the nurse to use? Have the client hold the penis while the examiner looks for discharge. Gently squeeze the glans between the thumb and index finger. Inspect the scrotal skin while holding the penis aside. Observe the glans of the penis for signs of abnormal discharge.
prolapse Explanation: The nurse should document this condition as rectal prolapse. Soft structures like nodules that may be present in the muscular anal ring are called rectal polyps. They are rather common and occur in varying size and number. If cancer metastasizes to the peritoneal cavity, it may be felt as a nodular, hard, shelf-like structure called rectal shelf that protrudes onto the anterior surface of the rectum in the area of the rectouterine pouch in women. Rectal cancer may feel like a firm nodule, an ulcerated nodule with rolled edges, or, as it grows, a large, irregularly shaped, fixed, hard nodule.
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 Rectal polyps shelf cancer
Nontender and rubbery Explanation: The prostate is normally nontender and rubbery. A swollen and tender prostate may indicate acute prostatitis. An enlarged smooth, firm, slightly elastic prostate that may not have a median sulcus suggests benign prostatic hypertrophy. A hard area on the prostate or hard, fixed, irregular nodules on the prostate suggest cancer.
A nurse recognizes that which finding is normal upon palpation of the prostate? Swollen and tender Enlarged, smooth, firm, slightly elastic Hard, fixed, irregular nodules Nontender and rubbery
Left testicular torsion Explanation: Signs of testicular torsion include acute pain that is not relieved by elevating the testicle, nausea, and vomiting. Epididymitis usually presents in adult males. The client presents with unilateral pain to one testis, but fever, dysuria, and possibly urethral discharge. Hydrocele is the accumulation of fluid around a testicle. This condition usually presents as a non-tender and soft testicle. Often testicular cancer presents lump or swelling, which may or may not be painful. The condition could also present with pain in the abdomen or low back.
A teenage male client comes to the ED with severe left testicular pain and vomiting. Elevation of his left testicle does not lessen the pain. What could these symptoms indicate for this client? Left testicular torsion Epididymitis Hydrocele Testicular cancer
Any of the above Explanation: A tender, painful, swelling of the scrotum can be a medical emergency. All of these conditions should be considered as well as acute orchitis.
A tender painful swelling of the scrotum should suggest which of the following? Acute epididymitis Strangulated inguinal hernia Torsion of the spermatic cord Any of the above
The internal sphincter is under involuntary control. Explanation: The anal canal is the final segment of the digestive system; it begins at the anal sphincter and ends at the anorectal junction (also known as the pectinate line, mucocutaneous junction, or dentate line). It contains two sphincters. The external sphincter is composed of skeletal muscle and is under voluntary control. The internal sphincter contains smooth muscle and is under involuntary control.
After teaching a group of students about the anal canal, the instructor determines that the teaching was successful when the students state which of the following? The anus contains three sphincters. The internal sphincter is under involuntary control. The external sphincter contains smooth muscle. The anus ends at the intersphincteric groove.
Somatic sensory nerves Explanation: The anal canal is lined with skin that contains no hair or sebaceous glands but does contain many somatic sensory nerves, making it susceptible to painful stimuli. The anorectal junction is also known as the dentate line.
During a class, a student asks the instructor, "What does the anal canal contain?" Which of the following would the instructor include in the response? Hair Sebaceous glands Somatic sensory nerves Dentate line
BPH Explanation: BPH is a common finding in men older than 60 years of age and is exhibited by a rubbery or boggy glandular consistency. Cancer, prostatic calculi and chronic fibrosis are noted to be hard during the prostate exam.
During a prostate examination, the prostate is noted to have a rubbery or boggy glandular consistency. The nurse recognizes that this is what? BPH Prostate cancer Prostatic calculi Chronic fibrosis
Hydrocele Explanation: Swelling or masses that contain serous fluid, such as hydrocele or spermatocele, light up with a red glow with transillumination. Swellings or masses that are solid, or filled with blood, such as tumors, hernias, or varicocele, do not transilluminate
During a scrotal exam, the nurse notes an enlarged scrotal sac that easily transilluminates. Which of the following would the nurse suspect? Tumor Hernia Varicocele Hydrocele
The cremasteric reflex controls the rise and relaxation of the scrotum. Explanation: The movement of the scrotum is related to the cremasteric reflex. The scrotum maintains temperature control because the cremasteric muscle is sensitive to changes in temperature. The muscle contracts when cold, raising the scrotum and testes, and relaxes when warm, lowering the scrotum and testes away from the heat of the body.
During the health history a young male client asks the nurse why his scrotum rises and relaxes. The nurse would incorporate knowledge of which of the following when responding to this client? When the temperature is warm, the scrotum rises. The cremasteric reflex controls the rise and relaxation of the scrotum. When the scrotum relaxes, it has many rugae. I f the temperature is colder, the scrotum relaxes.
