Chapter 42 PrepU: Structure and Function of the Male Genitourinary System
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? A. Enlarged breast B. Undescended testicles C. Enlarged prostate gland D. Increased sperm count
A
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? A. Inguinal hernia B. Phimosis C. Benign prostatic hyperplasia D. HPV infection
A
The nurse knows that which structures are a part of the male reproductive system? Select all that apply. A. Pair of gonads B. Seminiferous tubules C. Prostate gland D. Urinary bladder E. Pair of kidneys
A, B, C
Sperm production by the testes is optimal at 3.6°F to 5.4°F (2°C to 3°C) below body temperature. Two systems of the body maintain the temperature of the testes at a level that allows sperm production. What is the system that assists in maintaining the testes at a temperature lower than body temperature? A. pampiniform plexus B. testicular artery C. cremaster veins D. tunica vaginalis
A
The client presents with symptoms consistent with hypogonadism. For a diagnosis of hypogonadism, the nurse expects which diagnostic test to be ordered? A. Total testosterone levels B. Nitric oxide level C. Growth releasing hormone level D. Thyroid stimulating hormone level
A
The main actions of testosterone are varied, and many of the biologic effects are well known in the male. The nurse who is familiar with the actions of testosterone will also know about which biologic effect of testosterone? A. Stimulates erythropoiesis B. Increased body fat C. Depression D. Decreased protein metabolism
A
The male reproductive system is composed of two systems. The nurse knows that which system is responsible for the transportation and storage of sperm? A. Ductile system B. Accessory glands C. Pampiniform plexus D. Symphysis pubis
A
The neural control of the sexual act that constitutes the culmination of the male sexual act includes which autonomic nervous system control mechanism? A. Emission B. Erection C. Psychic thoughts D. Sexual stimulation
A
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? A. Hypogonadism B. Benign prostatic hyperplasia C. Prostate cancer D. Klinefelter syndrome
A
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? A. Type 2 diabetes B. Venous stasis C. Asthma D. Bell's palsy
A
The nurse is speaking with a couple at the fertility clinic about ways to increase sperm counts. Which topic does the nurse include in the discussion? A. Avoid tight undergarments B. Drink plenty of fluids C. Bathe in cool water D. Avoid caffeine
A
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? A. Obstruction B. Atony C. Drainage D. Filtration
A
The testes secrete several male sex hormones. Which of these hormones is the most abundant and considered the main testicular hormone? A. Testosterone B. Dihydrotestosterone C. Androstenedione D. Progesterone
A
Where is the final site for sperm maturation? A. Epididymis B. Bladder C. Urethra D. Bulbourethral gland
A
The health care provider has just completed an assessment of a client who is experiencing erectile dysfunction. Select the psychogenic factors that may be contributing to the dysfunction. Select all that apply. A. Anxiety B. Depression C. Schizophrenia D. Stroke E. Parkinson disease F. Hormonal imbalance
A, B, C
A 40-year-old male client with multiple health problems has been diagnosed with a testosterone deficiency. The nurse knows that which assessment findings would correlate with a testosterone deficiency? Select all that apply. A. A high-pitched voice. B. Long-lasting chronic hip dysplasia. C. Complaints of multiple upper respiratory infections. D. A low muscle mass in proportion to his total body weight. E. Hot flashes and diaphoresis.
A, D, E
A 17-year-old male has developed phimosis to the point that he is having difficulty voiding. The nurse should prepare this teenager for: A. Radiation therapy to loosen the foreskin B. Circumcision C. Injection of lidocaine into the head of the penis D. Traumatic retraction of the foreskin
B
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? A. Progesterone B. Testosterone C. Dihydrotestosterone D. Estrogen
B
Which statements are accurate when it comes to changes in the male reproductive system as one ages? Select all that apply. A. Androgen hormone levels increase with age. B. Sexual energy levels decrease as one ages, with decreasing testosterone levels. C. The testes become smaller and lose their firmness. D. The prostate gland enlarges with age. E. The force of ejaculation increases with age.
B, C, D
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? A. Hypergonadism B. Pituitary adenoma C. Hypogonadism D. Adrenal insufficiency
C
A nurse suspects an older adult client is experiencing benign prostatic hyperplasia (BPH). Which question should the nurse ask this client? A. "Have you noticed any unusual discharge from your penis?" B. "Have you experienced a decrease in your sex drive?" C. "Has the force of your urinary stream decreased?" D. "Do you have any difficulty in achieving an erection?"
C
An adult client had bilateral orchiectomy (testicular removal) due to cancer. What will be the primary effect of the disruption in testosterone synthesis? A. His voice will likely increase in pitch. B. He will develop some secondary female sex characteristics. C. He will likely experience an overall reduction in muscle mass. D. He will likely develop acne on his face and trunk.
