Chapters 39-41 Patho
A female client asks her health care provider about guidelines for clinical breast examination (CBE). The most appropriate response would be:
"Between the ages of 20 and 39 years, average-risk women should undergo CBE every 3 years." Explanation:p. 1044.
A male college student has arrived at the student clinic complaining of tingling, itching and pains in his groin. Upon inspection, the nurse notices some pustules and vesicles. While taking a detailed sexual history, the nurse should ask which of the following questions to rule out further complications.
"Do you have pain when you urinate or difficulty starting the stream?" Explanation: p. 1052
A nurse in the newborn nursery has an infant with herpes simplex virus-1 (HSV-1). The mother asks "how can this happen? Which of the following is the best information for the nurse to give the mother?
"Do you know if you have this virus or any lesions around your genitalia?" Explanation:p. 1053.
A 20 year-old male has been diagnosed with a chlamydial infection, and his primary care provider is performing teaching in an effort to prevent the client from infecting others in the future. Which of the following statements by the client demonstrates the best understanding of his health problem?
"Even if I spread it to someone else, there's a good chance she won't have any symptoms or know she has it." Explanation: p. 1056.
A nurse suspects an elderly client is experiencing benign prostatic hyperplasia (BPH). Which of the following questions should the nurse ask this client?
"Has the force of your urinary stream decreased?" Explanation:, p. 1008.
When a woman asks the nurse at what age menopause usually occurs, what should the nurse respond?
48 to 55 years of age Explanation:p. 1040.
A 40 year-old woman with gray, runny vaginal discharge that has a foul, fishy odor has been told that she most likely has vaginosis. Which of the following phenomena most likely contributed to her present condition?
A sharp reduction in the number of lactobacilli in the client's vaginal flora. Explanation:p. 1055.
When caring for the client with acute bacterial prostatitis, the nurse plans for which of these interventions?
Antibiotics Explanation:p. 1007.
The anatomy of the prostate gland is made up of three concentric areas surrounding the prostatic uretha, into which they open. The nurse understands that an overgrowth of the mucosal glands can cause which disorder in older men?:
Benign prostatic hypertrophy Explanation: p. 1009.
The nurse provides prophylactic treatment for a neonate to prevent conjunctival gonorrhea. The nurse is aware that the intervention will reduce the risk of:
Blindness Explanation:p. 1058.
A client with on the urology floor who has BPH asks the nurse how the pharmacologic agent finasteride will help decrease the size of his prostate. Which these does the nurse explain to the client is the mechanism of action?
Blocking effects of androgens on the prostate Explanation:p. 1008.
Laboratory analysis of vaginal discharge identifies hyphae on microscopic exam and pH of 4.2. The client most likely has:
C. albicans Explanation:p. 1054.
A sexually active female presents to the clinic with white copious vaginal discharge, itch, swelling, and dysuria. The nurse anticipates the client will be treated for the overgrowth of which of the following organisms?
Candida albicans Explanation:p. 1054.
A patient comes to the clinic and informs the nurse that he is having difficulty obtaining and maintaining an erection, which had never happened before. When assessing the client, which of the following systems should the nurse be sure to focus on?
Cardiovascular system Explanation:p. 999.
During unprotected sex, a 17 year-old female high school senior has been exposed to the human papillomavirus (HPV). The school nurse would recognize that the student is at a considerable risk of developing which of the following diagnoses?
Condylomata acuminata Explanation:p. 1050.
A patient develops Reiter's syndrome. Which of the following symptoms will the nurse assess? Select all that apply.
Conjunctivitis Pain in the joints Explanation:p. 1057.
Which structure supports the breasts while dividing the breast into 15 to 25 lobes?
Cooper's ligaments Explanation:p. 1041.
The nurse is teaching a male client about testicular cancer. Which of the following does the nurse discuss as a major risk factor for testicular cancer?
Cryptorchidism Explanation: p. 1012.
What are the central nervous symptoms associated with tertiary stage syphilis? Select all that apply.
Dementia Blindness Ataxia Explanation:p. 1060.
A client has progressed to the stage of advanced syphilis (tertiary). Assessment findings of the client may include:
Dementia Explanation:p. 1060.
The male reproductive system is comprised of two systems. The nurse knows that which system is responsible for the transportation and storage of sperm?
Ductile system Explanation:p. 996.
When is syphilis highly contagious?
During its primary stage Explanation:p. 1060.
A client who has been diagnosed with premenstrual syndrome (PMS) asks if there is anything to help alleviate the symptoms. The best response would be:
Eat a diet low in simple sugars and high in protein Explanation: p. 1040.
Sperm follow a prescribed route through the excretory ducts of the male reproductive system. Place the following components of the genital duct system in the order that sperm follow. Use all the options.
Efferent ductules Ductus deferens Prostatic urethra Urethra Seminiferous tubules Epididymis Explanation: p. 996.
The nurse working in a fertility clinic is assessing a patient's risk for fallopian tube obstruction. Which one of the following places the woman at greatest risk?
Endometriosis Explanation:p. 1031.
Which of the following is the final site for sperm maturation?
Epididymis Explanation: p. 996.
Of the following list of medications, which would likely be prescribed to a patient with benign prostatic hyperplasia (BPH) as a way to decrease the prostate size by blocking the effects of androgens on the prostate?
Finasteride (Proscar), a 5a-reductase inhibitor Explanation:p. 1008.
The nurse is caring for a client with lichen simplex chronicus. What assessment finding does the nurse expect?
Gray-white plaques with an irregular surface Explanation:p. 1025.
A 75-year-old man presents at the clinic complaining of pain during intercourse and an upward bowing of his penis during erection. The client's history mentions an inflammation of the penis that was treated 3 months ago. The physician's physical examination of the client notes beads of scar tissue along the dorsal midline of the penile shaft. What would be the suspected diagnosis of this client?
Peyronie disease Explanation:p. 1011
A nurse is evaluating diagnostic tests for a client suspected of having prostate cancer. Which of the following results requires further evaluation?
Prostate-specific antigen (PSA) of 12 ng/mL Explanation:p. 1010.
