Chapter 26: Assessing Male Genitalia and Rectum

Which of the following male clients is most in need of immediate medical treatment? 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 A 70-year-old retiree whose intestines are palpable in his scrotum A 22-year-old student who has presented with a cluster of painful lesions on the shaft of his penis

A 15-year-old boy who has been brought in by his mother for assessment of his severely painful testes that are retracted upward

Which client would the nurse identify as being at highest risk for the development of testicular cancer? A 39-year-old African-American man who is HIV-negative. A 25-year-old man with a history of cryptorchidism. A 75-year-old white man with erectile dysfunction. A 45-year-old white man with a history of hypertension.

A 25-year-old man with a history of cryptorchidism.

You are caring for a 33 year old male who has come to the clinic for a physical examination. He states that he has not had a routine physical in five years. During the examination the physician finds that digital rectal examination (DRE) reveals extensive hardening in the posterior lobe of the prostate gland that is not mobile. The nurse recognizes that the observation typically indicates what Metastatic disease Evidence of a more advanced lesion A sign of early prostate cancer A normal finding

A sign of early prostate cancer

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 symmetry of the inguinal areas with straining Absence of bowel sounds in the scrotum Absence of a varicocele

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? Hydrocele Prostate cancer Acute prostatitis Benign prostatic hypertrophy

Acute prostatitis

A nurse is caring for a client with prostatitis. The nurse knows that what nursing care measure will be employed when caring for this client? Administer the prescribed dose of antibiotics Restrict the fluid intake of the client Avoid sitz bath procedures Discourage the client from using stool softners

Administer the prescribed dose of antibiotics

A clinic nurse is admitting a teenage client with complaints of itching and burning in his genital area. He tells you "I am sure I have an sexually transmitted infection. This will be the third one in 3 months." What intervention would be most appropriate with this client? Provide client with educational material on testicular cancer Assess the client's knowledge and understanding of safe sexual practices Provide samples of spermicides to client Teach the client correct use of condom to prevent pregnancy

Assess the client's knowledge and understanding of safe sexual practices

A patient has undergone a digital rectal examination. This assessment will allow the clinician to diagnose which of the following? Testicular cancer Urinary incontinence ED BPH

BPH

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 Smooth, nontender cord Left testicle is slightly lower than the right Beaded or thickened cord

Beaded or thickened cord

The physician explains to the patient that they have an inflammation of the Cowper's glands. Where are the Cowper glands located? Within the anterior aspect of the urethra just above the prostate Near the urethra, alongside the vas deferens Within the epididymis Below the prostate within the posterior aspect of the urethra

Below the prostate within the posterior aspect of the urethra

Which of the following is inconsistent with a digital rectal examination? Assists in screening for cancer of prostate gland Can reveal a hydrocele Enables examiner to assess size, shape, and consistency of prostate gland Recommended for men greater than 40 years of age

Can reveal a hydrocele

When palpating the rectal mucosa, how does the nurse rotate the examining hand? Counterclockwise, then clockwise From the nurse's left, then to the right Clockwise, then counterclockwise Anteriorly, then posteriorly

Clockwise, then counterclockwise

After teaching a group of student about structural abnormalities of the male reproductive system, the instructor determines that the teaching was successful when the students identify which of the following as an example? Erectile dysfunction Cryptorchidism Prostatitis Priapism

Cryptorchidism

Which of the following would the nurse expect to be done to assess the size of the prostate? Digital rectal examination Pelvic examination Transillumination Bladder percussion

Digital rectal examination

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 from this data? Sexual Dysfunction Readiness for Enhanced Self-Health Management Ineffective Health Maintenance Disturbed Sleep Pattern

Disturbed Sleep Pattern

Which of the following recommendations would a nurse advocate during infancy and childhood to help reduce potential adult complications such as orchitis? Engage in activities and exercises that minimize heavy lifting. Encourage the consumption of foods that are rich in fat and starch. Urge the limited intake of foods and fluids containing caffeine. Ensure immunizations against infectious diseases such as mumps

Ensure immunizations against infectious diseases such as mumps

A male in college presents to the health clinic with complaints of fever, malaise, and swelling of the sides of the neck. A blood test confirms the presence of mumps. The nurse should educate the client to report which changes of his genitalia to the health care provider? Red rash on the penis Silvery lesion on the glans Feelings of heaviness and pain in the scrotum Clear vesicles that erupt from ulcers

Feelings of heaviness and pain in the scrotum

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

The nurse is preparing a presentation for a local community group about prostate cancer and possible dietary risk factors. Which of the following would the nurse most likely include? High-fat diet High-iron High fiber High-calorie

High-fat diet

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? Orchitis Prostatism Cryptorchidism Hydrocele

Hydrocele

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? Epispadias Phimosis Hypospadias Cryptorchidism

