Ch 26 - Assessing Male Genitalia and Rectum

The nurse notes that a male client is having problems urinating because of benign prostatic hypertrophy. Which medication should the nurse expect to be prescribed for this client? Select all that apply. A. Terazosin B. Verapamil C. Finasteride D. Dutasteride E. Furosemide

A, C, D: Terazosin; Finasteride; Dutasteride Male clients with benign prostatic hypertrophy with voiding symptoms may be prescribed terazosin, finasteride, or dutasteride. Verapamil is a calcium channel blocker and is not used for benign prostatic hypertrophy. Furosemide is a diuretic and is not used for benign prostatic hypertrophy.

Prostate enlargement is common in older men. The nurse should be aware of what signs and symptoms when interviewing an older male client? Select all that apply. A. Sensation of residual urine B. Straining to urinate C. Dribbling D. Increased caliber of urine stream E. Chronic kidney infection F. Erection that will not subside

A, B, C: Sensation of residual urine; Straining to urinate; Dribbling The location of the prostate gland can affect urine flow if the prostate becomes enlarged. The following are the signs of partial prostate obstruction: recurrent acute UTIs, the sensation of residual urine, decreased caliber of the urine stream, hesitancy, straining, and terminal dribbling. Chronic kidney infection and a nonsubsiding erection represent other medical problems unrelated to the prostate.

A 55-year-old male presents to the health care clinic with reports of difficulty starting the urine stream, dribbling frequently, and getting up several times a night to urinate. He has decreased his fluid intake to try to control the nighttime urination. The nurse assesses a temperature of 101.5°F oral, dry skin and mucous membranes, and suprapubic tenderness. Which nursing diagnosis can the nurse confirm from this data? A. Disturbed Sleep Pattern B. Sexual Dysfunction C. Readiness for Enhanced Self-Health Management D. Ineffective Health Maintenance

A. Disturbed Sleep Pattern The nursing diagnosis of Disturbed Sleep Patterns related to frequent awakenings and frequent voiding meets the major defining characteristics for this nursing diagnosis. There is no evidence to support diagnoses of Sexual Dysfunction,Readiness for Enhanced Self-Health Management, or Ineffective Health Maintenance.

Which of the following recommendations would a nurse advocate during infancy and childhood to help reduce potential adult complications such as orchitis? A. Ensure immunizations against infectious diseases such as mumps. B. Engage in activities and exercises that minimize heavy lifting. C. Encourage the consumption of foods that are rich in fat and starch. D. Urge the limited intake of foods and fluids containing caffeine.

A. Ensure immunizations against infectious diseases such as mumps. Nurses should advocate for infant and childhood immunizations against infectious diseases such as mumps to reduce potential adult complications such as orchitis. Minimizing activities involving heavy lifting or urging limited intake of caffeine have no effect on the potential for adult complications such as orchitis. The nurse should encourage foods that are low in fat and starch; however, this also would have no effect on the potential for orchitis.

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? A. Hypospadias B. Epispadias C. Cryptorchidism D. Phimosis

A. Hypospadias A urethral meatus located on the underside of the penis is called hypospadias. A meatus located on the upper surface is called epispadias. These congenital conditions are usually repaired surgically at a young age if they are severe. Cryptorchidism is an undescended testicle, and with phimosis, the foreskin becomes so tight that it will not retract over the glans penis.

A client reports the new onset of mucous in the stool. How should the nurse document this in the client's history? A. Steatorrhea B. Diarrhea C. Change in bowel habits D. Fecal incontinence

A. Steatorrhea The proper term for mucus in the stool is steatorrhea, which indicates the presence of excessive fat in the stool. Diarrhea is an increase in the frequency of loose stool. Change in bowel habits is not specific to the problem the client reported. Fecal incontinence is the inappropriate release of inability to control the bowels.

A 23 year old male comes to the clinic complaining of sudden and severe pain in his scrotum. The nurse would suspect what? A. Torsion of the spermatic cord B. Spermatocele C. Orchitis D. Varicocele

A. Torsion of the spermatic cord Torsion of the psermatic cord is usually accompanied by a sudden, severe pain of the scrotum and is a urological emergency. A spermatocele is a sperm-filled cystic mass located on the epididymis. Orchitis is inflammation of the testes. A varicocele is an abnormal dilation of veins in the spermatic cord.

The prostate gland consists of two lobes separated by the A. median sulcus. B. rectovesical pouch. C. anorectal junction. D. valves of Houston.