The nurse is reviewing a patient's electronic medical record. The VDRL test result will be elevated during which stage of syphilis?
Secondary Explanation: p. 1061
A 23-year-old diagnosed with syphilis presents with palmar rash, sore throat, fever, and a red-brown lesion on the genital area. The symptoms have been present for 3 weeks. Select the stage of syphilis this client is currently in.
Secondary Explanation:p. 1060.
Select the structure responsible for secreting fructose that will provide energy for spermatic motility.
Seminal vesicles Explanation:p. 996.
A client tells the nurse that her mother recently passed from ovarian cancer. The client asks why the survival rate from ovarian cancer is so low. The best response would be:
Symptoms of ovarian cancer are nonspecific and therefore difficult to interpret. Explanation: p. 1036
Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) produce profound effects on the ovaries. What do high levels of estrogen do to FSH and LH?
↑LH and ↓FSH Explanation: p. 1023.
A young pregnant mother is told after an ultrasound that the fetus' testes have not descended. What hormone is responsible for the descent of the testes?
Testosterone Explanation: p. 995.
The testes secrete several male sex hormones. Which of these hormones is the most abundant and considered the main testicular hormone?
Testosterone Explanation:p. 994.
A patient was diagnosed with human immunodeficiency virus (HIV), which causes acquired immunodeficiency syndrome (AIDS). The nurse realizes that the patient needs further teaching about the disease process based on which of the following statements made by the patient?
"HIV only infects B cells." Explanation: p. 1055-1057.
A client is admitted with secondary orchitis. Which assessment question is most relevant?
"Have you ever had mumps?" Explanation: p. 1055.
A patient is diagnosed with granuloma inguinale. Which of the following questions should the nurse ask the patient?
"Have you traveled outside of the country recently?" Explanation:p. 1053.
Following a visit to her campus medical clinic motivated by persistent abdominal pain and dyspareunia, a 20 year-old female college student has been referred for a diagnostic workup to rule out pelvic inflammatory disease. Her elevated white cell and C-reactive protein levels lead her care provider to suspect pelvic inflammatory disease (PID). What follow-up question is most likely to help with the differential diagnosis?:
"How many sexual partners have you had?" Explanation:p. 1030.
A patient asks how his condition, Condylomata acuminata, is caused. Which of the following is the nurse's response?
"Human papillomavirus (HPV) is the cause of your condition." Explanation:p. 1050.
The nurse is teaching a patient with polycystic ovary syndrome (PCOS) about the condition. Which of the following statements by the patient indicates a need for further instruction?
"I developed this as a result of a sexually transmitted infection." Explanation: p. 1036.
A nurse is teaching a class about the proper way to insert an indwelling catheter. Which of the following statements made by one of the students would demonstrate that the teaching has been effective?
"I will insert the catheter into the urethra." Explanation:p. 1034.
A client comes to the clinic and is diagnosed with genital herpes. Which statement by the client indicates that the nurse's teaching about management of the disease has been effective?
"I will take the acyclovir (Zovirax) every 8 hours for the next week." Explanation:p. 1052
A female patient reports that her mother-in-law was just diagnosed with cervical cancer and asks the nurse about her own risk. Which response by the nurse is correct?
"If you had the human papilloma virus (HPV) vaccine, your risk is greatly reduced." Explanation:p. 1028.
A client diagnosed with endometriosis asks the nurse how it is that she did not know about this when she had it for so long. What is the nurse's best response?
"Its symptoms mimic those of other disorders " Explanation: p. 1031.
A patient is told that her herpes virus has been latent. Which of the following does the nurse say to explain this to the patient?
"Latent means the virus remains dormant and can reactivate." Explanation:p. 1051.
A 20-year-old male has been diagnosed with testicular cancer, and is seeking information about his diagnosis from a number of websites. Which of the following statements that he has read is most plausible?
"Men with cryptorchidism - the term for an undescended testicle - are known to have a higher risk of developing testicular cancer." Explanation:p. 1013.
A female client is diagnosed with chlamydia during a routine pelvic examination. Which statement by the client indicates that the nurse's teaching about management of the disease has been effective?
"My partner will need to take antibiotics at the same time I do." Explanation:p. 1058.
A patient states to the nurse "How could I be sick! I feel fine!" The patient has a sexually transmitted infection. Which of the following is the nurse's best response?
"Often, sexually transmitted infections are asymptomatic." Explanation:p. 1049.
What should the nurse teach the client about assessing for possible breast cancer?
"Perform monthly self-breast exams after menses." Explanation: p. 1044.
A female patient informs the nurse that she is having hot flashes on occasion, has trouble sleeping, and thinks that she is having some symptoms of menopause. The patient asks the nurse how long these symptoms will last prior to experiencing menopause. Which of the following is the best response?
"Perimenopause can precede menopause by approximately 4 years." Explanation:p. 1040.
During a group prenatal class, the nurse teaching the course is explaining the thinning of the cervix that accompanies the stages of labor leading up to delivery. A participant admits that she is not familiar with either the location or normal role of the cervix. Which of the following responses by the nurse would be most appropriate?
"The cervix is the opening between the uterus and the vagina and so it opens wide during the lead-up to birth." Explanation:p. 1019.
The parents of a baby born with hypospadias ask the nurse if the baby can be circumcised. The best response would be:
"The circumcision will not be done now; the foreskin is needed for surgical repair." Explanation:, p. 1012.
A woman asks "why do I have to tell my sexual partner about chlamydia? I thought this was a "female" disease." Which of the following is the nurse's best response
"The condition is transmittable to men and may cause infertility." Explanation: p. 1057.
After an office visit with her primary health provider, a female patient with an elevated CA-125 test result asks the nurse if that means she has ovarian cancer. Which of the following is the nurse's best response?
"The test is not specific for ovarian cancer but suggests further evaluation to find the cause of the elevation." Explanation:p. 1037.
A patient asks why his partners need to know that he was diagnosed with syphilis. Which of the following is the nurse's best response?
"They will have to be treated prophylactically." Explanation:p. 1059.
