NURB 3060 PrepU: Chapter 26: Assessing Male Genitalia and Rectum

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?

Hydrocele

The nurse educates the client that what condition may be associated with a varicocele?

Infertility

During assessment of the genitalia of an adult male, the client has an erection. The nurse should

continue the examination in an unhurried manner.

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

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

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

History of hypertension

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

Symptoms of prostate disorder include which of the following?

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

The nurse caring for a client with a varicocele explains the side effects of this condition. With what disorder is this condition associated?

Infertility

On inspection and palpation, the nurse finds that a client's testes are small, probably less than 2 cm, and firm. Which of the following conditions should the nurse most suspect in this situation?

Klinefelter's syndrome

A client presents to the health care clinic with reports of clay-colored stool. The nurse recognizes that this finding is most likely a result of which of the following?

Lack of bile pigment

A teenage male client comes to the ED with severe left testicular pain and vomiting. Elevation of his left testicle does not lessen the pain. What could these symptoms indicate for this client?

Left testicular torsion

During palpation of the male genitalia, which of the following is an expected finding?

Palpable spermatic cord

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?

Phimosis

During the physical examination of the genitalia for an uncircumcised client, the nurse asks the client to retract the foreskin of the penis. The nurse observes that the foreskin is tight and cannot be retracted. How should the nurse document this condition?

Phimosis

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.

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

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

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

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

On inspection of a client's penis, the nurse observes a small, silvery-white papule. Which of the following conditions should the nurse suspect in this client?

Syphilitic chancre

Where is the corona of the penis found?

base of glans

The nurse suspects that a male client may have a hernia. The nurse should further assess the client for

bowel sounds at the bulge.

The inguinal canal in a male client is located

just above and parallel to the inguinal ligament.

The prostate gland consists of two lobes separated by the

median sulcus.

Which of the following unexpected findings of the testes is most likely to result in painful palpation of the testes?

orchitis

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

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

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

The testes in the male scrotum are

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

syphilis.

After teaching a client about measures to reduce his risk for colon cancer, the nurse determines that the teaching was successful when the client states which of the following?

"I should eat a half-cup of raisins every day."

A 15-year-old high school football player comes to the office with his mother. He complains of severe testicular pain since 8:00 this morning. He denies any sexual activity and states that it hurts so bad he can't even urinate. He is nauseated and vomiting. He denies any recent illness or fever. Past medical history is unremarkable. He denies any tobacco, alcohol, or drug use. His parents are both in good health. Examination shows a young teenager lying on the bed with an emesis basin. He is very uncomfortable and keeps shifting his position. Blood pressure is 150/100, pulse is 110, and respirations are 24. On visualization of the penis he is circumcised; there are no lesions or discharge from the meatus. Scrotal skin is tense and red. Palpation of the left testicle causes severe pain and causes the client to cry. His prostate examination is unremarkable. His cremasteric reflex on the left is absent but normal on the right. Catheterization is necessary to get a urine sample, the analysis of which is unremarkable. The boy is admitted to the emergency department of a nearby hospital for further workup. What is the most likely cause of this young man's symptoms?

Torsion of the spermatic cord

A client asks the nurse when a colonoscopy is recommended. Which advise by the nurse provides the most appropriate advice?

"A flexible sigmoidoscopy should be done every five years starting at age 50"

A nurse is teaching young adolescent males about sexually transmitted infections and their common assessment findings. The nurse determines understanding when the attendees make which of the following statements? Select all that apply.

"Genital warts are caused by papillomavirus." "Syphilis usually presents with a painless white-silver papule." "Pediculosis pubis presents with lice or nit eggs ('crabs') at the base of the penis." "Herpes simplex is painful and episodic with periods of remission and exacerbation."

On palpating a client's scrotum and testes, the nurse notes that the testes appear to be of normal shape and size. Which of the following would indicate a normal length for testes?

4.5 cm

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

65-year-old Caucasian male whose father had prostate cancer at age 55

Which client would the nurse identify as being at highest risk for the development of testicular cancer?

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

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

A positive transillumination test

Which of the following is inconsistent with a digital rectal examination?

Can reveal a hydrocele

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 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

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?

Risk for urge incontinence

The client tells the nurse that he has little or no interest in sex. He says he is concerned and he knows his wife is unhappy with his lack of libido. What can the nurse tell the client often causes lack of libido?

