Male Reproductive

A 20-year-old male has been diagnosed with a chlamydial infection, and his primary care provider is performing teaching in an effort to prevent the patient from infecting others in the future. Which of the following statements by the patient demonstrates the best understanding of his health problem? Question options: "Even if I spread it to someone else, there's a good chance she won't have any symptoms or know she has it." "Each of the three stages of the disease seems to be worse than the previous one." "Even though I couldn't end up sterile, a woman that I give it to certainly could." "Either me or a partner could end up with an eye infection from chlamydia that could make us blind."

"Even if I spread it to someone else, there's a good chance she won't have any symptoms or know she has it."

A 51-year-old woman who has been receiving estrogen and progesterone therapy (EPT) for the last 5 years has visited her care provider because her peers have told her about the risks of heart disease, stroke, and breast cancer that could accompany hormone therapy (HT). How should her care provider respond to her concerns? Question options: "There's in fact a slight protective effect against stroke associated with HT, but this is partially offset by increased rates of heart disease and breast cancer." "HT is actually associated with a decrease in heart disease risk, but there is an increase in stroke risk; the breast cancer connection is still unclear." "All things considered, the benefits of HT outweigh the slightly increased risks of heart disease, stroke, or breast cancer." "There is a demonstrable increase in breast cancer risk with HT, but the risk of stroke or heart disease actually goes down slightly."

"HT is actually associated with a decrease in heart disease risk, but there is an increase in stroke risk; the breast cancer connection is still unclear."

Following a visit to her campus medical clinic motivated by persistent abdominal pain and dyspareunia, a 20-year-old female college student has been referred for a diagnostic workup to rule out pelvic inflammatory disease. Her elevated white cell and C-reactive protein levels lead her care provider to suspect pelvic inflammatory disease (PID). What follow-up question is most likely to help with the differential diagnosis? Question options: "Have you ever had a therapeutic abortion in the past?" "How many sexual partners have you had?" "What does your daily hygiene routine usually consist of?" "Are you using tampons during your period, or do you normally use pads?"

"How many sexual partners have you had?"

A pregnant 23-year-old with a diagnosis of herpes simplex virus (HSV) is receiving prenatal care from her nurse practitioner. What is the nurse practitioner most likely to tell the patient about the precautions that will be taken to prevent transmission of the virus to her baby? Question options: "We'll have to book you for a caesarean delivery in order to ensure that your baby isn't exposed to the virus." "A vaginal delivery will be safe as long as you are consistent about taking your vancyclovir." "If there aren't any visible lesions when you enter labor, a vaginal delivery will be safe to go ahead with." "After your caesarean section, it will be safest if you don't breast-feed your child."

"If there aren't any visible lesions when you enter labor, a vaginal delivery will be safe to go ahead with."

A 20-year-old male has been diagnosed with testicular cancer and is seeking information about his diagnosis from a number of websites. Which of the following statements that he has read is most plausible? Question options: "Recent developments in the treatment of testicular cancer mean that few men now need to have a testicle removed." "For most men with testicular cancer, bloody urine is their first sign that something is wrong." "Men with cryptorchidism—the term for an undescended testicle—are known to have a higher risk of developing testicular cancer." "Testicular cancer is a leading cause of death among males who should be in the prime of their lives."

"Men with cryptorchidism—the term for an undescended testicle—are known to have a higher risk of developing testicular cancer."

During a group prenatal class, the nurse teaching the course is explaining the thinning of the cervix that accompanies the stages of labor leading up to delivery. A participant admits that she is not familiar with either the location or normal role of the cervix. Which of the following responses, by the nurse, would be most appropriate? Question options: "The cervix is the soft lining of your uterus that has to expand greatly to accommodate your baby during delivery." "Your cervix is the part of your uterus where the fallopian tubes join it and the baby has to pass through it to the vagina." "The cervix is the opening between the uterus and the vagina and so it opens wide during the lead-up to birth." "Your cervix is just the term for the lowest part of your uterus and it is tightly shut at all times except in women who are giving birth."

"The cervix is the opening between the uterus and the vagina and so it opens wide during the lead-up to birth."

A 57-year-old woman who has been diagnosed with atrophic vaginitis has expressed her surprise to her care provider, citing a lifetime largely free of gynecological health problems. She has asked what may have contributed to her problem. How can the care provider best respond? Question options: "The exact cause of this problem isn't known, but it can usually be resolved with a diet high in probiotic bacteria." "This type of vaginitis is most commonly a symptom of a latent sexually transmitted infection that you may have contracted in the distant past." "Vaginitis is not usually the direct result of any single problem, but rather an inevitability of the vaginal dryness that accompanies menopause." "The lower levels of estrogen since you've begun menopause make your vagina prone to infection."

"The lower levels of estrogen since you've begun menopause make your vagina prone to infection."