Which of the following is essential for the nurse to include in the care plan for a patient with herpes simplex virus-1 (HSV-1)?
"This disease is transmitted by oral secretions." Explanation: p. 1052.
An older adult female comes in to the clinic for her yearly gynecology appointment and informs the nurse that she is having pain when having intercourse with her spouse. The patient has been postmenopausal for at least 5 years. Which of the following is the nurse's best response?
"This is caused by a decrease in estrogen levels, but there are things that you may be able to use to help." Explanation: p. 1040.
A young woman has contracted the human papillomavirus (HPV) and has developed genital warts. The client is eager to receive an HPV vaccine, citing the large number of television advertisements she has seen. How should the nurse best respond?
"Unfortunately, these vaccines may be less effective once you have HPV." Explanation: p. 1051.
A client is diagnosed with trichomoniasis. Which of the following is appropriate for the nurse to tell the patient?
"We need to contact your sexual partners." Explanation:p. 1055.
A 68 year-old man has revealed to his care provider that he is distraught over his increasingly frequent inability to maintain an erection. Which of the following teaching points is most warranted?
"While this problem is often a part of the aging process, it might be a result of some of the medications that you take." Explanation:p. 999.
A female patient with uterine leiomyomas asks the nurse about her risk of uterine cancer. Which of the following statements best answers the question?
"Your leiomyomas may cause heavy periods but will not become cancerous." Explanation:p. 1033.
A male client is diagnosed with gonococcal urethritis. He tells the nurse he had recent sexual contact with a woman but states she did not appear to have any disease. Which of the following is the nurse's best response to the client?
"Women may not know they have gonorrhea because they may not have symptoms." Explanation:p. 1058.
A female patient with uterine prolapse asks the nurse about treatment options. Which of the following responses by the nurse is appropriate?
"You may need surgery to support your uterus." Explanation:p. 1035.
A patient asks the nurse how he will know if he has syphilis after sexual contact? Which of the following is the nurse's best response?
"You will develop a sore on your penis or scrotum." Explanation: p. 1059.
Which of the following female patients is at risk for amenorrhea?
18-year-old with anorexia nervosa Explanation:p. 1023.
After inoculation with HPV, genital warts may begin to grow. They usually manifest as soft, raised fleshy lesions on the external genitalia of either male or female. What is the incubation period for HPV-induced genital warts?
6 weeks to 8 months Explanation:p. 1050.
It is important to test anyone who has had sex with an individual tests positive for gonorrhea, within how many days of the diagnosis?
60 days Explanation:p. 1059.
Which of the following patients is at greatest risk for the impairment of spermatogenesis
A 15-year-old male who is diagnosed with mumps orchitis Explanation: p. 1005.
Which of the following women is most likely to have a sexually transmitted infection as a contributing factor to her health problem?
A 41 year-old with a diagnosis of mucopurulent cervicitis Explanation:p. 1028.
The nurse suspects which of the following female clients may be at risk for infertility?
A long distance runner Explanation: p. 1023.
Which of the following patients is at highest risk of developing trichomoniasis?
A patient who is sexually active Explanation:p. 1055.
An 18-month-old boy is diagnosed with cryptorchidism. Based on this diagnosis, which of the following does the nurse expect to observe during the physical assessment?
Absence of the testis in the scrotum bilaterally Explanation:p. 1013
What is a primary intervention for the nurse to implement for a client with pelvic inflammatory disease ?
Administer antibiotic therapy. Explanation:p. 1030.
A 40-year-old man presents at the clinic complaining of painful urination and rectal pain. His vital signs are temperature, 101.7°F; blood pressure, 105/74; pulse, 98; respiration, 22. While taking a history, the nurse notes the client has had chills, malaise, and myalgia. What would the nurse suspect as a diagnosis?
Acute bacterial prostatitis Explanation:p. 1007.
There is no known cure for genital herpes, and methods of treatment are often symptomatic. Pharmacologic management of genital herpes includes which drugs?
Acyclovir Explanation: p. 1052.
A client has been diagnosed with syphilis after seeking care for a penile lesion. The nurse should anticipate which intervention?
Administration of injectable penicillin Explanation: p. 1061.
While the cause of BPH is unknown, we do know that the incidence of BPH increases with age. What ethnic group is BPH highest in?
African American Explanation: p. 1008.
A male client seeks treatment for erectile dysfunction. What factors contribute to this condition? Select all that apply.
Age 65 years Cardiovascular disease Antihypertensive medications Explanation:p. 998.
Spermatozoa are produced in the seminiferous tubules of the testes and are moved through the genital ducts to be stored in the ampulla of the vas deferens before ejaculation through the penis. Unlike the female egg, which remains briefly fertile, spermatozoa can remain fertile for up to 42 days. Where are the spermatozoa stored so they maintain their fertility?
Ampulla Explanation:p. 996.
A 24-year-old female presents with vulvar pruritus accompanied by irritation, pain on urination, erythema, and an odourless, thick, acid vaginal discharge. She denies sexual activity during the last 6 months. Her records show that she has diabetes mellitus and uses oral contraceptives. Which category of medication is most likely to resolve her symptoms?
An azole antifungal agent Explanation: p. 1054.
The male reproductive system undergoes changes as aging occurs. What is the term used to describe a relative or absolute hypogonadism associated with aging?
Andropause Explanation:p. 1014.
Leiomyomas, or intrauterine fibroids, are the most common form of pelvic tumor. Approximately half the time leiomyomas are asymptomatic. What are the symptoms of leiomyomas that are not asymptomatic? Select all that apply.
Anemia Urinary frequency Rectal pressure Menorrhagia Abdominal distention Explanation:p. 1033.
The nurse is explaining ovulation to a female client. The nurse explains that follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are important hormones needed to ovulate and are secreted by which of the following glands?
Anterior Pituitary Explanation:p. 1021.
Select the structure primarily responsible for the secretions of luteinizing hormone (LH), follicle-stimulating hormone (FSH), and prolactin.
Anterior pituitary gland Explanation:p. 1024.