A. median sulcus. The prostate gland consists of two lobes separated by a shallow groove called the median sulcus.

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? A. Acute prostatitis B. Benign prostatic hypertrophy C. Hydrocele D. Prostate cancer

B. Benign prostatic hypertrophy The prostate is normally nontender and rubbery. A swollen and tender prostate may indicate acute prostatitis. An enlarged smooth, firm, slightly elastic prostate that may not have a median sulcus suggests benign prostatic hypertrophy. This condition is common in men older than 50 years. A hard area on the prostate or hard, fixed, irregular nodules on the prostate suggest cancer. Hydrocele is a painless swelling of the scrotum.

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? A. Prostate B. Epididymis C. Urethral meatus D. Glans penis

B. Epididymis Painful ejaculation is often a sign of infection or inflammation within the epididymis. The prostate, if enlarged, may cause difficulty with urination. A discharge from the urethral meatus may be present with an infection. The glans penis is the base of the penis, where the urethral opening is located.

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? A. Phimosis B. Hypospadias C. Epispadias D. Paraphimosis

B. Hypospadias With hypospadias, the urethral meatus opens on the ventral side of teh penis. The deviation of the meatus makes it difficult to urinate when standing. The physical appearance of the penis is altered, sometimes causing body image disturbances. Phimosis is when the prepuce cannot be retracted over the glans. Paraphimosis occurs when the retracted prepuce cannot be placed back over the glans. Epispadias occurs when the urethral meatus opens on the dorsal surface of the penis.

When assessing a client with benign prostatic hypertrophy, which of the following would the nurse expect the client to report as the initial complaint? A. Urinary frequency B. Increased effort to void C. Narrowing of urinary stream D. Nocturia

B. Increased effort to void The symptoms of BPH appear gradually. At first, the client notices that it takes more effort to void. Eventually, the urinary stream narrows and has decreased force. The bladder empties incompletely. As residual urine accumulates, the client has an urge to void more often and nocturia occurs.

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? A. "I will eat a diet high with lots of red meat." B. "I need to cut back on the amount of fruit I eat." C. "I should eat a half-cup of raisins every day." D. "I should avoid eating green leafy vegetables."

C. "I should eat a half-cup of raisins every day." Raisins contain tartaric acid and fiber, which reduce bile acids and speed food through the gastrointestinal system, thus decreasing constipation and the risk for cancer. A diet high in animal proteins such as red meats is a risk factor for colon cancer; therefore the client should eat a diet that is low in animal protein. The client also should increase his fiber intake, including fruits and vegetables such as green leafy vegetables.

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? A. Avoid sitz bath procedures B. Restrict the fluid intake of the client C. Administer the prescribed dose of antibiotics D. Discourage the client from using stool softeners

C. Administer the prescribed dose of antibiotics The nurse should administer the prescribed dose of antibiotics when caring for the client. Sitz bath procedures can be provided to relieve the condition. The nurse should encourage the client to increase his fluid intake to flush bacteria out of the bladder. The client can use the prescribed dose of stool softeners to prevent constipation.

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? A. Orchitis B. Cryptorchidism C. Epididymitis D. Hydrocele

C. 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.

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? A. Cryptorchidism B. Orchitis C. Hydrocele D. Prostatism

C. Hydrocele A hydrocele refers to a collection of fluid in the tunica vaginalis of the testes. Cryptorchidism is the most common congenital defect in males; characterized by failure of one or both of the testes to descend into the scrotum. Orchitis is an inflammation of the testes (testicular congestion) caused by pyogenic, viral, spirochetal, parasitic, traumatic, chemical, or unknown factors. Prostatism is an obstructive and irritative symptom complex that includes increased frequency and hesitancy in starting urination, a decrease in the volume and force of the urinary stream, acute urinary retention, and recurrent urinary tract infections.

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? A. Bowen's disease B. Peyronie's disease C. Phimosis D. Priapism

C. Phimosis Phimosis is the term used to describe a condition in which the foreskin is constricted so it cannot be retracted over the glans. Bowen's disease is an in situ carcinoma of the penis. Peyronie's disease is an acquired, benign condition that involves the buildup of fibrous plaques in the sheath of the corpus cavernosum. Priapism is an uncontrolled, persistent erection of the penis from either neural or vascular causes, including medications, sickle cell thrombosis, leukemic cell infiltration, spinal cord tumors, and tumor invasion of the penis or its vessels.