Which of the following women is most likely to have a sexually transmitted infection as a contributing factor to her health problem? Question options: A 41-year-old with a diagnosis of mucopurulent cervicitis A 32-year-old who is undergoing diagnostics to rule out endometriosis A 40-year-old who is being treated for vaginal cancer A 29-year-old woman with a diagnosis of localized vulvodynia

A 41-year-old with a diagnosis of mucopurulent cervicitis

Which of the following sexually active women most likely faces the highest risk of developing an ectopic pregnancy? Question options: A 22-year-old who has a history of anorexia nervosa and who has a body mass index (BMI) of 12.0 (normal is 18.5 to 24.9). A 27-year-old who stopped using medroxyprogesterone contraceptive injection (Depo-Provera) several months ago A 42-year-old who has decided to try to have one more child and has had her tubal ligation reversed A 14-year-old who experienced menarche 2 years prior

A 42-year-old who has decided to try to have one more child and has had her tubal ligation reversed

A newborn male has been diagnosed with hypospadias following his postpartum assessment by a nurse practitioner. Which of the following diagnostics and treatment options is the nurse practitioner most likely to rule out first? Question options: Testosterone supplementation Surgical repair Circumcision Chromosomal studies

Circumcision

After a long and frustrating course of constant vaginal pain, a 38-year-old woman has been diagnosed with generalized vulvodynia by her nurse practitioner. What treatment plan is her nurse practitioner most likely to propose? Question options: Narcotic analgesia and nonsteroidal anti-inflammatory medications Lifestyle modifications aimed at accommodating and managing neuropathic pain Antidepressant and antiepileptic medications Alternative herbal therapies coupled with antifungal medications

Antidepressant and antiepileptic medications

Which of the following factors are NOT known to contribute to vaginal yeast infections? Question options: High hormone levels during pregnancy Use of oral contraceptives Recent antibiotic therapy Poorly controlled diabetes' Inflammation of the Skene and Bartholin glands

Inflammation of the Skene and Bartholin glands

A 71-year-old man has visited his nurse practitioner for a check-up, during which the nurse practitioner has initiated a discussion about the patient's sexual function. Which of the following phenomena would the nurse practitioner most likely consider a pathological rather than an age-related change? Question options: A decrease in the force of the man's ejaculation Cessation of FSH production A decrease in the size and firmness of the patient's testes The presence of relative or absolute hypogonadism

Cessation of FSH production

Which of the following statements best captures an aspect of normal spermatogenesis? Question options: Each primary spermatocyte undergoes two nuclear divisions, yielding four cells with 23 chromosomes each. Spermatogonia adjacent to the tubular wall undergo meiotic division and provide a continuous source of new germinal cells. Sertoli cells differentiate into spermatids, each of which can contribute half of the chromosomes necessary for reproduction. Testosterone chemically lyses each primary spermatocyte into two secondary spermatocytes with 23 chromosomes each.

Each primary spermatocyte undergoes two nuclear divisions, yielding four cells with 23 chromosomes each.

John presents to the clinic with complaints of scrotal heaviness. Your assessment reveals swelling of the testicle and warm scrotal skin. What would your diagnosis be? Question options: Epididymitis Testicular torsion Orchitis Cryptorchidism

Epididymitis

Having heard positive reports of the benefits of HT from her sister-in-law and friends, a 49-year-old woman has presented to her nurse practitioner asking to start HT. Her uterus is intact and previous bone scans have indicated low bone density. The patient also has a family history of heart disease. She characterizes her symptoms of menopause as "noticeable, but not debilitating by any means." Based on the most current research, what is her nurse practitioner's best course of action? Question options: Begin low-dose HT but perform regular breast cancer screening and heart health checks Forgo HT but consider alternative therapies and reevaluate if her symptoms significantly affect her quality of life Forgo HT in light of her preexisting low bone density and consequent risk of osteoporosis Begin estrogen-progesterone HT (EPT) to prevent future menopausal symptoms and coronary heart disease (CHD)

Forgo HT but consider alternative therapies and reevaluate if her symptoms significantly affect her quality of life

Long, stretchy cervical mucus that exhibits ferning on a microscope slide is characteristic of which of the following? Question options: Low human chorionic gonadotropin levels High progesterone levels Low estrogen levels High LH levels

High LH levels

A 66-year-old man has presented to a nurse practitioner to get a refill for his antiplatelet medication. The patient has a history of ischemic heart disease and suffered a myocardial infarction 5 years ago and has unstable angina; he uses a transdermal nitroglycerin patch to control his angina. The patient has a 40-pack-year smoking history and uses nebulized bronchodilators at home for the treatment of transient shortness of breath. He has long-standing hypertension that is treated with a potassium-sparing diuretic and a ß-adrenergic blocking medication. During the nurse's assessment, the man notes that he has been unable to maintain his erection in recent months. Which of the following aspects of the man's health problems and treatments would the nurse identify as NOT being contributing to his erectile dysfunction (ED)? Question options: His age His smoking history His ischemic heart disease His hypertension His use of bronchodilators His antihypertensive medications

His use of bronchodilators

A 29-year-old woman has been trying for many months to become pregnant, and fertilization has just occurred following her most recent ovulation. What process will now occur that will differentiate this ovulatory cycle from those prior? Question options: The basal layer of the endometrium will be sloughed in preparation for implantation. The corpus luteum will atrophy and be replaced by corpus albicans. The remaining primary follicles will provide hormonal support for the first 3 months of pregnancy. Human chorionic gonadotropin will be produced, preventing luteal regression.