Following a long history of intermittent back pain and urinary urgency, a 50-year-old client has been diagnosed with chronic bacterial prostatitis. Which of the following factors is most likely to influence his healthcare provider's choice of treatment?
Antibacterial drugs penetrate poorly into the chronically inflamed prostate. Explanation:p. 1007.
A client presents with signs and symptoms of candidiasis and is concerned about why this occurs after taking antibiotics. The most appropriate information for the nurse to provide would be:
Antibiotics suppress the normal protective vaginal flora allowing overgrowth of C. albicans. Explanation: p. 1054.
A patient with painful genital herpes lesions relates pain as being a 7 out of 10. Which of the following is the nurse's best action? Select all that apply.
Apply cool compresses. Call the healthcare provider for oral analgesics. Apply topical anesthetic cream. Explanation:p. 1052.
In assessing a patient, the nurse notes a grayish discharge from the vaginal area accompanied by a foul odor. Which of the following is the nurse's best action?
Asking about other symptoms Explanation: p. 1055.
The nursing student is teaching an all-male class at a local middle school about reproduction. When should she tell the students that spermatogenesis begins and ends?
At about 13 years and throughout the reproductive years Explanation: p. 995.
A female client's assessment identifies symptoms of dyspareunia and burning. The nurse is aware that the client may have developed:
Atrophic vaginitis Explanation:p. 1026.
A nurse is attempting to culture a lesion to determine if a patient has genital herpes. Which of the following is the nurse's best action?
Attempt to culture a lesion as soon as it develops. Explanation: p. 1052.
A male patient has experienced a forceful hit to the testes. The nurse expects that the sensory nerves that transmit pain impulses are associated with which nervous system?
Autonomic nervous system Explanation:p. 998.
A woman of child-bearing age asks the nurse about a natural method to avoid pregnancy. What is an appropriate response?
Avoid sex when cervical mucus is most stretchy Explanation: p. 1022.
The nurse is speaking with a couple at the fertility clinic about ways to increase sperm counts. Which of these does the nurse include in the discussion?
Avoid tight undergarments Explanation: p. 1003.
Benign prostatic hypertrophy (BPH) and prostatic adenocarcinomas presently differently. The nurse is aware of which of the following differences?
BPH is commonly located in the periurethral zone of the prostate, while prostate cancers are commonly located in the peripheral zones of the prostate. Explanation: p. 1008.
A male patient who is in his 60s comes to the clinic for his yearly checkup. After examining the patient, the physician informs him that he has an overgrowth of mucosal glands of the prostate. Based solely on this finding, what diagnosis should the nurse suspect in this case?
Benign prostate hyperplasia (BPH) Explanation: p. 1008.
The nurse in the urology office recognizes screening men at risk for prostate cancer includes which of these diagnostic studies?
Blood level of PSA and digital rectal exam Explanation:p. 1009.
A 20-year-old female comes to the clinic for an annual exam. She reports having unprotected sexual intercourse with several men over the last year. Blood tests reveal that she is positive for human papillomavirus. The nurse teaches the patient about which of the following complications that may occur because of the infection?
Cervical cancer Explanation:p. 1050-1052.
The nurse is reviewing the uses and side effects of Azithromycin. What infection is Azithromycin the antibiotic of choice for the treatment?
Chlamydial Explanation: p. 1058.
Which of the following is the most common cause of recurrent urinary tract infections in males
Chronic bacterial prostatitis Explanation:p. 1007.
The pediatric nurse is caring for a newborn with hypospadias. The mother requests that a circumcision be performed prior to discharge. Which information related to treatment of hypospadias should the nurse convey?
Circumcision is avoided as the foreskin will be used to repair the urinary opening. Explanation: p. 1012.
A 24 year-old female presents with vulvar pruritus accompanied by irritation, pain on urination, erythema, and an odorless, thick, acid vaginal discharge. She denies sexual activity during the last six months. Her records show that she has diabetes mellitus and uses oral contraceptives. Which category of antimicrobial medication is most likely to clear her symptoms?
Clotrimazole, an antifungal agent. Explanation:p. 1054.
A male athlete admitted to the emergency room is suspected of abusing androgens. Which physical characteristic would the nurse expect to see if the testosterone has been aromatized to estradial?
Enlarged breast Explanation: p. 1014.
A 60-year-old man comes to the clinic and has been found to have a history of type 2 diabetes mellitus and cardiovascular disease. The manifestations of these diseases will warrant the nurse to assess the patient for which of the following problems?
Erectile dysfunction Explanation:p. 999.
If a male has a history of impaired blood flow in his vascular system, he may be prone to developing:
Erectile dysfunction. Explanation: p. 999.
How often do most women in the middle reproductive years menstruate?
Every 28 to 30 days Explanation:p. 1020.
The nurse is caring for a client with cancer of the scrotum. When performing a health history, which of these does the nurse explore as risks for this type of malignancy?
Exposure to tar and soot Explanation: p. 1005.
The endocrine system is highly involved in the female reproductive system. Which hormones are used to stimulate the primordial follicles?
FSH and LH Explanation: p. 1023.
A nurse educator is explaining the process of sexual intercourse, fertilization, and fetal development to a high school biology class. What process should the nurse describe?
Fertilization in the outer portion of the fallopian tube Explanation:p. 1019.
A female patient informs the nurse that she had intercourse yesterday evening and is wondering if she could become pregnant. She asks the nurse that if she was pregnant, where it would be located at present. Which of the following should the nurse tell the patient?
Fertilization normally occurs in the middle to outer portion of the Fallopian tube. Explanation: p. 1024.
Unbeknownst to him, a 30 year-old male has contracted Treponema pallidum during a sexual encounter the night before. Place the following manifestations the microorganism in the chronological order that they would occur in the absence of treatment. Use all the options.
Formation of aneurysms Appearance of a rash on the man's palms and feet. Development of painless chancres on the man's scrotum. Latency Explanation: p. 1059.
A nursing student studying obstetrics asks the faculty, "How does the sperm get so much energy to swim up the fallopian tubes?" The instructor responds based on which pathophysiological principle?
