chapter 26: Assessing Male Genitalia and Rectum
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? 3 cm 4.5 cm 6 cm 1.5 cm
4.5 cm Explanation: Testes are ovoid, approximately 3.5 to 5 cm long, 2.5 cm wide, and 2.5 cm deep, and equal bilaterally in size and shape.
What ethnic group has a significantly higher incidence rate of prostate cancer? Caucasian African American Asian Native American
African American Explanation: 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.
Which of the following groups has the highest incidence of prostate cancer? Asian American men African American men Caucasian men Native American menv
African American men Explanation: African American men have the highest incidence of prostate cancer—two to three times higher than Caucasian men.
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 Explanation: The nurse should document this condition as cryptorchidism, a condition in which the scrotum appears underdeveloped and the testis cannot be palpated. Cryptorchidism is the failure of one or both testicles to descend into the scrotum. Orchitis is the inflammation of the testes, associated frequently with mumps; the scrotum appears enlarged and reddened. Epididymitis is an infection of the epididymis; the scrotum appears enlarged, reddened, and swollen, and a tender epididymis is palpated. Hydrocele appears as a swelling in the scrotum and is usually painless. Reference:
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? Increased fat content Gastrointestinal bleeding Lack of bile pigment Cancer of the colon
Gastrointestinal bleeding Explanation: Black stools may indicate gastrointestinal bleeding in this client who has not been receiving iron supplements or taking Pepto-Bismol. Clay-colored stool results from the lack of bile pigment. Yellow stool suggests increased fat content or steatorrhea. Cancer of the rectum or colon may be indicated by blood detected in the stool.
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? Apply scrotal support. Apply a dressing over the scrotum. Prepare the client for surgery. Prepare the client for circumcision.
Prepare the client for surgery. Explanation: For the client with torsion, immediate surgery is necessary to prevent atropy 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.
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? Testosterone hypersecretion Side effects of medications Mental illness Manic episodes
Side effects of medications Explanation: Lack of libido may arise from psychogenic causes such as depression, endocrine dysfunction, or side effects of medications.
Before beginning the examination of the genitalia of an adult male client, the nurse should ask the client to empty his bladder. ask the client to leave his shirt in place. tell the client that he will remain in a supine position. tell the client that he may leave his underwear in place.
ask the client to empty his bladder. Explanation: Before the examination, instruct the client to empty his bladder so that he will be comfortable.
The prostate functions to secrete a milky substance that neutralizes female acidic secretions. produce mucus-like fluid to assist in lubrication. store sperm until ejaculation occurs. produce the ejaculate that nourishes and protects sperm.
secrete a milky substance that neutralizes female acidic secretions. Explanation: The prostate secretes a thin, milky substance that promotes sperm motility and neutralizes female acidic vaginal secretions.
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. Alcohol use Diet high in animal fats Age older than 65 years Asian American heritage Environmental exposure Low levels of PSA
Asian American heritage Diet high in animal fats Environmental exposure Explanation: Risk factors for prostate cancer include: age older than 50 years, African American heritage, diet high in animal fats, family history of prostate cancer, environmental exposure, and PSA elevation.
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) Orchitis Chronic bacterial prostatitis (CBP) Epididymitis
Benign prostatic hyperplasia (BPH) Explanation: 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 in the scrotum and sometimes urethral irritation. Symptoms of epididymitis include redness, pain, and various degrees of scrotal swelling.
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-iron High-calorie High fiber High-fat diet
High-fat diet Explanation: 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.
Which of the following should nurses teach all men, especially those who have had cryptorchidism? Need to undergo a baseline and follow up lymph node biopsies. Need for blood tests to measure serum acid phosphate levels. Importance of regular monitoring of prostate-specific antigen (PSA) levels. How to perform a testicular self-examination.
How to perform a testicular self-examination. Explanation: The nurses should teach all men, especially those who have had cryptorchidism, to perform testicular self-examination to detect any abnormal mass in the scrotum. The nurse instructs the clients to examine the testicles monthly, preferably when warm, such as in the shower. Having regular PSA levels, lymph node biopsies, and blood tests for measuring serum acid phosphatase are for the clients who are treated for prostate cancer.
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 Hydrocele Testicular cancer Epididymitis
Left testicular torsion Explanation: 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 is a sign or symptom of benign prostatic hypertrophy (BPH)? Nocturia Weight loss Fever Bone pain
Nocturia Explanation: 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.
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? External hemorrhoid Anal fissure Perianal abscess Pilonidal cyst
Pilonidal cyst Explanation: 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.
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 Urethral meatus Corpus spongiosum Corpus cavernosa
Prepuce Explanation: 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.
A patient presents at the clinic with severe scrotal pain. What is the presumptive diagnosis? Testicular torsion Hydrocele Priapism Varicocele
Testicular torsion Explanation: Any patient with scrotal pain should be presumed to have testicular torsion until another diagnosis can be proven.
An uncircumcised male client has just come to the recovery room following a 4-hour back surgery. Before surgery a urinary catheter was placed. During the postoperative assessment, the recovery nurse discovers that the client has developed paraphimosis. What might have happened to the client to cause this? The catheter was too taut for too long and has damaged the urethra The client is having a reaction to an anesthesia agent he received during surgery The foreskin was not pulled back over the head of the penis after catheter placement The client is having an anatomical reaction to being face down on a pillow for 4 hours
The foreskin was not pulled back over the head of the penis after catheter placement Explanation: Paraphimosis occurs when the retracted prepuce cannot be placed back over the glans. Paraphimosis may be severe enough to restrict circulation to the glans. An uncircumcised male should always have the foreskin pulled toward the urethral opening. The other options are distracters to the question.
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 Spermatocele Orchitis Varicocele
Torsion of the spermatic cord Explanation: Torsion of the spermatic 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.