CH. 26 Assessing Male Genitalia & Rectum w/PrepU

What care should a nurse take when performing the hands-on assessment of the anus, rectum, and prostate? Select all that apply. Explain each step of the examination and encourage the client to relax Examine the upper rectum and sigmoid using the finger Use gentle movements with the finger and ensure adequate lubrication Listen and watch for signs of discomfort and tensing muscles Examine the genitalia after examining the anus, rectum, and prostate

-Explain each step of the examination and encourage the client to relax -Use gentle movements with the finger and ensure adequate lubrication -Listen and watch for signs of discomfort and tensing muscles

During a health assessment interview, a nurse learns that the client has a family history of colorectal cancer. What information should the nurse give the client about reducing the risk for colorectal cancer? Select all that apply. Avoid taking vitamin A supplements Get regular exercise for at least 30 minutes every day Fecal occult blood test (FOBT) should be done yearly Limit exposure to cadmium and sheet metal work Consume foods with adequate folic acid

-Get regular exercise for at least 30 minutes every day -Fecal occult blood test (FOBT) should be done yearly -Consume foods with adequate folic acid

A 45-year-old client with a family history of prostate cancer comes to the clinic for an annual physical examination. The nurse practitioner prepares to perform a focused assessment of the prostate gland to determine enlargement. The client asks the nurse, "What will be included in the prostate assessment?" What is the best response by the nurse? Select all that apply. Inspect stool. Palpate for inguinal and femoral hernia. Perform a digital rectum exam (DRE). Conduct a prostate specific antigen (PSA) test. Transilluminate the scrotum.

-Perform a digital rectum exam (DRE). -Transilluminate the scrotum. -Conduct a prostate specific antigen (PSA) test.

Prostate cancer is the leading cancer diagnosed in men in the United States. To increase knowledge of risk factors, the nurse would teach men that (Select all that apply.)

-each decade after age 50 increases the risk -it occurs earlier and is more advanced in African American men -15% have an affected first-degree relative

Which of the following would lead the nurse to suspect a hydrocele versus other causes of scrotal swelling?

A positive transillumination test

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 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?

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

What ethnic group has a significantly higher incidence rate of prostate cancer?

African American

A patient has undergone a digital rectal examination. This assessment will allow the clinician to diagnose which of the following?

BPH

The nurse is palpating the prostate of a 55-year-old client and finds it to be enlarged, smooth, firm, and slightly elastic, without a median sulcus. Which condition should the nurse most suspect?

BPH

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

Below the prostate within the posterior aspect of the urethra

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?

Benign prostatic hyperplasia (BPH)

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) Epididymitis Orchitis

Benign prostatic hyperplasia (BPH)

The nurse is palpating the prostate of a 55-year-old client and finds it to be enlarged, smooth, firm, and slightly elastic, without a median sulcus. Which condition should the nurse most suspect? Benign prostatic hypertrophy Hydrocele Prostate cancer Acute prostatitis

Benign prostatic hypertrophy

When palpating the rectal mucosa, how does the nurse rotate the examining hand?

Clockwise, then counterclockwise

A nurse examining a client's external genitalia notices that his scrotum and testes draw up and he shivers. This phenomenon is known as which of the following?

Cremasteric reflex

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?

Cryptorchidism

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

epididymitis

The rectum is lined with folds of mucosa, and each fold contains a network of arteries, veins, and visceral nerves. When these veins undergo chronic pressure, the result may be

hemorrhoids

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? Epididymis Glans penis Urethral meatus Prostate

Epididymis

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?

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?

Epididymitis The nurse should document this condition as epididymitis, which is an infection of the epididymis. In this condition, the scrotum appears enlarged, reddened, and swollen, and a tender epididymis is palpated. Cryptorchidism is a condition in which the scrotum appears underdeveloped and the testis cannot be palpated. It occurs when one or both testicles fail to descend into the scrotum. Orchitis is the inflammation of the testes, associated frequently with mumps; the scrotum appears enlarged and reddened. Hydrocele appears as a swelling in the scrotum and is usually painless.

Which of the following statements is true of prostate cancer?

Ethnicity is a risk factor.

A nurse examines the anal area of a client and observes the presence of a varicose vein. How should the nurse document this finding?

External hemorrhoid

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

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?

Femoral A bulge or mass on the front of the thigh in the femoral canal area is a femoral hernia.

A client presents to the health care clinic with reports of black stool. The client denies the ingestion of iron supplements or taking Pepto-Bismol. The nurse recognizes that the black stools could be an indication of what disease process?

Gastrointestinal bleeding

Which of the following should nurses teach all men, especially those who have had cryptorchidism?

How to perform a testicular self-examination.

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

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?

Incarcerated 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.

Symptoms of prostate disorder include which of the following? Incomplete emptying, nocturia, weak urinary stream Elevated PSA level, daytime polyuria, low back pain Nocturia, daytime polyuria, strong urinary stream Decreased urination, painful urination, elevated PSA level

Incomplete emptying, nocturia, weak urinary stream

A client presents to the health care clinic with reports of yellow stool. Which condition should the nurse most suspect?

Increased fat content Yellow stool suggests increased fat content or steatorrhea

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 Atrophy Klinefelter's syndrome

Klinefelter's syndrome

An older gentleman asks the nurse what the effects of aging are on the male reproductive system. What is the best response by the nurse to the client about the effects of aging on the male reproductive system?

