Chapter 23 Jensen Questions
A 50-year-old male client asks the nurse what signs he should look for with prostate cancer. How would the nurse respond? "An early sign of prostate caner is swelling of the testicles." "Early cancer of the prostate does not usually produce symptoms." 'An early sign of prostate cancer is blood in the urine." "The first sign of prostate cancer is frequent urinary tract infections."
"Early cancer of the prostate does not usually produce symptoms."
Which question would be most important to ask when obtaining the nursing health history of a male client with extensive peripheral vascular disease? "What dietary supplements do you take?" "When was your last prostate exam for cancer?" "Have you experienced a change in your usual sexual activity?" "Have you had an electrocardiogram recently?"
"Have you experienced a change in your usual sexual activity?"
Which question would be most important to ask when obtaining the nursing health history of a male client with extensive peripheral vascular disease? "When was your last prostate exam for cancer?" "Have you experienced a change in your usual sexual activity?" "Have you had an electrocardiogram recently?" "What dietary supplements do you take?"
"Have you experienced a change in your usual sexual activity?"
During the health history, a young male client asks the nurse why his scrotum rises and relaxes. The nurse would include which statement when responding to the client? "When the temperature is warm, it causes the scrotum to rise." "The cremasteric reflex controls the rise and relaxation of the scrotum." "When the scrotum is in a relaxed state, it has many rugae." "When the temperature is colder, the scrotum relaxes."
"The cremasteric reflex controls the rise and relaxation of the scrotum."
A client has admitted to the nurse that he has been having difficulty obtaining and maintaining erections for many months. Which of the nurse's assessment questions most clearly addresses a potential cause for the client's problem? "How would you describe a typical day's food intake?" "What medications are you currently taking?" "Have you ever been screened for prostate cancer?" "Do you ever experience pain when you urinate?"
"What medications are you currently taking?"
On palpating a client's scrotum and testes, the nurse notes that the testes appear to be of normal shape and size. Which of the following would indicate a normal length for testes? 1.5 cm 3 cm 4.5 cm 6 cm
4.5 cm Testes are ovoid, approximately 3.5 to 5 cm long, 2.5 cm wide, and 2.5 cm deep, and equal bilaterally in size and shape.
On palpating a client's scrotum and testes, the nurse notes that the testes appear to be of normal shape and size. Which of the following would indicate a normal length for testes? 4.5 cm 3 cm 6 cm 1.5 cm
4.5 cm Testes are ovoid, approximately 3.5 to 5 cm long, 2.5 cm wide, and 2.5 cm deep, and equal bilaterally in size and shape.
Which of the following male clients is most in need of immediate medical treatment? A 15-year-old boy who has been brought in by his mother for assessment of his severely painful testes that are retracted upward A 22-year-old student who has presented with a cluster of painful lesions on the shaft of his penis A 70-year-old retiree whose intestines are palpable in his scrotum A 30-year-old who presents with palpable nodules in his left testis
A 15-year-old boy who has been brought in by his mother for assessment of his severely painful testes that are retracted upward
The nurse is assessing a male client complaining of testicular pain. Which symptom helps the nurse determine that the client does not need immediate surgical intervention? Absence of nausea and vomiting. Elevation of affected testicle does not lessen pain. Denies urethral irritation. Temperature 100.4 degrees Fahrenheit.
Absence of nausea and vomiting.
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
Absence of symmetry of the inguinal areas with straining
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? Prostate cancer Hydrocele Benign prostatic hypertrophy Acute prostatitis
Acute prostatitis
Which of the following groups has the highest incidence of prostate cancer? Caucasian men Native American men African American men Asian American men
African American men
The exact cause of benign prostatic hypertrophy (BPH) is unknown, but the condition is believed to be associated with what factors? Age-related hormonal changes Environmental factors Diet Lifestyle
Age-related hormonal changes
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? Previously thrombosed hemorrhoid Hemorrhoids Rectal prolapse Anal fissure
Anal fissure
How should a nurse proceed with palpation of the anus to best facilitate the exam without causing the client undo discomfort? 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 Use the fingertips of one hand because they are the smallest part of the finger
Ask the client to bear down and place the lubricated finger on the anal opening
During a prostate examination, the prostate is noted to have a rubbery or boggy glandular consistency. The nurse recognizes that this is what? BPH Chronic fibrosis Prostatic calculi Prostate cancer
BPH
During a prostate examination, the prostate is noted to have a rubbery or boggy glandular consistency. The nurse recognizes that this is what? BPH Prostatic calculi Chronic fibrosis Prostate cancer
BPH
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
BPH 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.