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? A. Hydrocele B. Phimosis C. Torsion of the spermatic cord D. Varicocele

C. Torsion of the spermatic cord Symptoms of torsion of the spermatic cord include an acute onset of sudden severe scrotal pain, vomiting, abdominal pain, and nausea. Extreme cold, such as with jumping into very cold water, may cause torsion. With hydrocele, the scrotum enlarges; pain and swelling may be present. However, the client with a hydrocele is often asymptomatic. In a client with phimosis, the foreskin becomes so tight that it will not retract over the glans penis. Varicocele can cause pain in the testicle or pain radiating to the other side. Symptoms of varicocele include swelling and a nagging dull pain in the scrotum.

When palpating the rectal mucosa, how does the nurse rotate the examining hand? A. From the nurse's left, then to the right B. Anteriorly, then posteriorly C. Counterclockwise, then clockwise D. Clockwise, then counterclockwise

D. Clockwise, then counterclockwise To palpate the rectal mucosa, the nurse rotates the hand clockwise to palpate the right side of the client's rectal mucosa, then counterclockwise to palpate the surface posteriorly and on the client's left side.

Which of the following statements is true of prostate cancer? A. Survival rates are low. B. It is one of the less common forms of cancer. C. Family history does not appear to be a risk factor. D. Ethnicity is a risk factor.

D. Ethnicity is a risk factor. While prostate cancer is the most commonly diagnosed cancer in men and the third leading type resulting in death, the proportion of men diagnosed with prostate cancer who survive is high. Lung and colon cancers are more common causes of mortality. Genetics appear to account for several cases. The rate of prostate cancer is highest in men of African ancestry.

A nurse examines the anal area of a client and observes the presence of a varicose vein. How should the nurse document this finding? A. Perianal abscess B. Anal fissure C. Anorectal fistula D. External hemorrhoid

D. External hemorrhoid Hemorrhoids are usually painless papules caused by varicose veins, either external or internal. If the hemorrhoid becomes thrombosed is can become painful and swollen. A perianal abscess is a cavity of pus caused by infection in the skin around the anal opening. An anal fissure is a split in the tissue of the anal canal caused by trauma. An anorectal fistula is a small, round opening in the skin that surrounds the anal opening. It suggests an inflammatory tract from the anus or rectum out to the skin.

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? A. Scrotal B. Incarcerated C. Strangulated D. Femoral

D. Femoral A bulge or mass on the front of the thigh in the femoral canal area is a femoral hernia. A hernia is strangulated if the blood supply is cut off. In this case, the client typically complains of extreme tenderness and nausea. A scrotal mass that remains when the client lies down and over which bowel sounds can be auscultated is a scrotal hernia. If the mass in the scrotum cannot be pushed into the abdomen, it could be an incarcerated hernia.

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? A. High-iron B. High-calorie C. High fiber D. High-fat diet

D. High-fat diet Although the case of prostatic cancer is unknown, there seems to be a relationship with increased testosterone levels and a diet high in fat. No other dietary links have been suggested.

The nurse identifies a cheesy white material that has accumulated under a male client's foreskin of the penis. What does this finding suggest to the nurse? A. balanitis B. hypospadias C. sexually transmitted infection D. smegma

D. smegma A cheesy white material may accumulate under the foreskin of a client. This is smegma and is considered normal. Balanitis refers to inflammation of the glans, not the expected secretions of the glans that cause smegma to accumulate. The accumulation of secretions from the glans (smegma) does not indicate that a sexually transmitted infection is present. Hypospadias refers to a congenital condition that involves ventral displacement of the meatus on the penis.

Which of the following groups has the highest incidence of prostate cancer? A. Caucasian men B. Native American men C. African American men D. Asian American men

C. African American men African American men have the highest incidence of prostate cancer—two to three times higher than Caucasian men.

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? A. Ineffective sexuality pattern B. Risk for infection C. Risk for urge incontinence D. Urinary retention

C. Risk for urge incontinence The most appropriate nursing diagnosis is risk for urge incontinence related to irritation of bladder. Risk factors for this diagnosis are voiding more than once every 2 hours and awakening at night. Urinary retention would be a concern if the client was unable to urinate, or urinated frequently with only small amounts of urine voided. Frequent urination at night is not a risk for infection. The symptoms noted are not related to ineffective sexuality pattern.

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 A. polyps. B. tumors. C. fissures. D. hemorrhoids.

D. hemorrhoids. The anorectal junction is not palpable, but may be visualized during internal examination. The folds contain a network of arteries, veins, and visceral nerves. If the veins in these folds undergo chronic pressure, they may become engorged with blood, forming hemorrhoids.