Many men experience benign or malignant hypertrophy of the prostate gland.

Which client should a nurse recognize has the highest risk to develop prostate cancer?

More risk factors... higher risk Age, African American race, and having a brother or father who was diagnosed with prostate cancer before the age of 60 are the greatest risk factors. Therefore, the older male with a first-degree relative has the highest risk.

A nurse recognizes that which finding is normal upon palpation of the prostate?

Non-tender and rubbery

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?

Orchitis Acute orchitis results in inflamed, painful testes. Cryptorchidism, Klinefelter's syndrome, and testicular tumors are all disorders that are usually painless.

Palpating the prostate gland prior to drawing a prostate-specific antigen (PSA) will likely raise the?

PSA level

Which of the following conditions consists of a tight prepuce that, once retracted, cannot be returned? Paraphimosis Balanitis Phimosis Balanoposthitis

Paraphimosis

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?

Pilonidal cyst A pilonidal cyst is a congenital disorder characterized by a small dimple or cyst/sinus that contains hair.

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?

Prepare the client for surgery. For the client with torsion, immediate surgery is necessary to prevent atrophy of the spermatic cord and preserve fertility. Analgesics would be given preoperatively. Postoperatively, a scrotal support is applied and dressings are inspected for drainage.

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?

Prepuce If the man has not been circumcised, a hood-like fold of skin called the foreskin, or prepuce, covers the glans. In the center of the corpus spongiosum is the urethra, which travels through the shaft and opens as a slit at the tip of the glans as the urethral meatus

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

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

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?

Reassure him that it is not unusual to have an erection during the examination

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?

Rectal polyp

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

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. Pa

Scrotal hernia Scrotal hernias occur when the small intestine passes through a weak spot of the inguinal ring. The examiner cannot get a finger above the hernia into the ring. Hernias are often caused by increased abdominal pressure such as in weight lifting. Clients who have a hernia on one side often have another hernia on the opposite side.

Upon inspection and palpation of the scrotum, the nurse discovers a mass. The client complains of tenderness in the area and nausea. The nurse is concerned that the blood supply to the mass may be cut off. The nurse should document this finding as which type of hernia?

Strangulated A hernia is strangulated if the blood supply is cut off. In this case, the client typically complains of extreme tenderness and nausea. If you suspect that the client has a strangulated hernia, refer the client immediately to the physician and prepare him for surgery.

After positioning 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? The pilonidal cyst is a particular form of scarring that results from sacral pressure. A pilonidal cyst appears to be a sinus but is in fact superficial. The pilonidal cyst and sinus are usually benign, but can occasionally become infected or develop further sinuses. 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.

A client reports the new onset of mucous in the stool. How should the nurse document this in the client's history?

The proper term for mucus in the stool is steatorrhea, which indicates the presence of excessive fat in the stool.

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

Before beginning the examination of the genitalia of an adult male client, the nurse should

ask the client to empty his bladder.

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

cryptorchidism

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?

herpes infection. Pimple-like lesions from herpes are sometimes detected on the glans.

A 68-year-old man comes to the clinic reporting that he is having difficulty obtaining an erection. When reviewing the patient's history what might the nurse note that contributes to impotence?

history of hypertension Vascular problems cause about half the cases of impotence in men older than 50 years.

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 A urethral meatus located on the underside of the penis is called hypospadias.

The prostate gland consists of two lobes separated by the

median sulcus.

What information should nurse include in the teaching plan for a client considering a vasectomy?

offers permanent birth control

A new nurse is performing a focused prostate assessment on an older client. What action by the new nurse would require intervention by the charge nurse? notes the size and nodularity of the prostate gland moves the pad of their index finger over the prostate gland to feel the sulcus moves their body away from the client to achieve a proper angle to assess the prostate gland performs a prostate gland examination just prior to obtaining a prostate specific antigen test

performs a prostate gland examination just prior to obtaining a prostate-specific antigen test If the nurse performs a prostate examination just prior to obtaining the prostate specific antigen (PSA), the PSA may be falsely elevated from manipulating the prostate gland. Moving the pad of the index finger over the prostate gland to feel for the sulcus is appropriate. Noting the size and nodularity of the prostate gland is appropriate, as well as moving the body away from the client to achieve a proper angle to assess the prostate gland.

Circumcision is done to relieve?

phimosis or paraphimosis.

A male client comes to the clinic reporting a painless red, oval ulceration on his penis that had started out as a small silvery-white bump. Which of the following disorders would the nurse suspect? primary sign of syphilis human immunodeficiency virus (HIV) herpes progenitalis phimosis

primary sign of syphilis

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

A male client tells the nurse that he has received a diagnosis of hernia. He visits the clinic because he is nauseated and has extreme tenderness on the left side. The nurse should

refer the client to an emergency room.

What suspended the testes in the male scrotum ?

suspended by the spermatic cord.

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. papilloma virus. syphilis. gonorrhea.

syphilis

A 45-year-old male client tells the nurse that he has had problems in having an erection for the last couple of weeks but is "doing better now." The nurse should explain to the client that transient impotence may be indicative of prostate enlargement. inguinal hernias have been associated with transient impotence. transient periods of erectile dysfunction are common. impotence in males should be investigated.

transient periods of erectile dysfunction are common.