Hypospadias

Upon inspection and palpation of the scrotum, the nurse discovers a mass. The nurse finds that the mass cannot be pushed back into the abdomen. The nurse should document this finding as which type of hernia? Scrotal Femoral Strangulated Incarcerated

Incarcerated

A client presents to the health care clinic with reports of yellow stool. Which condition should the nurse most suspect? Cancer of the colon Gastrointestinal bleeding Increased fat content Lack of bile pigment

Increased fat content

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 patient? Hydrocele Epididymitis Left testicular torsion Testicular cancer

Left testicular torsion

Which of the following is a sign or symptom of benign prostatic hypertrophy (BPH)? Fever Bone pain Nocturia Weight loss

Nocturia

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 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 a dressing over the scrotum. Prepare the client for surgery. Apply scrotal support. Prepare the client for circumcision.

Prepare the client for surgery.

The nurse is documenting current health concerns during the health history of an older adult male client. Identification of what may help most at this time? Number of sexual partners Number of sexually transmitted infections Sexual preference Previous problems

Previous problems

On palpation of a client's prostate, a nurse detects hard, fixed, and irregular nodules on the prostate. Which condition should the nurse most suspect in this client? Prostate cancer Benign prostatic hypertrophy Acute prostatitis Hydrocele

Prostate cancer

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? Prostatitis Colonic polyp Prostate cancer Colon cancer

Prostatitis

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? Request that the client avoid talking Reassure him that it is not unusual to have an erection during 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

An adult male client comes to the clinic complaining of awakening at night to void and voiding more than once in a 2-hour time period. The client has a history of bladder irritation. What would be an appropriate nursing diagnosis for this client? Urinary retention Ineffective sexuality pattern Risk for infection Risk for urge incontinence

Risk for urge incontinence

A client reports the new onset of mucous in the stool. How should the nurse document this in the client's history? Steatorrhea Fecal incontinence Diarrhea Change in bowel habits

Steatorrhea

An uncircumcised male client has just come to the recovery room following a 4-hour back surgery. Before surgery a urinary catheter was placed. During the postoperative assessment, the recovery nurse discovers that the client has developed paraphimosis. What might have happened to the client to cause this? The client is having an anatomical reaction to being face down on a pillow for 4 hours The foreskin was not pulled back over the head of the penis after catheter placement The catheter was too taut for too long and has damaged the urethra The client is having a reaction to an anesthesia agent he received during surgery

The foreskin was not pulled back over the head of the penis after catheter placement

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

Torsion of the spermatic cord

A young man feels something in his scrotum and comes to you for clarification. On your examination, you feel what feels like a "bag of worms" in the left scrotum, superior to the testicles. Which of the following is most likely? Normal vas deferens Testicular carcinoma Varicocele Hydrocele of the spermatic cord

Varicocele

The nurse has assessed a male client and determines that one of the testes is absent. The nurse should explain to the client that this condition is termed orchitis. hematocele. hypospadias. cryptorchidism.

cryptorchidism.

While reviewing the medical record before examining a male clinic patient, 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 hypospadias varicocele epispadias Hydrocele

epispadias

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 gonorrhea. herpes infection. venereal warts. Syphilis.

herpes infection.

What ethnic group has a significantly higher incidence rate of prostate cancer? African American Asian Native American Caucasian

African American

You are giving an educational event to a local men's group about prostate cancer. What group should you be sure to tell the attendees of this event should receive information regarding the predisposition of prostate cancer? African Americans Asian Americans Euro-Americans Native Americans

African Americans

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 Anorectal fistula Anal fissure External hemorrhoid

External hemorrhoid

What information should nurse include in the teaching plan for a client considering a vasectomy? protects from sexually transmitted infection May causes urinary incontinence increases the amount of ejaculate offers permanent birth control

offers permanent birth control

17-year-old male client expresses concern about feeling lumps on his testicles. What response by the nurse would best address the client's concerns? "Do you think you have malformed testicles?" "The normal testicle contains internal structures that cause lumps on the surface." "Don't worry, that is the way normal testicles feel." "Lumpy testicles are not going to cause a problem with sexual performance."

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

Which of the following statements is true of prostate cancer? Family history does not appear to be a risk factor. Ethnicity is a risk factor. It is one of the less common forms of cancer. Survival rates are low.

Ethnicity is a risk factor.

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 Femoral Strangulated Incarcerated

Femoral

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 Phimosis Hypospadias

Hypospadias

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? Peyronie's disease Priapism Bowen's disease Phimosis

Phimosis

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? Corpus spongiosum Prepuce Corpus cavernosa Urethral meatus

Prepuce

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? Anorectal cancer Benign prostatic hyperplasia (BPH) Prostatitis Prostate cancer

Prostate cancer