Absence of symmetry of the inguinal areas with straining Explanation: Even in the presence of a hernia, absolute symmetry to inspection may be preserved. The actions of straining and increasing intra-abdominal pressure cause the hernia to protrude. Hernias will not necessarily be present on CT scans unless this maneuver is undertaken. Pain with straining and bowel sounds heard in the scrotum further support the diagnosis of indirect hernia.
Francis is a middle-aged man who noted right sided lower abdominal pain after straining with yardwork. Which of the following findings would make a hernia a more likely diagnosis? Absence of pain with straining Absence of bowel sounds in the scrotum Absence of a varicocele Absence of symmetry of the inguinal areas with straining
Ask the client to bear down and place the lubricated finger on the anal opening Explanation: The nurse should lubricate the index finger of the gloved hand and ask the client to bear down. As the client bears down, place the pad of the index finger on the anal opening. When the sphincter relaxes, insert the finger with the pad facing down. Do not use the fingertip because this may cause the sphincter to tighten and this will cause pain when placed into the rectum. Spread the gluteal folds with the hands and attempt to visualize the anal opening is necessary if the client reports severe pain in order to see if there is a lesion present
How should a nurse proceed with palpation of the anus to best facilitate the exam without causing the client undo discomfort? Use the fingertips of one hand because they are the smallest part of the finger Use gentle but firm force to push past the sphincter into the anal canal Ask the client to bear down and place the lubricated finger on the anal opening Spread the gluteal folds with the hands and attempt to visualize the anal opening
Rectal prolapse Explanation: When a client bears down, bulges of red mucous membrane may indicate a rectal prolapse. Hemorrhoids or an anal fissure may also be seen. A previously thrombosed hemorrhoid appears as a skin tag that protrudes from the anus.
In inspecting a client's anus, a nurse notes bulges of red mucous membrane when the client bears down. Which of the following conditions does this most likely indicate? Hemorrhoids Anal fissure Rectal prolapse Previously thrombosed hemorrhoid
Prostatitis Explanation: This examination, associated with a history of dysuria, frequency, and incomplete voiding, should lead to a suspicion of acute prostatitis. Prostate cancer, colon cancer, and polyps should not ordinarily cause systemic symptoms such as fever.
Mr. Jackson, 50 years old, has had discomfort between his scrotum and anus. He also has had some fevers and dysuria. Rectal examination is halted by tenderness anteriorly, but no frank mass is palpable. What is the most likely diagnosis? Prostate cancer Colon cancer Prostatitis Colonic polyp
Syphilitic chancre Explanation: Syphilitic chancre initially is a small, silvery-white papule that develops a red, oval ulceration. Herpes progenitalis is characterized by clusters of pimple-like, clear vesicles that erupt and become ulcers. Cancer of the glans penis appears as a hardened nodule or ulcer on the glans. Hypospadias is a condition in which the urethral meatus is located underneath the glans (ventral side).
On inspection of a client's penis, the nurse observes a small, silvery-white papule. Which of the following conditions should the nurse suspect in this client? Herpes progenitalis Syphilitic chancre Cancer of the glans penis Hypospadias
Prostate cancer Explanation: The prostate is normally nontender and rubbery. A swollen and tender prostate may indicate acute prostatitis. An enlarged smooth, firm, slightly elastic prostate that may not have a median sulcus suggests benign prostatic hypertrophy. A hard area on the prostate or hard, fixed, irregular nodules on the prostate suggest cancer. Hydrocele is a painless swelling of the scrotum
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? Acute prostatitis Benign prostatic hypertrophy Hydrocele Prostate cancer
Obtain a sample of the discharge for culture. Explanation: Any urethral discharge should be cultured. A urine sample may be indicated, but this is not always the case. Repeating palpation of the urethra after voiding will not add meaningful data. The presence of discharge does not create a direct indication for scrotal and testicular palpation, although these actions are part of the overall genitourinary assessment.
Palpation of a male client's urethra produces a yellowish-white discharge. What is the nurse's best action? Obtain a urine sample for culture and sensitivity testing. Obtain a sample of the discharge for culture. Ask the client to void and then repeat palpation of the client's urethra. Palpate the client's scrotum and testes for the presence of fluid.
glans. Explanation: The corpus spongiosum extends distally to form the acorn-shaped glans.
The corpora spongiosum extends distally to form the acorn-shaped glans. frenulum. corona. scrotum.