When assessing a client during the physical examination of the genitalia, the nurse palpates the scrotal contents. Which finding should the nurse recognize as an indication that an infection or cysts are present? Palpable and tortuous veins Beaded or thickened cord Smooth, nontender cord Left testicle is slightly lower than the right
Beaded or thickened cord
When inspecting the anus, to better inspect the anal opening it would be helpful to instruct the client to do which of the following? Squat Bear down Cough Deep breathe
Bear down or Valsalva maneuver
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
Benign prostatic hyperplasia (BPH) 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 72-year-old male presents at a local clinic and states: "I have to urinate all the time, and I never feel like my bladder is emptied. It really bothers me at night." What condition might the nurse suspect related to this chief complaint? Chronic bacterial prostatitis (CBP) Benign prostatic hyperplasia (BPH) Orchitis Epididymitis
Benign prostatic hyperplasia (BPH) Initial symptoms of BPH may be urinary difficulties. The client does not empty his bladder completely when he voids and finds that he must void frequently, often during the night. He may also find starting to void increasingly difficult or painful and may notice traces of blood in his urine. Cystitis may result. The client with chronic prostatitis is usually asymptomatic, but he may complain of back or perineal pain. Symptoms of orchitis include pain and swelling in the scrotum and sometimes urethral irritation. Symptoms of epididymitis include redness, pain, and various degrees of scrotal swelling.
A 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. Prostate cancer Cancer of the glans penis HIV/AIDS Testicular cancer Colorectal cancer
Cancer of the glans penis HIV/AIDS
What part of the penis fills with blood when the penis becomes erect? Corpus spongiosum Corpora cavernosa Corona Urethral meatus
Corpora cavernosa
A client is concerned about his risk for developing testicular cancer. Which of the following should the nurse mention as a risk factor for this type of cancer? Being uncircumcised Smoking Cryptorchidism Sedentary lifestyle
Cryptorchidism
When examining a newborn male infant, the nurse notes that neither testicle is descended. How would the nurse document this finding? Epididymitis Orchitis Cryptorchidism Varicocele
Cryptorchidism Absence of a testis in the scrotum suggests cryptorchidism. Epididymitis is an infection of the epididymis. Orchitis is an inflammation of the testes. Varicocele is an abnormal dilation of veins in the spermatic cord.
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
Digital rectal examination 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.
A male client presents to the health care clinic with reports of pain with ejaculation. The nurse should be prepared to inspect which part of the anatomy to determine the likely cause of the client's pain? Glans penis Epididymis Prostate Urethral meatus
Epididymis
A client complains of scrotal pain, and the nurse elicits a positive Prehn sign with relief of the pain. The nurse suspects which of the following? Scrotal mass Epididymitis Tortuous varicocele Strangulated hernia
Epididymitis
A nurse examines the external genitalia of a client and observes that the scrotum is enlarged, reddened, and swollen. On palpation, the epididymis is tender and the client complains of sudden pain. How should the nurse document this condition? Orchitis Cryptorchidism Epididymitis Hydrocele
Epididymitis
A client complains of scrotal pain, and the nurse elicits a positive Prehn sign. The nurse would refer the client for treatment of what condition? Strangulated hernia Tortuous varicocele Epididymitis Scrotal mass
Epididymitis Passive elevation of the testes with relief of scrotal pain is a positive Prehn's sign indicating epididymitis. Painless nodules may indicate a scrotal mass or tumor. Tenderness and swelling may indicate a strangulated hernia. Palpable tortuous veins suggest a varicocele.
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 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.
Upon inspection and palpation of the front of the client's thigh, the nurse discovers a bulge that appears when the client coughs. The nurse should document this finding as which type of hernia? Scrotal Incarcerated Strangulated Femoral
Femoral A bulge or mass on the front of the thigh in the femoral canal area is a femoral hernia. A hernia is strangulated if the blood supply is cut off. In this case, the client typically complains of extreme tenderness and nausea. A scrotal mass that remains when the client lies down and over which bowel sounds can be auscultated is a scrotal hernia. If the mass in the scrotum cannot be pushed into the abdomen, it could be an incarcerated hernia.
An Advanced Practice Nurse is preparing to do a rectal examination on a 77-year-old client. The client complains of pain as soon as the examination begins. What might this client have? Fissures Constipation Scrotal enlargement Benign prostatic hyperplasia (BPH)
Fissures
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.