C
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? A. "Spermatogenesis is inhibited because sex hormones no longer stimulate the Sertoli cells." B. "Spermatozoa can no longer reach the epididymis and do not survive." C. "The rete testis becomes inhospitable to sperm." D. "Sperm can no longer pass through the ductus deferens."
D
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: A. Inguinal hernia B. Cancer of the scrotum C. Testicular aneurysm D. Testicular torsion
D
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? A. "Most men my age develop hernias so there is no cause for concern." B. "My hernia is a result of a congenital abnormality." C. "I will need immediate surgery since the hernia is blocking blood supply to my intestines." D. "The hernia is a loop of bowel protruding through a weak spot in my abdominal muscles."
D
A nurse educator is explaining male reproductive physiology during grand rounds and is referring to the process of spermatogenesis. Where does spermatogenesis occur? A. Sertoli cells B. The spermatogonia C. The epididymis D. The seminiferous tubules
D
A nurse is performing a genital examination on a male client who develops an erection. What is the nurse's most appropriate intervention? A. Ask the client if he would prefer someone else to perform the examination B. Ignore the erection and continue with the examination C. Stop examining the client and leave the room D. Reassure the client that this is a normal response and continue with the examination
D
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. A. Urine elimination B. Production of androgens C. Sexual function D. Production of sex hormones
A, C
An 18-month-old boy is diagnosed with cryptorchidism. Based on this diagnosis, what does the nurse expect to observe during the physical assessment? A. Testes that are hard and difficult to palpate B. Absence of the testis in the scrotum bilaterally C. Enlargement of the scrotum D. Testes that migrate into the abdomen when the child squats
B
The nurse assessing an adult male with impaired testosterone should evaluate which of the following as an expected finding? A. Anxiety B. Fatigue C. Increased libido D. Loss of fat mass
B
The nurse conducting a health promotion class for teenage boys on human reproduction determines that the participants are understanding the information when they state: A. Spermatogenesis begins during fetal development. B. Spermatogenesis continues throughout a man's reproductive years. C. Spermatogenesis occurs in the prostate gland. D. Sperm in various stages of development are embedded in the corpora cavernosa.
B
In the male stages of the sexual act, emission precedes which stage, which is mediated through spinal cord reflexes? A. Ejaculation B. Detumescence C. Erection D. Climax
A
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? A. Cancer of the prostate B. Benign prostatic hyperplasia (BPH) C. Cancer of the urinary system D. Infection of the prostate
B
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? A. The prostate gland is located in the inguinal canal. B. The prostate gland is located in the pelvis, inferior to the bladder. C. The prostate gland is located beneath the scrotal sac. D. The prostate gland is located in the meatus of the penis.
B
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: A. continue to monitor the client every 6 months to see if there is a change in size. B. prescribe diuretics like furosemide to help remove excess fluid. C. order an ultrasound or biopsy to rule out testicular cancer. D. gently try to express the fluid out of the scrotal sac.
C
The nursing instructor is teaching the class about the male hormone testosterone. Which statement made by a student indicates a need for further instruction? A. Testosterone is secreted by the testes. B. Testosterone is essential for the appropriate differentiation of the internal and external genitalia. C. Testosterone does not affect development of increased musculature during puberty. D. Testosterone is necessary for the descent of the testes in the fetus.
C
The nursing students are studying about testosterone and androgens and the role they play in the male. The student correctly identifies which scenario to be a situation where hormone replacement is recommended? A. For athletes who want to increase athletic ability B. For bodybuilders who want bigger muscles C. For aging men with low androgen levels D. For teenagers who want to get big "faster"
C
A nursing student is studying pathophysiology as part of the nursing curriculum. Which statement made by the student indicates a need for further instruction? A. The male testes are located inside the abdominal cavity. B. The male testes are also known as gonads. C. The male testes are located outside the abdominal cavity. D. The testes are egg-shaped structures in the scrotum.
A
An older male client complains of inhibited sexual functioning. The nurse knows which nursing diagnosis could be a priority for his inhibited sexual function? A. Impaired self-esteem B. Impaired comfort C. Ineffective childbearing process D. Noncompliance
A
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? A. At about 9 years and until 21 years B. At about 13 years and throughout the reproductive years C. At about 16 years and throughout the reproductive years D. At about 9 years and until 55 years
B
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? A. "Tight fitting undergarments are best so sperm cannot move around too much to become deformed." B. "Only plain white undergarments are best. Chemicals from colored briefs may damage the sperm." C. "Since you live in your clothing the better part of the day, tight-fitting underwear is a must to prevent scrotal movement." D. "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."
D