Human chorionic gonadotropin will be produced, preventing luteal regression.

Which of the following conditions usually improves when a woman is taking oral contraceptives? Question options: Herpes simplex virus Iron deficiency anemia Migraine headaches Human Papillomavirus infection

Iron deficiency anemia

A 39-year-old male patient has been recently diagnosed with primary hypogonadism. Which of the following lab results would be most indicative of this diagnosis? Question options: Low testosterone levels; normal levels of LH and FSH Low levels of GnRH Low free testosterone, LH, and FSH levels Normal levels of free testosterone; low levels of total testosterone

Low testosterone levels; normal levels of LH and FSH

A 13-year-old patient undergoing puberty is alarmed to find small, white bumps surrounding the areolae on her nipples. You reassure her that these are a normal sign of her sexual maturation and tell her that they are which of the following: Question options: Cooper ligaments Montgomery tubercles Bartholin glands Skene glands

Montgomery tubercles

A 24-year-old woman has presented to an inner-city free clinic because of the copious, foul vaginal discharge that she has had in recent days. Microscopy has confirmed the presence of Trichomonas vaginalis. What is the woman's most likely treatment and prognosis? Question options: Vaginal suppositories and topical ointments can provide symptom relief but cannot eradicate the microorganism. Antifungal medications are effective against the anovulation and risk of HIV that accompany the infection. Oral antibiotics can prevent complications such as infertility and pelvic inflammatory disease. Abstinence will be required until the infection resolves, since treatments do not yet have proven efficacy.

Oral antibiotics can prevent complications such as infertility and pelvic inflammatory disease.

A 13-year-old female is undergoing rapid development of her breasts after experiencing menarche several months ago. Which of the following hormones are NOT active in the development of her breasts? Question options: Prolactin Oxytocin Estrogen Follicle-stimulating hormone Progesterone

Oxytocin

A couple that has three daughters would like to add a son to their family, and they have recently learned that the woman is pregnant. Which of the following phenomena would most likely be associated with the woman's eventual delivery of a healthy son? Question options: The production of dihydrotestosterone (DHT) by the embryo and DHT's differentiation into testosterone Development of testes under the influence of the X chromosome Suppression of female reproductive structures by antimüllerian hormone (AMH) Atrophy of the wolffian ducts during embryonic development

Suppression of female reproductive structures by antimüllerian hormone (AMH)

A 14-year-old boy has been brought to the emergency department by his mother in excruciating pain that is radiating from his scrotum to his inguinal area. The boy's heart rate is 122 beats per minute and he vomited twice before arrival at the hospital. Examination reveals that his scrotum is reddened and slightly swollen and the testes are firm to the touch and tender, with extensive cremaster muscle contraction noted. What is the boy's most likely diagnosis? Question options: Varicocele Testicular torsion Hydrocele Epididymitis

Testicular torsion

A 40-year-old male patient with multiple health problems has been diagnosed with a testosterone deficiency. Which of the following assessment findings would his care provider attribute to an etiology other than this deficiency? Question options: The patient has a low muscle mass as a proportion of total body weight. The patient has a history of susceptibility to upper respiratory infections. The patient has long-standing anemia and low red cell counts. The patient has a voice that is unusually high in pitch.

The patient has a history of susceptibility to upper respiratory infections.

A 40-year-old woman has been found to have a deficiency in estrogen. Which of the following physiological phenomena is most likely to remain unaffected? Question options: The synthesis and release of adrenal glucocorticoids The maintenance of normal skin and blood vessel structure The regulation of uterine endothelial development Parathyroid hormone antagonism and the rate of bone resorption

The synthesis and release of adrenal glucocorticoids

Which of the following situations would be considered pathologic in an otherwise healthy 30-year-old female? Question options: The woman's ovaries are not producing progesterone. The epithelium covering the woman's ovaries is broken during the time of ovulation. The woman's ovaries do not synthesize or secrete luteinizing hormone (LH). The woman's ovaries are not producing new ova.

The woman's ovaries are not producing progesterone.

A 60-year-old woman who is 11 years menopausal has presented to the emergency department stating, "I haven't had my period in years, but lately I've been bleeding again, and quite heavily in the last few days." The care team needs to rule out endometrial cancer. How should they best explain the most accurate plan for confirming or ruling out the diagnosis? Question options: "We can do a Pap smear right now and we will get the results as soon as we can." "We are going to order blood work that will measure your hormone levels." "We're going to have to open your cervix with a speculum and take scrapings from the wall of your uterus." "We're going to book a CT scan for you as soon as possible so that we can see what is inside your uterus."

We're going to have to open your cervix with a speculum and take scrapings from the wall of your uterus."