Gently squeeze the glans between the thumb and index finger.
A male client is complaining of pain with urination, rectal pain and urethral discharge. The nurse suspects this is what? Gonorrhea Chlamydia Scabies Syphilis
Gonorrhea 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.
What documentation in a client's history should a nurse recognize as an indication that the client has a normal prostate? Heart shaped, smooth with two distinct lobes Nontender, firm, and slightly tender to palpation Rubbery with two lobes, left slightly larger than the right Slightly tender to palpation but smooth and rubbery
Heart shaped, smooth with two distinct lobes
A male client seeks medical attention for a swelling in the groin area. What should the nurse consider is occurring with this client? Select all that apply. Hydrocele Hematocele Infection Cancer Hernia
Hernia Cancer Infection
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
History of hypertension
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
Hydrocele
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
Hydrocele
During the physical examination of a male client's genitalia, the nurse observes that the urinary meatus is displaced to the ventral surface of the penis. How should the nurse document this condition? Paraphimosis Epispadias Hypospadias Phimosis
Hypospadias
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
Hypospadias
Symptoms of prostate disorder include which of the following? Nocturia, daytime polyuria, strong urinary stream Incomplete emptying, nocturia, weak urinary stream Elevated PSA level, daytime polyuria, low back pain Decreased urination, painful urination, elevated PSA level
Incomplete emptying, nocturia, weak urinary stream
When assessing a client with benign prostatic hypertrophy, which of the following would the nurse expect the client to report as the initial complaint? Urinary frequency Increased effort to void Narrowing of urinary stream Nocturia
Increased effort to void The symptoms of BPH appear gradually. At first, the client notices that it takes more effort to void. Eventually, the urinary stream narrows and has decreased force. The bladder empties incompletely. As residual urine accumulates, the client has an urge to void more often and nocturia occurs.
A client presents to the health care clinic with reports of yellow stool. Which condition should the nurse most suspect? Lack of bile pigment Increased fat content Gastrointestinal bleeding Cancer of the colon
Increased fat content
The nurse educates the client that what condition may be associated with a varicocele? Infertility Circulatory obstruction Ischemia Klinefelter's syndrome
Infertility
The nurse educates the client that what condition may be associated with a varicocele? Klinefelter's syndrome Circulatory obstruction Infertility Ischemia
Infertility
The nurse caring for a client with a varicocele explains the side effects of this condition. With what disorder is this condition associated? Thyroid disorder Undescended testicle Epididymitis Infertility
Infertility A varicocele is an abnormal dilatation of the testicular veins in the scrotum, causing a reflux of blood down to the scrotum when standing or straining. The scrotal temperature is higher than normal because of the blood pooling in the area. Heat impairs spermatogenesis and sperm storage, resulting in a low sperm count and infertility.
On inspection and palpation, the nurse finds that a client's testes are small, probably less than 2 cm, and firm. Which of the following conditions should the nurse most suspect in this situation? Orchitis Epididymitis Klinefelter's syndrome Atrophy
Klinefelter's syndrome
Which position should a nurse assist a client to assume to ensure comfort during the examination of the anus, rectum, and prostate of a male client? Knee-chest Lithotomy Left lateral Standing
Left lateral
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
Left testicular torsion
A teenage boy has been diagnosed with orchitis. When reviewing the child's health history, the nurse should expect that the client may have recently been treated for what health problem? Phimosis Varicella Influenza A Measles
Measles
A nurse recognizes that which finding is normal upon palpation of the prostate? Enlarged, smooth, firm, slightly elastic Nontender and rubbery Swollen and tender Hard, fixed, irregular nodules
Nontender and rubbery
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
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? Reiter's syndrome Normal findings Effects of chemotherapy Gonorrhea
Normal findings
When palpating the prostate, the nurse detects a nontender, rubbery prostate with lateral lobes that are 2.5 cm and heart-shaped. The nurse would interpret this finding as indicating which of the following? Prostatitis Benign hypertrophy Cancer Normal prostate
Normal prostate The prostate is normally nontender and rubbery with two lateral lobes that are smooth, 2.5 cm long, and heart shaped. Swelling and tenderness suggest prostatitis. Enlargement of a smooth, firm, slightly elastic prostate suggests benign hypertrophy. A hardened area on the prostate or hard fixed irregular nodules suggest prostate cancer.
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.
Obtain a sample of the discharge for culture.