While conducting a complete bed bath for a male client, the nurse inspects the scrotum for: Select all that apply. A. Swelling B. Lumps C. Discharge D. Wrinkled skin E. Veins

A, B, E: Swelling; Lumps; Veins The scrotum is to be inspected for swelling, lumps, or veins. The scrotum does not have a discharge. The scrotal sac is typically wrinkled and would not need to be assessed.

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? A. Acute prostatitis B. Hydrocele C. Benign prostatic hypertrophy D. Prostate cancer

A. Acute prostatitis The prostate is normally nontender and rubbery. A swollen and tender prostate that is firm and warm to the touch may indicate acute prostatitis. An enlarged smooth, firm, slightly elastic prostate that may not have a median sulcus suggests benign prostatic hypertrophy. A hard area on the prostate or hard, fixed, irregular nodules on the prostate suggest cancer. Hydrocele is a painless swelling of the scrotum.

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? A. Benign prostatic hyperplasia (BPH) B. Prostatitis C. Prostate cancer D. Anorectal cancer

A. Benign prostatic hyperplasia (BPH) BPH becomes more prevalent during the fifth decade and is often associated with hesitancy in starting a stream, decreased strength of stream, nocturia, and leaking of urine. On examination an enlarged, symmetrical, firm prostate is palpated. The anterior lobe cannot be felt. These clients may also develop UTIs secondary to their obstruction.

While reviewing the medical record before examining a male clinic client, the nurse notes that the urinary meatus is located on the top of the glans of the penis. The nurse understands the correct term for this congenital defect is A. epispadias B. hypospadias C. hydrocele D. varicocele

A. epispadias Rationale: N/A

Which of the following would the nurse expect to be done to assess the size of the prostate? A. Digital rectal examination B. Transillumination C. Pelvic examination D. Bladder percussion

A. Digital rectal examination A digital rectal examination is performed to assess the prostate for size as well as evidence of tumor. Transillumination is used to determine the density of scrotal tissue. Pelvic examination is performed to evaluate female reproductive structures. Bladder percussion reveals information about the status of the bladder.

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? A. Left testicular torsion B. Epididymitis C. Hydrocele D. Testicular cancer

A. Left testicular torsion Signs of testicular torsion include acute pain that is not relieved by elevating the testicle, nausea, and vomiting. Epididymitis usually presents in adult males. The client presents with unilateral pain to one testis, but fever, dysuria, and possibly urethral discharge. Hydrocele is the accumulation of fluid around a testicle. This condition usually presents as a non-tender and soft testicle. Often testicular cancer presents lump or swelling, which may or may not be painful. The condition could also present with pain in the abdomen or low back.

Which of the following unexpected findings of the testes is most likely to result in painful palpation of the testes? A. Orchitis B. Cryptorchidism C. Klinefelter's syndrome D. Testicular tumor

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

A client presents at the clinic with severe scrotal pain. What is the presumptive diagnosis? A. Testicular torsion B. Priapism C. Hydrocele D. Varicocele

A. Testicular torsion Any client with scrotal pain should be presumed to have testicular torsion until another diagnosis can be proven.

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? A. prolapse B. Rectal polyps C. shelf D. cancer

A. prolapse The nurse should document this condition as rectal prolapse. Soft structures like nodules that may be present in the muscular anal ring are called rectal polyps. They are rather common and occur in varying size and number. If cancer metastasizes to the peritoneal cavity, it may be felt as a nodular, hard, shelf-like structure called rectal shelf that protrudes onto the anterior surface of the rectum in the area of the rectouterine pouch in women. Rectal cancer may feel like a firm nodule, an ulcerated nodule with rolled edges, or, as it grows, a large, irregularly shaped, fixed hard nodule.

Which client would the nurse identify as being at highest risk for the development of testicular cancer? A. A 45-year-old white man with a history of hypertension. B. A 25-year-old man with a history of cryptorchidism. C. A 39-year-old African-American man who is HIV-negative. D. A 75-year-old white man with erectile dysfunction.

B. A 25-year-old man with a history of cryptorchidism. Testicular cancer is most common in between 15 and 34 years of age and is the leading cause of cancer deaths in men between 25 to 34 years of age. Its incidence is higher in Caucasians and men with a history of cryptorchidism. Other clients at risk are those with a family history of the disease, those who are HIV-positive or have developed AIDS, and those who already have had cancer in one testicle.

