test 5 Male genitals and butt

A 17-year-old male client expresses concern about feeling lumps on his testicles. What response by the nurse would best address the client's concerns?

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

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.

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

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

African American

The nurse is preparing an instructional session for male clients about preventing penile cancer. Which non-modifiable risk factor should the nurse include in the teaching?

Age 60 years or older

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

BPH

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

Bear down.

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)

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

Clockwise, then counterclockwise

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

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 Use gentle movements with the finger and ensure adequate lubrication Listen and watch for signs of discomfort and tensing muscles

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

Condylomata Acuminata

Genital Warts ´Soft, pointed, moist, fleshy, painless papules ´May be single or multiple cauliflower like patch or may grow into grapelike clusters ´Gray, pale yellow, or pink in white males ´Black or translucent gray in black males ´Occur on shaft of penis or around anus ´Caused by HPV ´Most common STD ´Correlated with early onset sexual activity and multiple sex partners

A male client is complaining of pain with urination, rectal pain and urethral discharge. The nurse suspects this is what?

Gonorrhea

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

High-fat diet

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

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

How to perform a testicular self-examination.

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

A male infant is born with the urethral meatus opening on the underside of the penis. When providing information to the parents, what is the correct terminology to use for this condition?

Hypospadias

When invaginating the skin of the scrotum to assess the inguinal regions, which of the following is an expected finding?

Inability to introduce the index finger into the inguinal ring

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

Infertility

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

Which position should a nurse assist a client to assume to ensure comfort during the examination of the anus, rectum, and prostate of a male client?

Left lateral

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

Left testicular torsion

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

Nontender and rubbery

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

Orchitis

If the anal sphincter tightens as the nurse palpates it, what should he or she do?

Pause, reassure the client, and proceed.

A nurse is instructing a client on how to perform testicular self-examination (TSE). Which of the following should the nurse mention? Select all that apply.

Perform the TSE once a month Stand in front of a mirror and check for scrotal swelling Roll the testis gently in a horizontal plane between thumb and fingers

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

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 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 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

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

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

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

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

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.

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

Priapism

a painful erection that lasts 4 hours or more but is not accompanied by sexual excitement

Testicular Torsion

a sharp pain in the scrotum caused by twisting of the vas deferens and blood vessels leading into the testicle

Hypospadias

abnormal congenital opening of the male urethra on the undersurface of the penis

Epispadias

congenital defect in which the urinary meatus is located on the upper surface of the penis

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

continue the examination in an unhurried manner.

A good time to examine the testicles is

during the shower or bath, when your hands are warm and soapy and the scrotum is warm. Cold hands stimulate a muscle reflex, retracting the scrotal contents. If you ever notice a firm, painless lump, a hard area, or an overall enlarged testicle, call your physician for a further check.

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.

Epididymitis

inflammation of the epididymis that is frequently caused by the spread of infection from the urethra or the bladder

Orchitis

inflammation of the testes

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.

Hydrocele

scrotal swelling caused by a collection of fluid

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.

cryptorchidism

undescended testicles

Collecting Subjective Data Preadolescents and Adolescents about genitals

´Ask questions that seem appropriate for boy's age but be aware that norms vary widely ´Ask direct, matter-of-fact questions. Avoid sounding judgmental ´Start with a permission statement. "Often boys your age experience ..."This conveys that it is normal and all right to think or feel a certain way ´Try the ubiquity approach, "When did you ..." rather than "Do you ..."This method is less threatening because it implies that the topic is normal and unexceptional ´Around age 12 - 13, ask changes they may have noticed ´Does patient have someone they can talk with ´Boys around age 12 - 13 have a normal experience of fluid coming out of penis at night called nocturnal emissions or "wet dreams." ´Teenage boys experience erections at embarrassing times, sexual fantasies or masturbating ´Any questions about birth control or STIs ´Does patient use birth control ´Has anyone touched you inappropriately

Syphilitic Chancre

´Begins within 2-4 weeks of infection ´Small, solitary, silvery papule the erodes to a red, round or oval ulcer with a yellowish serous discharge ´Nontender indurated base ´Lymph nodes enlarge but are nontender

Herpes

´Clusters of small vesicles with surrounding erythema ´Painful ´Erupt on the glans or foreskin ´Can rupture and form superficial ulcers ´STD/STI ´Initial infection lasts 7-10 days ´Remains dormant indefinitely ´Recurrent infections last 3-10 days with milder symptoms

Phimosis

´Foreskin is advanced and fixed tight and it is impossible to retract over glans ´May be congenital or acquired secondary to infection ´Poor hygiene can be cause ´Constriction impedes circulation, so glans swell ´If dirt or smegma, which increases risk of inflammation or untreated, it may compromise arterial circulation, calculus formation

Peyronie's Disease

´Hard, nontender, subcutaneous plaques palpated on dorsal or lateral surface of penis ´Associated with painful bending of the penis during erection ´Plaques are fibrosis ´Usually occurs after 45 years

Urethritis

´Infection of urethra ´Painful burning urination ´Meatus is reddened, everted, and swollen ´Purulent discharge ´Urine is cloudy and mucous shreds

Collecting Objective Data Physical Examination Penis

´Inspect base of penis and pubic hair ´Inspect skin of shaft ´Palpate the shaft ´Inspect the foreskin ´Inspect the glans ´Palpate for urethral discharge

Collecting Objective Data Physical Examination Inguinal area

´Inspect for inguinal and femoral hernia ´Palpate for inguinal hernia and inguinal nodes ´Palpate inguinal lymph nodes ´Palpate for femoral hernia

Collecting Objective Data Physical Examination Anus and Rectum

´Inspect perianal area ´Inspect the sacrococcygeal area ´Palpate anus ´Palpate the rectum ´Palpate the peritoneal cavity ´Palpate the prostate gland ´Check stool

Collecting Objective Data Physical Examination Scrotum

´Inspect the size, shape and position of the scrotum ´Inspect the scrotal skin ´Palpate the scrotal contents ´Palpate the spermatic cord and vas deferens

Collecting Objective DataPhysical Examination

´Instruct patient to empty bladder ´If no gown, provide sheet and have patient lower pants and undergarments ´Ask patient to stand ´For anus, rectum, and prostate patient will be in left lateral position ´Be professional ´Preserve patient privacy ´Use a chaperone ´Always wear gloves ´Some men may prefer a male examiner ´If an erection occurs, DO NOT STOP the examination or leave the room ´This only focuses more attention on the erection and increases embarrassment ´Reassure male patient that is a normal physiologic response to touch ´Proceed with rest of the examination

Carcinoma

´Red, raised warty growth or ulcer ´Watery discharge ´As it grows, may necrose and slough ´Usually painless ´Almost always on glans or inner lip of foreskin ´Enlarged lymph nodes are common