2 Explanation: Tanner stage 2 for males consists of sparse growth and slightly curly pubic hair, slight or no enlargement of the penis, and both the testes and scrotum larger, reddened, and beginning to exhibit textural changes. Tanner stage 1 is characterized by no pubic hair and a penis, testes, and scrotum of the same size and proportion as in childhood. Tanner stage 3 is characterized by darker, coarse curly sparse pubic hair over the symphysis pubis, a larger and longer penis, and continued enlargement of the testes and scrotum. Tanner stage 4 is characterized by coarse, curly pubic hair that does not extend to the medial thighs, increased penile length and width with development of the glans, and continued enlargement of the testes and scrotum with a darkening of the scrotal skin.
The nurse is assessing a 12-year-old boy and finds the following: sparse growth of pubic hair, beginning penile enlargement, and beginning textural changes on the scrotum. The nurse would document which Tanner stage? 1 2 3 4
Herpes Explanation: Herpes is associated with clusters of pimple-like clear vesicles. Gonorrhea has drainage. Syphilis has a chancre. Chlamydia is asymptomatic.
The nurse is assessing male genitalia and finds clusters of pimple-like clear vesicles. The nurse recognizes this as what? Herpes Syphilis Gonorrhea Chlamydia
epididymitis. Explanation: In epididymitis the scrotum appears enlarged, reddened, and swollen.
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 cancer. hydrocele. epididymitis. hematocele.
Remove urinary catheters as soon as possible. Explanation: Urinary tract infection (UTI), a type of HAI, accounts for more than 30% of infections reported by acute care hospitals in the United States. Virtually all hospital-associated UTIs are caused by instrumentation of the urinary tract, mainly from indwelling urinary catheters. Prevention of a catheter-acquired urinary tract infection (CAUTI) is a key component of an acute-care hospital's client safety and quality improvement program.
The nurse is aware of the heightened risk of urinary tract infections in older males. In order to reduce this risk, the nurse should prioritize which of the following interventions? Remove urinary catheters as soon as possible. Encourage the use of intravenous fluids to ensure hydration. Promote physical activity among older males. Encourage older men to avoid low-pH foods and beverages.
Men having sex with men Explanation: Although transmission routes vary (male-to-male anal sex, intravenous drug use, heterosexual sex, mother-to-infant transmission, and other mechanisms of body fluid transfer), the highest incidence of HIV in the United States still occurs in men who have sex with men (MSM), followed by intravenous drug users.
The nurse is presenting a program about sexually transmitted infections, including HIV, to a group of young men. The nurse would include who as the having the highest incidence of HIV infection in the United States? Men having sex with men Heterosexual partners Bisexual individuals Intravenous drug users
median sulcus. Explanation: The prostate gland consists of two lobes separated by a shallow groove called the median sulcus.
The prostate gland consists of two lobes separated by the median sulcus. rectovesical pouch. anorectal junction. valves of Houston.
Scrotal Explanation: The nurse should document this finding as scrotal hernia if the bulge remains when the client lies down and bowel sounds can be auscultated over it. If the mass in the scrotum cannot be pushed into the abdomen, it could be an incarcerated hernia. A hernia is strangulated if the blood supply is cut off. A bulge or mass on the front of the thigh in the femoral canal area is a femoral hernia.
Upon inspection and palpation of the scrotum, the nurse discovers a mass. The nurse asks the client to lie down, and the bulge remains. On auscultation, the nurse finds bowel sounds. The nurse should document this finding as which type of hernia? Scrotal Incarcerated Strangulated Femoral
Hypospadias Explanation: A urethral meatus located on the underside of the penis is called hypospadias. A meatus located on the upper surface is called epispadias. These congenital conditions are usually repaired surgically at a young age if they are severe. Cryptorchidism is an undescended testicle, and with phimosis, the foreskin becomes so tight that it will not retract over the glans penis.
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 Epispadias Cryptorchidism Phimosis
African American Explanation: For undetermined reasons, incidence rates are significantly higher in African American men than in Caucasian men: 232 cases per 100,000 compared with 146 cases per 100,000, even after adjustments for access to care. Prostate cancer occurs at an earlier age and more advanced stage in African American men.
What ethnic group has a significantly higher incidence rate of prostate cancer? Native American African American Caucasian Asian
Pilonidal cyst Explanation: A pilonidal cyst is a congenital disorder characterized by a small dimple or cyst/sinus that contains hair. External hemorrhoids are usually painless papules below the anorectal junction, caused by varicose veins. Anal fissures are splits in the tissue of the anal canal caused by trauma. Perianal abscess is a cavity of pus, caused by infection in the skin around the anal opening.
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? External hemorrhoid Pilonidal cyst Anal fissure Perianal abscess
Ask the client to bear down Explanation: When palpating the anus of a client, the nurse should ask the client to bear down. The nurse should explain to the client that it may feel like the bowels are going to move, but that will not happen. The gloved index finger, not middle finger, should be lubricated. As the client bears down, the nurse places the pad of the index finger, not the fingertip, on the anal opening. If the sphincter does not relax and the client reports pain, then the nurse should spread the gluteal folds with the hands in close approximation to the anus and attempt to visualize a lesion that may be causing pain.