What ethnic group has a significantly higher incidence rate of prostate cancer? A. Native American B. African American C. Caucasian D. Asian

B. African American For undetermined reasons, incidence rates are significantly higher in African American men than in Caucasian men: 232 cases per 100,000 compared with 146 cases per 100,000, even after adjustments for access to care. Prostate cancer occurs at an earlier age and more advanced stage in African American men.

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? A. Chronic bacterial prostatitis (CBP) B. Benign prostatic hyperplasia (BPH) C. Orchitis D. Epididymitis

B. Benign prostatic hyperplasia (BPH) Initial symptoms of BPH may be urinary difficulties. The client does not empty his bladder completely when he voids and finds that he must void frequently, often during the night. He may also find starting to void increasingly difficult or painful and may notice traces of blood in his urine. Cystitis may result. The client with chronic prostatitis is usually asymptomatic, but he may complain of back or perineal pain. Symptoms of orchitis include pain and swelling int eh scrotum and sometimes urethral irritation. Symptoms of epididymitis include redness, pain, and various degrees of scrotal swelling.

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? A. External hemorrhoid B. Pilonidal cyst C. Anal fissure D. Perianal abscess

B. Pilonidal cyst A pilonidal cyst is a congenital disorder characterized by a small dimple or cyst/sinus that contains hair. External hemorrhoids are usually painless papules below the anorectal junction, caused by varicose veins. Anal fissures are splits in the tissue of the anal canal caused by trauma. Perianal abscess is a cavity of pus, caused by infection in the skin around the anal opening.

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? A. Apply scrotal support. B. Prepare the client for surgery. C. Apply a dressing over the scrotum. D. Prepare the client for circumcision.

B. 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. Circumcision is done to relieve phimosis or paraphimosis.

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? A. Urethral meatus B. Prepuce C. Corpus cavernosa D. Corpus spongiosum

B. 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. The shaft of the penis is composed of three cylindrical masses of vascular erectile tissue that are bound together by fibrous tissue—two corpora cavernosa on the dorsal side and the corpus spongiosum on the ventral side.

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? A. Herpes progenitalis B. Syphilitic chancre C. Cancer of the glans penis D. Hypospadias

B. Syphilitic chancre Syphilitic chancre initially is a small, silvery-white papule that develops a red, oval ulceration. Herpes progenitalis is characterized by clusters of pimple-like, clear vesicles that erupt and become ulcers. Cancer of the glans penis appears as a hardened nodule or ulcer on the glans. Hypospadias is a condition in which the urethral meatus is located underneath the glans (ventral side).

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 A. venereal warts. B. herpes infection. C. syphilis. D. gonorrhea.

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

A client asks the nurse when a colonoscopy is recommended. Which advise by the nurse provides the most appropriate advice? A. "A colonoscopy should be done every year starting at age 65" B. "Either a fecal occult blood test or a colonoscopy is acceptable" C. "A flexible sigmoidoscopy should be done every five years starting at age 50" D. "Your doctor will decide what schedule is best for you"

C. "A flexible sigmoidoscopy should be done every five years starting at age 50" Beginning at age 50, men and women should have a fecal occult blood test or a flexible sigmoidoscopy every five (5) years. Both of these are preferred over either one separately. All screening should start at age 50, not 60 years of age. Health care providers should adhere to the screening guidelines not make their own decisions.

A male client suffers from urinary retention. Which instructions are best to teach the client? A. "Drink plenty of water each day, at least 8-10 eight ounce glasses." B. "Frequently go to the bathroom, every four hours." C. "Try voiding, then resting a few minutes, before going again." D. "Infections are uncommon, but change your underwear daily."

C. "Try voiding, then resting a few minutes, before going again." A client suffering from urinary retention can be instructed to try double voiding to completely empty the bladder. Retention of urine can lead to stasis and infection. Drinking more water and frequent toileting does not relieve the cause of urinary retention. If double voiding does not help, the client can be referred to a urologist.

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? A. Patellar reflex B. Rooting reflex C. Cremasteric reflex D. Vasovagal reflex

C. Cremasteric reflex The scrotum can maintain temperature control because the cremaster muscle is sensitive to changes in temperature. The muscle contracts when too cold, raising the scrotum and testes upward toward the body for warmth (cremasteric reflex). This accounts for the wrinkled appearance of the scrotal skin. The patellar reflex occurs when a physician strikes the patellar tendon of the knee and the leg jerks. The rooting reflex occurs in infants when they turn their heads toward anything that strokes the cheek or mouth. The vasovagal reflex is a contraction of muscles in the GI tract in response to distension of the tract following consumption of food and drink.