Fructose is secreted by the seminal vesicles and provides energy for motility of the sperm. Explanation:p. 996.
A nurse is describing the menstrual cycle to a client and is explaining the changes that occur each month. During a normal menstrual cycle, which layer is sloughed off?
Functional layer Explanation: p. 1024.
A 22-year-old female client states she has vaginal itching with pain and small vesicles that appear on her vagina when she is stressed. The client is most likely experiencing:
Genital herpes Explanation: p. 1052.
A 55 year-old male has presented to the emergency department because he is alarmed at the genitourinary symptoms he has experienced over the last several days. He reveals that he has had a number of new sexual relationships during a tropical vacation that ended 5 days ago. Over the last several days, he has had increasing pain in his urethra and a creamy yellow discharge from his penis. For the last two days, the discharge has been occasionally blood-tinged. What differential diagnosis would be the care team's first priority?
Gonorrhea Explanation:p. 1058.
Bacterial vaginosis is the most common vaginal infection seen by health care providers. What is the predominant symptom of bacterial vaginosis?
Grayish white discharge with a fishy odor Explanation:p. 1055.
A patient comes to the clinic and informs the nurse that he was playing soccer and was kicked in the scrotal area on the right side. The nurse observes that the scrotal skin on the right side is dark red. Which of the following should the nurse suspect this patient may have?
Hematocele Explanation: p. 1003.
The nurse is assessing a client with a collection of blood in the tunica vaginalis of the scrotum. How does the nurse correctly document this in the medical record
Hematocele Explanation: p. 1003.
A 38-year-old woman with proliferative breast changes of papilloma asks the nurse about her risk for breast cancer. Which of the following statements of risk is correct?
Higher because of your papilloma Explanation:p. 1044.
Select the factor that would increase a male's risk for the development of testicular cancer.
History of cryptorchidism Explanation:p. 1013.
A female client is found to have genital warts during a routine pelvic examination. Which of the following sexually transmitted diseases will the nurse prepare to test for?
Human papillomavirus Explanation:p. 1054.
There are two types of vulvar cancer. One type is found in older women, and one type is found in younger women, generally less than 40 years of age. What is the type found in younger women thought to be caused by?
Human papillomavirus Explanation:p. 1025.
Which of the following factors in a patient's history is most likely related to the diagnosis of cervical squamous dysplasia?
Human papillomavirus (HPV) infection Explanation:p. 1025.
The mother of a 5-year-old boy brings him into the clinic because there is a firm feeling swelling around one of his testes. What would the suspected diagnosis be?
Hydrocele Explanation: p. 1003.
Which chronic health issues increase a man's risk for developing erectile dysfunction? Select all that apply.
Hypertension Hyperlipidemia Diabetes mellitus Explanation:p. 999.
The nurse is performing a newborn assessment on a 2-day-old male infant. Assessment reveals the presence of the urethral opening on the ventral side of the penis. The nurse would document this finding as being which of the following
Hypospadias p. 1012.
A patient is admitted with a prolonged and painful erection that has lasted longer than four hours. The nurse knows that this is a true urologic emergency, and that the cause is which of the following?
Impaired blood flow in the corpora cavernosa of the penis Explanation: p. 1001.
An older male patient complains of inhibited sexual functioning. The nurse knows which of the following nursing diagnoses could be a priority for his inhibited sexual function?
Impaired self-esteem Explanation:p. 999.
The ovaries secrete both estrogen and progesterone. What is one function of progesterone in the body?
Increases body temperature at ovulation Explanation:p. 1023.
A male client reports sudden pain and a bulging in the scrotal sac after lifting a heavy object. The swelling does not reduce when the client is supine and he begins to sweat profusely. What condition is the likely cause of these manifestations?
Inguinal hernia Explanation: p. 1002.
The community health nurse is conducting a men's health class. Which of these does the nurse relate as the major role of the prostate?
It increases sperm motility. Explanation: p. 996.
The parents of a 9-year-old child ask the nurse for information about quadrivalent human papillomavirus recombinant vaccine (Gardasil) vaccine. Which of the following instructions are appropriate for the nurse to provide? Select all that apply.
It should be given before the child is sexually active. It prevents a common cause of cervical cancer. It can be given to boys and girls. Explanation:p. 1028.
The health care provider suspects a diagnosis of endometriosis for a female client. The diagnosis would be confirmed by:
Laparoscopy Explanation:p. 1030
A 23 year-old woman has been referred to a fertility clinic after one year of attempting to become pregnant. Her diagnostic workup has resulted in a diagnosis of polycystic ovary syndrome (PCOS). What will the first line of treatment most likely consist of?
Lifestyle modifications to include weight loss by lowering calories and fat consumption. Explanation: p. 1036.
A client was diagnosed with HSV several months ago and has adapted his lifestyle to limit the frequency and severity of recurrences. Which actions help facilitate this goal? Select all that apply.
Limiting stress Getting adequate sleep Explanation:p. 1052.
During the female menstrual cycle hormones are produced and excreted by various reproductive organs. The hormone progesterone is secreted and is metabolized in which of the following organs?
Liver Explanation:p. 1023.
Select the treatment of choice for syphilis.
Long-acting penicillin in a single injection Explanation:p. 1061.
The nurse is reviewing laboratory values of a seventy-year-old female client and observes the client's low-density lipoproteins (LDLs) level is elevated. The nurse understands a possible reason for this is which of the following?
Long-term estrogen deprivation Explanation: p. 1041.
A male client presents at the clinic with flulike symptoms and reports a weight loss of 10 pounds without trying. On physical examination, the client is found to have splenomegaly and large, tender, fluctuant inguinal lymph nodes. While taking the nursing history, it is discovered that the client prefers male sexual partners, and that 2 weeks ago the client had small, painless papules. What disease would the nurse suspect the client has?
Lymphogranuloma venereum Explanation:p. 1053
A woman reports to the primary healthcare provider that she experiences monthly changes before her menstrual cycle. Which of the following statements demonstrates understanding of premenstrual disorders?