Which action should the nurse take to best facilitate the examination of the anus in a client? Ask the client to bear down Lubricate the gloved middle finger Use the fingertip to palpate Avoid spreading the gluteal folds
African American men Explanation: African American men have the highest incidence of prostate cancer—two to three times higher than Caucasian men.
Which of the following groups has the highest incidence of prostate cancer? Caucasian men Native American men African American men Asian American men
A positive transillumination test Explanation: A cystic structure will often transilluminate well. While a transilluminator head for the battery handle is ideal, it is possible to use an otoscope to transilluminate the scrotum. The examiner should be able to get above the mass on palpation, and bowel sounds should not be present. If they are, it should lead the examiner to consider an inguinal hernia. Scrotal edema involves thickened skin, which can be measured by gently pinching a section of the scrotum itself
Which of the following would lead the nurse to suspect a hydrocele versus other causes of scrotal swelling? Bowel sounds in the scrotum Inability to palpate superior to the mass A positive transillumination test Normal thickness of the skin of the scrotum
Digital rectal examination Explanation: A digital rectal examination is performed to assess the prostate for size as well as evidence of tumor. Transillumination is used to determine the density of scrotal tissue. Pelvic examination is performed to evaluate female reproductive structures. Bladder percussion reveals information about the status of the bladder.
Which of the following would the nurse expect to be done to assess the size of the prostate? Digital rectal examination Transillumination Pelvic examination Bladder percussion
Anorectal fistula Explanation: An anorectal fistula is observed as a small round opening in the skin that surrounds the anal opening. Pinworm infection would be noted by redness and excoriation from scratching the area. Trauma would be noted by splits in the skin tissue of the anal canal, often with a swollen skin tag below the fissure on the anal margin. Perianal abscess would be noted as a cavity of pus around the anal opening.
Which of the following would the nurse most likely document when noting a small opening in the skin surrounding the anal opening? Pinworm infection Repetitive trauma Perianal abscess Anorectal fistula
herpes infection. Explanation: Pimple-like lesions from herpes are sometimes detected on the glans
While assessing an adult male client, the nurse detects pimple-like lesions on the client's glans. The nurse explains the need for a referral to the client. The nurse determines that the client has understood the instructions when the client says he may have venereal warts. herpes infection. syphilis. gonorrhea.
Normal findings Explanation: Scrotal skin is normally thin and rugated with little hair. Inflammation of the penis and scrotum may be seen in Reiter's syndrome. Absence or scarcity of pubic hair may suggest chemotherapy. A yellow urethral discharge is usually seen with gonorrhea.
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? Reiter's syndrome Normal findings Effects of chemotherapy Gonorrhea
Normal findings Explanation: Scrotal skin is normally thin and rugated with little hair. Inflammation of the penis and scrotum may be seen in Reiter's syndrome. Absence or scarcity of pubic hair may suggest chemotherapy. A yellow urethral discharge is usually seen with gonorrhea.
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? Reiter's syndrome Normal findings Effects of chemotherapy Gonorrhea
Normal findings Explanation: Scrotal skin is normally thin and rugated with little hair. Inflammation of the penis and scrotum may be seen in Reiter's syndrome. Absence or scarcity of pubic hair may suggest chemotherapy. A yellow urethral discharge is usually seen with gonorrhea.
While assessing the scrotum of an adult client, the nurse notes thin and rugated scrotal skin with little hair dispersion. The nurse interprets this finding as which of the following? Reiter's syndrome Normal findings Effects of chemotherapy Gonorrhea
syphilis. Explanation: Chancres (red, oval ulcerations) from syphilis are sometimes detected on the glans
While inspecting the genitalia of a male client, the nurse observes a chancre lesion under the foreskin. The nurse has explained this observation to the client. The nurse determines that the client understands the need for a referral when the client says that chancre lesions are associated with herpes virus. syphilis. papilloma virus. gonorrhea.
It allows sperm to mature. Explanation: The epididymis is a comma-shaped coiled tubular structure in which the sperm mature. The vas deferens provides the passage for transporting sperm from the testes to the urethra for ejaculation. The tunica vaginalis separates the testis from the scrotal wall. The testes produce sperm and testosterone.
While interviewing a teenage male client, the nurse reviews the various structures of the male genitalia. The client asks, "So what does this epididymis do?" Which of the following would the nurse include in the response? It allows sperm to mature. It transports sperm away from the testes. It separates the testes from the scrotal wall. It produces sperm and male sex hormones.