Chapter 42: Structure and Function of the Male Genitourinary System

The nurse is performing a health history of a client being evaluated for erectile dysfunction. Which disorder places the client at highest risk for the erectile dysfunction?

Type 2 diabetes

Report this Question The nursing student who is studying pathophysiology of the male genitourinary system correctly identifies which of these as functions of the penis? Select all that apply.

Urine elimination Sexual function

An older male client complains of inhibited sexual functioning. The nurse knows which nursing diagnosis could be a priority for his inhibited sexual function?

Impaired self-esteem

A nurse is evaluating diagnostic tests for a client suspected of having prostate cancer. Which result requires further evaluation?

Prostate-specific antigen (PSA) of 12 ng/mL (12 µg/L)

A 17-year-old male has developed phimosis to the point that he is having difficulty voiding. The nurse should prepare this teenager for:

Circumcision

A nurse is performing a genital examination on a 25-year-old male client. The nurse notes pigmented, wrinkled scrotal skin. Based on this information, what should the nurse do next?

Consider this a normal finding and proceed with the examination.

A nurse in a fertility clinic is taking a history from the couple. When asked what type of underwear the male wears, he responds by asking, "Why do you need to know this? It seems a little too personal." Which response by the nurse is most appropriate for the nurse to reply?

"For sperm production, it is best if underwear is loose to keep scrotal temperatures 3.5 to 5°F (2 to 3°C) below body temps."

Select the structure responsible for secreting fructose that will provide energy for spermatic motility.

Seminal vesicles

During a visit to the health care provider, a client complains of swelling in the scrotum. The health care worker suspects a hydrocele and performs an exam by shining a light through the scrotum. If the hydrocele is dense, the health care worker should:

order an ultrasound or biopsy to rule out testicular cancer.

A nurse suspects an older adult client is experiencing benign prostatic hyperplasia (BPH). Which question should the nurse ask this client?

"Has the force of your urinary stream decreased?"

A male client has been involved in a severe accident that has caused a complete transection of his spinal cord. The client's wife is concerned about their ability to become pregnant. Which response relating to childbearing and spinal cord injury is most accurate?

"Some men with complete transection of the spinal cord are able to produce an erection and ejaculation with genital stimulation."

A 41-year-old male client is planning on having a vasectomy. While explaining this surgery to the client, the health care worker will include which physiologic principle as the basis for this contraception technique?

"Sperm can no longer pass through the ductus deferens."

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."

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

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

In the early stages of fetal development, male and female reproductive organ development is undifferentiated. The nursing student understands that in the differentiation between male and female certain hormones are secreted and the testicular cells of the male embryo begin producing which hormone?

Anti-Müllerian hormone and testosterone

The nurse is teaching an all-male class at a local middle school about reproduction. Which time frame should the nurse tell the students that spermatogenesis begins and ends?

At about 13 years and throughout the reproductive years

A male client 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

A 60-year-old male client is informed by the health care provider that he has an overgrowth of mucosal glands of the prostate. Based solely on this finding, what diagnosis will the provider likely document in the health record?

Benign prostatic hyperplasia (BPH)

A client asks, "What gland is responsible for urethral lubrication during male sexual stimulation?" Which response by the health care provider would be the best reply?

Bulbourethral glands

The male reproductive system is composed of two systems. The nurse knows that which system is responsible for the transportation and storage of sperm?

Ductile system

In the male stages of the sexual act, emission precedes which stage, which is mediated through spinal cord reflexes?

Ejaculation

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 estradiol?

Enlarged breast

Where is the final site for sperm maturation?

Epididymis

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 client for which problem?

Erectile dysfunction

In the complex interaction of the sexual act in males, the nurse is aware that there are four stages involved. Which stage involves shunting of blood into the corpus cavernosum?

Erection

The nurse assessing an adult male with impaired testosterone should evaluate which of the following as an expected finding?

Fatigue

A male client is admitted with a spinal injury that has damaged his sacral plexus. The nurse understands that this type of injury could affect the impulse stimulation for initiating the sexual act through which organ?

Glans penis

An adult client had bilateral orchiectomy (testicular removal) due to cancer. What will be the primary effect of the disruption in testosterone synthesis?

He will likely experience an overall reduction in muscle mass.

A couple is undergoing initial testing to determine why they are unable to conceive. One of the tests shows that the man has a testosterone level of 198.8 ng/dL (6.9 nmol/L). The man reports being tired all the time. The woman is completely healthy. Which problem is most likely?

Hypogonadism

The nurse assesses the client upon admission to the hospital. He states that he has been losing facial and body hair, has been fatigued and depressed, and has erectile dysfunction and a decreased libido. The nurse understands these symptoms to occur with which disorder?

Hypogonadism

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

While discussing the physiologic process behind penile erection, the anatomy and physiology instructor mentions that what substance is released to facilitate smooth muscle relaxation and shunting of blood into the sinusoids?

Nitric oxide

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

The nurse knows that which structures are a part of the male reproductive system? Select all that apply.

Pair of gonads Seminiferous tubules Prostate gland

Sperm begin their life in the Sertoli cells. What factor functions in releasing mature spermatozoa from the Sertoli cells?

Plasminogen activator

A nurse is performing a genital examination on a male client who develops an erection. What is the nurse's most appropriate intervention?

Reassure the client that this is a normal response and continue with the examination

The nurse is teaching a group of nursing students about the purpose of the testes. What is the function of the male gonads?

Spermatogenesis

Which statement is correct regarding spermatogenesis?

Spermatogenesis and sperm maturation takes approximately 90 days.

The nurse conducting a health promotion class for teenage boys on human reproduction determines that the participants are understanding the information when they state:

Spermatogenesis continues throughout a man's reproductive years.

A couple who have three daughters would like to add a son to their family, and they have recently learned that the woman is pregnant. Which physiologic phenomenon would most likely be associated with the woman's eventual delivery of a healthy son?

Suppression of female reproductive structures by antimüllerian hormone (AMH)

A client arrives in the emergency department complaining of severe testicular pain associated with nausea and vomiting. His pulse rate is 120 beats/min. Physical exam reveals an enlarged testis that is painful to palpation. The nurse suspects:

Testicular torsion

A young pregnant mother is told after an ultrasound that the fetus's testes have not descended. What hormone is responsible for the descent of the testes?

Testosterone

An obstetrician is explaining the differentiation of embryonic tissue into a fetus to an aspiring class of nursing students. Which hormone is primarily responsible for the development of male sex characteristics?

Testosterone

Which hormone is responsible for the development of male facial hair and change in voice to a deeper level?

Testosterone

The nursing instructor is teaching the class about the male hormone testosterone. Which statement made by a student indicates a need for further instruction?

Testosterone does not affect development of increased musculature during puberty.

A male client 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.

A nurse is inspecting the scrotum and testes of a 43-year-old male client. Which finding requires additional evaluation?

The skin on the scrotum is hard, taut, and shiny.

The client presents with symptoms consistent with hypogonadism. For a diagnosis of hypogonadism, the nurse expects which diagnostic test to be ordered?

Total testosterone levels

An 18-month-old boy is diagnosed with cryptorchidism. Based on this diagnosis, what does the nurse expect to observe during the physical assessment?

Absence of the testis in the scrotum bilaterally