Many women report premenstrual emotional or physical changes. Explanation:p. 1040.
The ovaries have a dual function. The nurse is able to explain to the patient that any problems with the ovaries frequently cause which of the following problems?
Menstrual and fertility problems Explanation:p. 1020.
A young woman presents with vaginal itching and irritation of recent onset. Her labia are swollen, and she has a frothy yellowish discharge with an unpleasant smell and a pH of 6.8. She has been celibate during the last 6 months and has been taking antibiotics for a throat infection. Which medication is most likely to clear her symptoms?
Metronidazole Explanation: p. 1055.
A 13-year-old client undergoing puberty is alarmed to find small, white bumps surrounding her areolae. The nurse reassures her that these are a normal sign of her sexual maturation and tells her that they are:
Montgomery tubercles. Explanation:p. 1041.
Select the most common symptom a female diagnosed with chlamydial infection will develop.
Mucopurulent cervical discharge Explanation:p. 1056.
A patient is diagnosed with vulvar carcinoma, which appears as an inconspicuous thickening of the skin resembling eczema or dermatitis and may produce few symptoms other than pruritus, local discomfort, and exudation. The nurse understands that the cancer metastasizes readily through which mode?
Multiple lymph channels Explanation: p. 1026.
When screening for a sexually transmitted disease (STD), a microscopic evaluation of a discharge culture reveals hyphae and a pH level of 4.2. Which conditions are not likely to present based on these findings? Select all that apply.
N. gonorrhea C. trachomatis T. vaginalis Explanation:p. 1054.
Which of the following manifestations will the nurse expect a woman with nonproliferative fibrocystic breast changes to report? Select all that apply.
Nodular or lumpy breast tissue Tenderness during the luteal phase Explanation: p. 1043.
A female patient is planning to have a total hysterectomy with bilateral salpingoopherectomy. The patient wants to know what the function of the ovaries are and why they are so important. Which of the following data should the nurse provide? (Select all that apply.)
Ovaries store the female germ cells. Ovaries produce estrogen. Ovaries produce progesterone. Explanation:p. 1024.
A newly pregnant woman reports to the nurse that her breasts are excessively tender and that her areolae and nipples are becoming darker and more prominent. The nurse should describe which cause of these changes?
Normal changes of pregnancy due to increased levels of estrogen and progesterone. Explanation:p. 1042.
A female patient is being seen in the ED with complaints of lower abdominal pain, dyspareunia, back pain, purulent cervical discharge, and the presence of adnexal tenderness and painful cervix on bimanual pelvic examination. The nurse suspects the patient has pelvic inflammatory disease (PID), and will assess the patient for which of the following?
Number of sexual partners Explanation p. 1030.
Polycystic ovary syndrome (PCOS) is a common endocrine disorder. The nurse understands that about 50% of the women who are diagnosed with PCOS have which of the following problems?
Obesity Explanation:p. 1035.
A client asks the nurse there is anything that would greatly increase her risk of acquiring human papillomavirus (HPV). The best response by the nurse would be:
Oral-genital sex Explanation:p. 1050.
Which of these complications does the nurse recognize may occur after illness with parotitis (mumps)in young men?
Orchitis with residual sterility Explanation:p. 1005.
An older postmenopausal adult female fractured her left femoral head. She has sustained several fractures in the past 4 years and has been taking calcium and vitamin D supplements. Which of the following is a common problem that this patient is most likely suffering from?
Osteoporosis Explanation:p. 1041.
The nurse providing teaching about the female reproductive system includes which of the following?
Ovaries are responsible for ovulation and hormone production. Explanation: p. 1020.
A 30-year-old male has contracted an STI caused by Treponema pallidum. Which symptom did he most likely notice first?
Painless chancres on the man's scrotum Explanation: p. 1059.
The nurse knows that which of the following structures are a part of the male reproductive system? Select all that apply.
Pair of gonads Seminiferous tubules Prostate gland Explanation:p. 993.
The parents of a newborn boy have decided against circumcision. The nurse emphasizes that, as the child grows, the mother must properly cleanse the area beneath the foreskin and to return the foreskin to the original position to prevent which of these?
Paraphimosis Explanation:p. 1012.
A nurse is providing teaching to the parents of a child who has undergone corrective surgery for cryptorchidism. The most important information for the nurse to provide is:
Parents should be taught that their child needs frequent follow-up visits. Explanation:p. 1012.
As women age they tend to lack support of breast tissue. The nurse understands that development of which of the following muscles supports the breast mass higher on the chest wall?
Pectoralis muscles Explanation: p. 1042.
Endometriosis is the condition in which endometrial tissue is found growing outside the uterus in the pelvic cavity. What are risk factors for endometriosis?
Periods longer than 5 days and increased menstrual pain Explanation: p. 1030.
A 70 year-old woman who delivered 4 children during her reproductive years has weakened pelvic floor muscles. Which of her following anatomical structures is least susceptible to inappropriate herniation into her vagina?
Peritoneum Explanation: p. 1034.
A client in the urology clinic asks the nurse how the doctor will determine if his prostate lesion is due to benign prostatic hypertrophy (BPH) or prostate cancer. Which of these responses should the nurse convey?
Presence of cancers are determined through a biopsy. Explanation: p. 1011.
An adolescent male asks the health care provider what function the testes play in the male body. The best response would be
Production of androgens and spermatozoa Explanation: p. 994.
An adolescent male asks the health care provider what function the testes play in the male body. The best response would be:
Production of androgens and spermatozoa Explanation:p. 994
Which hormone is responsible for breast development and the increase in body temperature that occurs with ovulation?
Progesterone Explanation:p. 1023.
Which of the following statements best captures an aspect of the role of progesterone?
Progesterone: Levels peak after ovulation and is present throughout the menstrual cycle. Explanation:p. 1023.
The nurse is caring for a female client who has just given birth. The nurse knows that the hormone responsible for the client's ability to breastfeed is which of the following?
Prolactin p. 1042.
Spermatozoa are mobile in environments with a pH of 6.0-6.5. The nurse knows that secretions from which accessory organ help to neutralize the strongly acidic vaginal secretions?