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? A. Erectile dysfunction B. Prostatitis C. Cryptorchidism D. Priapism

C. Cryptorchidism Structural abnormalities include cryptorchidism, torsion of the spermatic cord, phimosis, paraphimosis, hydrocele, spermatocele, and varicocele. Erectile dysfunction and priapism are erection disorders. Prostatitis is an infectious disorder.

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? A. Prostate cancer B. Colon cancer C. Prostatitis D. Colonic polyp

C. Prostatitis This examination, associated with a history of dysuria, frequency, and incomplete voiding, should lead to a suspicion of acute prostatitis. Prostate cancer, colon cancer, and polyps should not ordinarily cause systemic symptoms such as fever.

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 A. hypospadias. B. hematocele. C. cryptorchidism. D. orchitis.

C. cryptorchidism. Absence of a testis suggests cryptorchidism (an undescended testicle).

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? A. "Do you think you have malformed testicles?" B. "Don't worry, that is the way normal testicles feel." C. "Lumpy testicles are not going to cause a problem with sexual performance." D. "The normal testicle contains internal structures that cause lumps on the surface."

D. "The normal testicle contains internal structures that cause lumps on the surface." Each normal testicle has a small, coiled tube (epididymis) that can feel like a small bump on the upper or middle outer side of the testicle. Normal testicles also have blood vessels, supporting tissues, and tubes that carry sperm. Asking for the client's opinion on whether or not the testicles are malformed does not yield assessment data or address the client's need for more information. Telling the client not to worry and describing the testicles as normal provides incomplete information to the client. Because the client's given concern is not regarding sexual performance, this is not a statement that the nurse should use; additionally, describing the testicles as lumpy is an inaccurate way to refer to an expected assessment finding.

Which of the following is inconsistent with a digital rectal examination? A. Recommended for men greater than 40 years of age B. Assists in screening for cancer of prostate gland C. Enables examiner to assess size, shape, and consistency of prostate gland D. Can reveal a hydrocele

D. Can reveal a hydrocele The DRE is recommended as a part of the regular health checkup for every man older than 40 years of age. It is a screening for cancer of the prostate gland. It enables the examiner to assess the size, shape, and consistency of the prostate gland.

Which of the following is a sign or symptom of benign prostatic hypertrophy (BPH)? A. Weight loss B. Bone pain C. Fever D. Nocturia

D. Nocturia BPH is usually not associated with systemic symptoms such as weight loss or fever. Bone pain is associated with prostate cancer, which often metastasizes to the lower axial skeleton. Nocturia, sensation of incomplete voiding, weak stream, and difficulty initiating urination are also common symptoms.

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? A. Acute prostatitis B. Benign prostatic hypertrophy C. Hydrocele D. Prostate cancer

D. Prostate cancer The prostate is normally nontender and rubbery. A swollen and tender prostate may indicate acute prostatitis. An enlarged, smooth, firm, slightly elastic prostate that may not have a median sulcus suggests benign prostatic hypertrophy. A hard area on the prostate or hard, fixed, irregular nodules on the prostate suggest cancer. Hydrocele is a painless swelling of the scrotum.

During assessment of an adult client, which of the following lifestyle practices would indicate to the nurse that the client may be at high risk for HIV/AIDS? A client who A. uses a condom on a regular basis. B. has multiple female partners. C. smokes marijuana occasionally. D. has anal intercourse with other males.

D. has anal intercourse with other males. Because HIV is preventable, knowing risks and practicing risk-reducing behaviors will help to stem the epidemic of this infection. Risks include having unprotected sex (especially male-on-male anal intercourse).

The nurse notes that a client has a small red papule that is clean, smooth, and glistening on the penis. What should the nurse suspect is causing this lesion? A. gonorrhea B. genital warts C. genital herpes D. primary syphilis

D. primary syphilis Manifestations of primary syphilis include a small red papule that is clean, smooth, and glistening. Manifestations of gonorrhea include a penile discharge and not skin changes. Manifestations of genital herpes include small scattered or grouped vesicles on the penis. Manifestations of genital warts include single or multiple papules or plaques of variable shapes.

During assessment of an elderly male client, the client tells the nurse that he has had difficulty urinating for the past few weeks. The nurse should refer the client to the physician for possible A. inguinal hernia. B. sexually transmitted disease. C. impotence. D. prostate enlargement.

D. prostate enlargement. Difficulty urinating may indicate an infection or blockage, including prostatic enlargement.