Side effects of medications

During a physical examination, the nurse inspects the eternal genitalia of a male client. Which of the following would the nurse identify as an abnormality?

Skin lesions

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

Steatorrhea

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

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.

An older adult male client reports difficulty urinating (hesitancy, urgency, and frequency). The nurse determines these symptoms are most likely related to which of the following physiological changes that commonly occur as men age?

enlarged prostate gland

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 corpora spongiosum extends distally to form the acorn-shaped

glans.

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 has a distinctive bulge in the right inguinal area when standing. What should the nurse suspect is occurring with this client?

hernia

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

A sign of early prostate cancer

The nurse is assessing a male client complaining of testicular pain. Which symptom helps the nurse determine that the client does not need immediate surgical intervention?

Absence of nausea and vomiting.

The nurse is teaching a class of senior citizens about the risk factors for prostate cancer. Which of the following would the nurse mention? Select all that apply.

African American heritage Excessive alcohol use Diet high in animal fats Environmental exposure

A tender painful swelling of the scrotum should suggest which of the following?

Any of the above

How should a nurse proceed with palpation of the anus to best facilitate the exam without causing the client undo discomfort?

Ask the client to bear down and place the lubricated finger on the anal opening

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

BPH

During a prostate examination, the prostate is noted to have a rubbery or boggy glandular consistency. The nurse recognizes that this is what?

BPH

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?

Beaded or thickened cord

During assessment of the inguinal regions for herniating masses, the nurse instructs the standing male client do which of the following?

Bear down.

A 60-year-old coach comes to the clinic complaining of difficulty starting to urinate for the last several months. He believes the problem is steadily getting worse. When asked he says he has a very weak stream, and it feels like it takes 10 minutes to empty his bladder. He also has the urge to go to the bathroom more often than he used to. He denies any blood or sediment in his urine and any pain with urination. He has had no fever, weight gain, weight loss, or night sweats. His medical history includes type 2 diabetes and high blood pressure treated with medications. He does not smoke but drinks a six pack of beer weekly. He has been married for 35 years. His mother died of a myocardial infarction in her 70s, and the client's father is currently in his 80s with high blood pressure and arthritis. Examination reveals a mildly obese alert and cooperative man. His blood pressure is 130/70 with a heart rate of 80. He is afebrile, and his cardiac, lung, and abdominal examinations are normal. Visualization of the anus shows no inflammation, masses, or fissures. Digital rectal examination reveals a smooth, enlarged prostate. No discrete masses are felt. There is no blood on the glove. An analysis of the urine shows no red blood cells, white blood cells, or bacteria. What disorder of the anus, rectum, or prostate is most likely?

Benign prostatic hyperplasia (BPH)

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

Which of the following recommendations would a nurse advocate during infancy and childhood to help reduce potential adult complications such as orchitis?

Ensure immunizations against infectious diseases such as mumps.

Upon inspection of the glans, a nurse observes the urethral opening present on the dorsal side of the penis. How should the nurse document this finding?

Epispadias

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

A nurse examines the external genitalia of a client and observes that the scrotum is underdeveloped and the testis cannot be palpated. How should the nurse document this condition?

Cryptorchidism

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

Which of the following statements is true of prostate cancer?

Ethnicity is a risk factor.

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.

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

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?

Feelings of heaviness and pain in the scrotum

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

How to perform a testicular self-examination.

The nurse is teaching a group of student nurses in the lab about male anatomical differences and assessment. Which of the following should be included in the teaching?

The assessment should be completed in a warm room.

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 and sinus are usually benign, but can occasionally become infected or develop further sinuses.

A nurse is assessing the genitalia of a male client. The nurse finds that the client has a piercing in his penis. Why is it important to investigate details of the piercing?

To assess for health risks relating to how it was performed

An adult male client comes to the clinic for his annual physical examination. During the nursing assessment, the nurse asks, "Do you have any current or chronic illnesses such as diabetes, hypertension, respiratory problems, or cardiovascular disease?" Why does the nurse ask this question?

To assess risk for erectile dysfunction

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

A teenager presents at the ER with severe scrotal and abdominal pain, vomiting, and nausea. He tells the nurse that he participated in a polar bear plunge in his community (jumping into cold water off-season). What conditions would the nurse suspect?

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?

Varicocele

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

ask the client to empty his bladder.