A nurse examines the external genitalia of a client who has been diagnosed with the mumps. The scrotum appears enlarged and reddened. How should the nurse document this condition? Cryptorchidism Orchitis Epididymitis Hydrocele
Orchitis
Which of the following unexpected findings of the testes is most likely to result in painful palpation of the testes? Klinefelter's syndrome Cryptorchidism Testicular tumor Orchitis
Orchitis
Which of the following conditions consists of a tight prepuce that, once retracted, cannot be returned? Phimosis Paraphimosis Balanitis Balanoposthitis
Paraphimosis This describes paraphimosis. Phimosis describes a foreskin that cannot be retracted. Balanitis involves an inflammation of the glans, whereas balanoposthitis involves inflammation of both the glans and prepuce.
A client with which of the following cancers is prone to developing phimosis? Prostate Leukemia Penile Testicular
Penile
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? Bowen's disease Peyronie's disease Phimosis Priapism
Phimosis Phimosis is the term used to describe a condition in which the foreskin is constricted so it cannot be retracted over the glans. Bowen's disease is an in situ carcinoma of the penis. Peyronie's disease is an acquired, benign condition that involves the buildup of fibrous plaques in the sheath of the corpus cavernosum. Priapism is an uncontrolled, persistent erection of the penis from either neural or vascular causes, including medications, sickle cell thrombosis, leukemic cell infiltration, spinal cord tumors, and tumor invasion of the penis or its vessels.
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
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? 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.
Position the client in a left side-lying position.
On inspecting a client's external genitalia, a nurse notes that he is uncircumcised. This means that which of the following covers the glans of the penis? Urethral meatus Prepuce Corpus cavernosa Corpus spongiosum
Prepuce
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
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
Prostatitis
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
Prostatitis
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? Don't say anything but continue the exam. Stop the exam and leave the room for 10 minutes. As the client whether continuing the exam will embarrass him. Reassure the client that this is not unusual.
Reassure the client that this is not unusual.
A 50-year-old truck driver comes to the clinic for a work physical. He has had no upper respiratory, cardiac, pulmonary, gastrointestinal, urinary, or musculoskeletal system complaints. Past medical history is significant for mild arthritis and prior knee surgery in college. He is married and just changed jobs, working for a different company. He smokes one pack of cigarettes a day, drinks fewer than six beers a week, and denies any illegal drugs. His mother has high blood pressure and arthritis; his father died of lung cancer in his 60s. On examination, the client's blood pressure is 130/80 and pulse is 80. Cardiac, lung, and abdominal examinations are normal. He has no inguinal hernia, but digital rectal examination reveals a soft, smooth, nontender, pedunculated mass on the posterior wall of the rectum. What anal, rectal, or prostate disorder best fits his presentation? Internal hemorrhoid Prostate cancer Anorectal cancer Rectal polyp
Rectal polyp
Upon examination of the rectum, the nurse notes a red, doughnut-like mass with radiating folds. The nurse suspects which of the following? Rectal polyp External hemorrhoid Rectal prolapse Anorectal fistula
Rectal prolapse 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.
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.
Remove urinary catheters as soon as possible.
The nurse notes that a male client's scrotal sac is documented as being "normal." What should the nurse expect to assess in this client? Select all that apply. Rugated Scattered lesions Color darker than the penis Thin skin Few strands of hair
Rugated Thin skin Few strands of hair Color darker than the penis
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
Scrotal 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.
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? Varicocele Hydrocele Scrotal hernia Scrotal edema
Scrotal hernia
When describing the prostate gland to a group of students, the instructor would explain that this gland does which of the following? Produces the ejaculate that nourishes the sperm Secretes mucus to make female vaginal sections more acidic Aids in transporting the sperm away from the testes Secretes a thin, milky fluid to promote sperm motility
Secretes a thin, milky fluid to promote sperm motility
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
Somatic sensory nerves 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.
A male client is receiving chemotherapy for the treatment of cancer. Which finding should the nurse anticipate during examination of the client's genitalia? Sparse pubic hair Hardness along the ventral surface of the penis Cyanosis to the glans Tenderness on scrotal palpation
Sparse pubic hair
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? Hernia Varicocele Tumor Spermatocele
Spermatocele When transilluminating the scrotal contents, a red glow is seen in swellings or masses that contain serous fluid such as spermatocele and hydrocele. Swellings or masses such as tumors, hernias, and varicocele that are solid or filled with blood do not light up with a red glow.