Prostate gland Explanation:p. 996.
A nurse who works on a urology-gynecology ward of a hospital is coming on shift and will be caring for a 34 year-old woman who has been admitted overnight for the treatment of a large endometriosis. What interventions should the nurse most realistically anticipate providing over the course of the shift and the next several days?
Providing pain control; preparing the client for a laparoscopic procedure or hysterectomy. Explanation: p. 1032.
Sperm production occurs in the seminiferous tubules. The nurse understands the anatomy of the testes and knows that as the tubules lead into the efferent ducts, the seminiferous tubules become which of the following structures?
Rete testis Explanation:p. 996.
A 34-year-old male has been diagnosed with testicular cancer after he visited his family physician with a complaint of an enlarged, painful testicle. Biopsy has indicated that his tumor is malignant, and his oncologist believes the tumor arose in the seminiferous epithelium and is producing a uniform population of cells. What is the client's most likely specific diagnosis?
Seminoma Explanation: p. 1006.
Select the most reliable test to diagnose syphilis.
Serology Explanation:p. 1060.
A female client experiencing hot flashes during perimenopause asks the nurse about hormone therapy (HT). Which is the appropriate response by the nurse?
Short term HT can be used to reduce symptoms. Explanation:p. 1041.
Priapism (a prolonged painful erection not associated with sexual excitement) can occur at any age. In boys, ages 5 to 10, what are the most common causes of priapism?
Sickle cell disease or neoplasms Explanation: p. 1011.
An older male client is experiencing difficulty initiating urination, and notes that the force and volume of the stream is reduced. What assessment data indicates benign prostatic hypertrophy (BPH)?
Slow onset Explanation:p. 1009.
Which of the following assessment findings helps the nurse confirm that the patient has genital warts?
Soft, raised lesions on external genitalia Explanation:p. 1050.
A 42-year-old man reports testicular tenderness. He is concerned also because he found a mass that moves around within the scrotal sack. Upon examination, the physician determines that the mass is near the end of the epididymis, lights up uniformly when illuminated, and is above the testes. Which condition does this client most likely have?
Spermatocele Explanation: A spermatocele is a painless, sperm-containing cyst that forms at the end of the epididymis.15 It is located above and posterior to the testis, is attached to the epididymis, and is separate from the testes. Spermatoceles may be solitary or multiple and usually are less than 1 cm in diameter. They are freely movable and should transilluminate. Spermatoceles rarely cause problems, but a large one may become painful and require excision.
For a woman, what is the most serious long-term outcome of an infection resulting from exposure to the N. gonorrhoeae bacteria?
Sterility Explanation:p. 1058.
The main actions of testosterone are varied, and many of the biologic effects are well known in the male. The nurse who is familiar with the actions of testosterone will also know about which of the following biologic effects of testosterone?
Stimulates erythropoiesis Explanation:p. 995.
A female client presents to the clinic with a rash on the palms of her hands, symptoms of hair loss, and the development of elevated, red-brown lesions that have begun to ulcerate and produce a foul discharge. Based on these symptoms, the nurse plans to test the client for which of the following sexually transmitted disease?
Syphilis Explanation:p. 1060
A young woman is almost ready to deliver, and she has an outbreak of genital herpes. Which of the following is the nurse's best action?
Tell the woman about a cesarean section. Explanation:p. 1053.
Candidiasis is a leading cause of vaginal infections. Which antifungal agent is not available without prescription to treat candidiasis? Terconazole Clotrimazole Miconazole Butaconazole
Terconazole Explanation: p. 1054.
A 14-year-old boy has been brought to the emergency department by his mother in excruciating pain that is radiating from his scrotum to his inguinal area. The boy's heart rate is 122 beats per minute and he has vomited twice before arrival at the hospital. Examination reveals that his scrotum is reddened and slightly swollen and the testes are firm to touch and tender, with extensive cremaster muscle contraction noted. What is the boy's most likely diagnosis?
Testicular torsion Explanation: p. 1004.
The nursing instructor is teaching the class about the male hormone testosterone. Which of the following statements made by a student indicates a need for further instruction?
Testosterone does not have any effect on development of increased musculature during puberty Explanation:p. 995.
A patient has been diagnosed with candidiasis. Which of the following symptoms was present to diagnose this condition?
Thick white secretions Explanation:p. 1054.
The nurse is discussing the menstrual cycle with a female client. The client asks, "Why does my side hurt half way through my monthly cycle almost every month? The nurse suspects the cause of the pain may be which of the following?
The client has a leakage of blood onto the peritoneal surface after ovulation has occurred. Explanation: p. 1024.
In the development of the testes, the nurse understands that which of the following can lead to an inguinal hernia later in life?
The inguinal canal has not closed almost completely. Explanation: p. 1002.
The nurse is caring for a client with significant benign prostatic hyperplasia (BPH)and hydronephrosis who is fearful of having corrective surgery. Which of these is important for the nurse to convey?
The obstruction is causing urine to flow backward and cause kidney dysfunction. Explanation:p. 1009.
The pediactric nurse is teaching the mother of a newborn with hypospadias about this disorder. Which of these does the nurse convey?
The opening of the urethra is found on the underside of the penis. Explanation:p. 1012.
A pregnant patient presents with bacterial vaginosis. Which of the following is the nurse's primary concern?
The patient has an increased risk of preterm labor. Explanation:p. 1055.
Which of the following patients will the nurse determine is a candidate for continuous antiviral suppressive therapy for genital herpes?.
The patient with more than six outbreaks this year Explanation:p. 1053
A male patient is being prepared for a physical examination of his prostate gland. How will the nurse explain the location of the prostate gland?
The prostate gland is located in the pelvis, inferior to the bladder. Explanation: p. 996.
A female patient is taking antibiotics to treat a skin infection and informs the nurse that she does not think the antibiotics are working because now she thinks she has a vaginal infection. Which of the following does the nurse believe has occurred due to the antibiotic use?
The use of the antibiotics decreases the number of lactobacilli in the vagina, which can result in a vaginal infection. Explanation:p. 1027.