A nurse is beginning the physical exam of a male client's genitals. The nurse is sitting on a stool in front of the client. Which position would be best to place the client in? Lying supine Kneeling Standing Sitting
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? Exposure to radiation Strenuous activity Erectile dysfunction Stress and inhibition
Strenuous activity
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
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 the genitalia of an older adult client. What would the nurse document as a normal finding? Decrease in size of the testes Testes hanging lower in the scrotum Abundant pubic hair Bulging in the inguinal area
Testes hanging lower in the scrotum In the older adult male, the testes hang lower in the scrotum, the penis becomes smaller, and pubic hair may be gray and sparse. The testes do not decrease in size with aging; however, they may decrease in size with long-term illness. Bulging in the inguinal area would be considered an abnormal finding associated with a hernia.
After discovering an abnormal mass in the scrotum, a nurse performs transillumination of the client's testicles and observes no red glow within the scrotal sac. The nurse recognizes that this client may be experiencing what type of condition? Testicular torsion Spermatocele Testicular tumor Hydrocele
Testicular tumor
An older adult client comes to the ED bleeding from the rectum. The client has a history of atrial fibrillation and has had two small strokes. The client is currently taking blood pressure medication and anticoagulation therapy at home. Why might this client need to be hospitalized? The client is on anticoagulation medication The client has had a stroke in the past All rectal bleeding requires immediate hospitalization The client is an older adult
The client is on anticoagulation medication
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 It is not uncommon for one testicle to be larger than the other If an abnormality is found by the client, he should be seen within six months by a healthcare provider The exam should be performed after the client takes a warm shower The exam should be performed monthly
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
After ing a 34-year-old client for examination of the anal region, the nurse notes a small opening above the gluteal crease that contains a tuft of hair. How should the nurse interpret this assessment finding? A pilonidal cyst appears to be a sinus but is in fact superficial. The pilonidal cyst is a particular form of scarring that results from sacral pressure. The cyst and sinus confirm an infectious process that necessitates antibiotic coverage. The pilonidal cyst and sinus are usually benign, but can occasionally become infected or develop further sinuses.
The pilonidal cyst and sinus are usually benign, but can occasionally become infected or develop further sinuses.
A nurse is assessing the genitalia of a male client. The nurse finds that the client has a piercing in his penis. Why is it important to investigate details of the piercing? To assess for health risks relating to how it was performed Because the nurse may also want to get a piercing there To call the authorities, because these piercings are illegal in most states To help the client better care for the piercing
To assess for health risks relating to how it was performed
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 Spermatocele Orchitis Varicocele
Torsion of the spermatic cord Torsion of the spermatic cord is usually accompanied by a sudden, severe pain of the scrotum and is a urological emergency. A spermatocele is a sperm-filled cystic mass located on the epididymis. Orchitis is inflammation of the testes. A varicocele is an abnormal dilation of veins in the spermatic cord.
A nurse is performing palpation of a client's prostate gland. Which of the following indicates proper procedure Turn the hand fully clockwise so that the tip of the finger faces the client's lumbar region Turn the hand fully clockwise so that the tip of the index finger faces the client's umbilicus Turn the hand fully counterclockwise so that the pad of the finger faces the client's side Turn the hand fully counterclockwise so that the pad of the index finger faces the client's umbilicus
Turn the hand fully counterclockwise so that the pad of the index finger faces the client's umbilicus
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.
bowel sounds at the bulge Bowel sounds auscultated over the mass indicate the presence of bowel and thus a scrotal hernia.
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.
epididymitis. In epididymitis the scrotum appears enlarged, reddened, and swollen.
While reviewing the medical record before examining a male clinic client, the nurse notes that the urinary meatus is located on the top of the glans of the penis. The nurse understands the correct term for this congenital defect is epispadias hypospadias hydrocele varicocele
epispadias
If a male client is uncircumcised, the glans of the penis is covered by the epididymis. frenulum. corona. foreskin.
foreskin. (or prepuce)
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
hernia 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.
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.
herpes infection.
The prostate gland consists of two lobes separated by the median sulcus. rectovesical pouch. anorectal junction. valves of Houston.
median sulcus.
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
prolapse 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 group of students is reviewing information about the male genitalia in preparation for a test. The students demonstrate understanding of the material when they identify which of the following as external genitalia? Scrotum Testis Vas deferens Spermatic cord
scrotum The external genitalia include the penis and scrotum. The testis, vas deferens, and spermatic cord are internal genitalia
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.
syphilis. Chancres (red, oval ulcerations) from syphilis are sometimes detected on the glans.