The nurse is caring for a baby with phimosis. Which of these does the nurse explain to the mother is the key feature of this disorder?
Tightening of the foreskin preventing full retraction over the penis Explanation:p. 1012.
Which of the following is the primary reason that the nurse urges patients to be seen by their healthcare provider when they have genital warts?
To be informed of the risk of premalignant and malignant changes Explanation:p. 1050.
A client who had been utilizing pharmacologic management for BPH is now experiencing severe signs of obstruction. The client would most likely require:
Transurethral prostatectomy Explanation:p. 1010.
A nurse is interviewing a patient about issues with infertility. Which condition contributes to the risk of infertility in both men and women?
Trichomoniasis Explanation:p. 1055.
Select the condition that contributes to the risk of infertility in males.
Trichomoniasis Explanation:p. 1055.
The nurse is performing a health history of a patient being evaluated for erectile dysfunction. Which of the following places the patient at highest risk for the disorder?
Type 2 diabetes Explanation:p. 999.
The nursing student who is studying pathophysiology of the male genitourinary system correctly identifies which of the following to be functions of the penis? Check all that apply.
Urine elimination Sexual function Explanation: p. 993.
The nurse is reviewing the history of an older adult female client who was recently diagnosed with coronary heart disease. What factors are known to contribute to this condition? Select all that apply.
Used hormone therapy for 5 years Smoked 1 pack/day for 20 years Has hypertension for 15 years Explanation: p. 1041.
A patient is suspected to have small varicoceles in his left scrotum. Which of the following assessment techniques may help accentuate small varicosities?
Valsalva maneuver Explanation: p. 1004.
A client has been diagnosed with breast cancer following a suspicious mammogram followed by biopsy. The nurse who is planning this client's care should recognize that her prognosis is primarily dependent on the:
extent to which lymph nodes are involved. Explanation:p. 1046.
The nurse is explaining the process of conception to a group of middle-school students and points out that fertilization occurs:
in the middle to outer portion of the fallopian tube. Explanation: p. 1024.
A female patient is being evaluated for abdominal pain and unusual menstrual bleeding. What factors in the history will the nurse identify as increasing the risk for endometrial cancer? Select all that apply.
obesity estrogen therapy diabetes mellitus polycystic ovary syndrome Explanation:p. 1032.
A male client is diagnosed with an inguinal hernia. Which statement by the client indicates that the nurse's teaching about the hernia has been effective?
"The hernia is a loop of bowel protruding through a weak spot in my abdominal muscles." Explanation:p. 1002.
A pregnant patient asks the nurse what is causing her lower leg edema, nausea, and constipation that she is experiencing. Which of the following is the nurse's best response?
"The increase in progesterone during pregnancy is most likely the cause of these discomforts." Explanation: p. 1023.
In teaching a patient about genital warts, which of the following statements is correct for the nurse to say?
"The incubation period is 6 weeks to 3 months." Explanation:, p. 1050.
The nurse is discussing the menstrual cycle with a female client. The client asks, "Why do my hands get puffy and I gain weight right before my periods?" Which of the following is an appropriate response by the nurse?
"The level of estrogen increases in your body before your period, and this causes fluid retention." Explanation: p. 1040.
A 57 year-old woman has been diagnosed with atrophic vaginitis and has expressed surprise to her care provider, citing a lifetime largely free of gynecological health problems. She has asked what may have contributed to her problem. How can the care provider best respond?
"The lower levels of estrogen since you've begun menopause make your vagina prone to infection." Explanation: p. 1027.
A client has been diagnosed with a chlamydial infection. Select the pharmacological treatment of choice.
Azithromycin Explanation: p. 1057.
The prostate gland functions in the elimination of urine. The nurse knows that the prostate gland if enlarged can cause which dysfunction of the urinary system?
Obstruction Explanation: p. 1008.
Which of the following female patients is exhibiting signs of untreated polycystic ovary syndrome (PCOS)?
One age 34, states excess body hair and menstrual cycles are irregular Explanation: p. 1035.
Select the correct statement regarding Herpes simplex virus.
Only two strains of the virus are considered sexually transmittable. Explanation:p. 1051.
A 24 year-old woman has presented to an inner city free clinic because of the copious, foul vaginal discharge that she has had in recent days. Microscopy has confirmed the presence of Trichomonas vaginalis. What is the woman's most likely treatment and prognosis?
Oral antiprotozoals to patient and sexual partners to help prevent complications p. 1055.
Which of the following patients would the nurse determine is at increased risk of infection with gonorrhea? Select all that apply.
The patient who is 25 years of age The patient with multiple sexual partners The patient who does not use condoms Explanation: p. 1059.
The nurse is re-enforcing information given to the client who is asking about screening for prostrate cancer. Which of these will be nurse teach the client about the PSA test?
An elevated score on a PSA test does not necessarily indicate the presence of cancer. Explanation:p. 1011.
The nurse in the urology clinic is reviewing the chart of a client with erectile dysfunction. Which of these factors in the client's history does the nurse recognize is a hormone-based conditions that may contribute to erectile dysfunction?
Hypogonadism Explanation: p. 999.
Events in the ovulatory cycle progress in a similar manner each month. Place the following events in the ovulatory cycle in the correct chronological order. Use all the options.
Formation of the theca. Formation of the corpus luteum Formation of the antral follicle Development of the zona pellicuda Bursting of the mature follicle Explanation:p. 1023.
A 54-year-old diabetic patient has come to the urology clinic complaining of erectile dysfunction. His history includes obesity, coronary artery disease which required CABG three years ago, hypertension, and gout. The nurse practitioner is reviewing his record in order to prescribe medication. The practitioner is considering prescribing sildenafil (Viagra). Which of the following home medications is contraindicated if taken concurrently with sildenofil?
Imdur (isosorbide mononitrate), a vasodilator Explanation: p. 999.
Fibrocystic changes in the breast are not uncommon. How is the diagnosis of fibrocystic changes made?
Ultrasonography and mammography Explanation: p. 1043.
