Patho Exam 5
Which report by a middle-aged woman should prompt a care provider to assess for the possibility of ovarian cancer? -"I'm having a lot of vaginal discharge lately and it's quite foul." -"My periods have become quite irregular since last winter." -"I have had a sharp, stabbing pain on my side for the last few days." -"I'm having a lot of indigestion and bloating, which I've never had before."
"I'm having a lot of indigestion and bloating, which I've never had before."
A 39-year-old male client has been recently diagnosed with primary hypogonadism. Which lab result would be most indicative of this diagnosis? -Normal levels of free testosterone; low levels of total testosterone -Low free testosterone, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels -Low levels of gonadotropin-releasing hormone (GnRH) -Low testosterone levels; high levels of LH and FSH
Low testosterone levels; high levels of LH and FSH
A male client presents at the clinic with flulike symptoms and reports a weight loss of 10 pounds without trying. On physical examination, the client is found to have splenomegaly and large, tender, fluctuant inguinal lymph nodes. While taking the nursing history, it is discovered that the client prefers male sexual partners, and that 2 weeks ago the client had small, painless papules. What disease would the nurse suspect the client has? -Genital herpes -Chancroid -Syphilis -Lymphogranuloma venereum
Lymphogranuloma venereum
A 24-year-old male client with a complete transection of the spinal cord asks, "Will I be able to father children in the future?" The nurse responds: -Probably not since your spinal cord has been completely severed. -A urologist may be able to insert a needle into your testes and withdraw some sperm. -With proper stimulation of your genitals, you may be able to produce an erection and ejaculation. -It takes sympathetic innervation to produce an erection and ejaculation, which is lost with your type of injury.
With proper stimulation of your genitals, you may be able to produce an erection and ejaculation.
A postmenopausal client reports painful intercourse. Which information should the nurse provide the client? -"Decreased estrogen levels can lead to vaginal dryness after menopause which can lead to painful intercourse." -"Painful intercourse may be evidence of cervical cancer. When was your last pelvic examination done?" -"Painful intercourse is usually due to psychologic issues. Do you feel anxious about having intercourse?" -"Menopause leads to a thickening of the vaginal tissue which can lead to painful intercourse."
"Decreased estrogen levels can lead to vaginal dryness after menopause which can lead to painful intercourse."
A male college student has arrived at the student clinic complaining of tingling, itching, and pains in his groin. Upon inspection, the nurse notices some pustules and vesicles. While taking a detailed sexual history, the nurse should ask which question to rule out further complications? -"Do you get cold sores very often?" -"Do you have pain when you urinate or difficulty starting the stream?" -"Have you noticed excessive swelling in your scrotum the last few days?" -"Have you been experiencing flank pain and bloody urine?"
"Do you have any pain when you urinate or difficulty starting the stream?"
The nurse has taught a 30-year-old female client to perform breast self-evaluation (BSE). Which statement by the client indicates correct understanding? -"I will perform BSE on the first of every month during a shower." -"I will let my partner examine my breasts on a monthly basis." -"I will look in a mirror and call my doctor for breast asymmetry." -"I will palpate my breasts for lumps a few days after my period."
"I will palpate my breasts for lumps a few days after my period"
A client comes to the clinic and is diagnosed with genital herpes. Which statement by the client indicates that the nurse's teaching about management of the disease has been effective? -"I will use antibacterial ointment on the area to relieve the pain." -"I will use condoms for intercourse until the medication is all gone." -"I will take the acyclovir every 8 hours for the next week." -"I will need to take all of the medication to be sure the infection is cured."
"I will take the acyclovir every 8 hours for the next week."
A pregnant 23-year-old diagnosed with herpes simplex virus (HSV) is receiving prenatal care from her family physician. To prevent transmission of the virus to her baby, the physician will educate the client by making which statement? -"After your cesarean 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 vaginal delivery will be safe as long as intravenous antibiotics are given prior to, and during, labor." -"We'll have to book you a cesarean delivery in order to ensure your baby isn't exposed to the virus."
"If there aren't any visible lesions when you enter labor, a vaginal delivery will be safe to go ahead with."
A 50-year-old woman experiencing hot flashes and other menopausal symptoms asks the nurse about the benefits of the traditional Chinese use of dong quai. What is the nurse's best response? -"More research is needed on herbal remedies. Neither safety nor efficacy is guaranteed." -"Each woman needs to make a choice about using herbals based on her personal beliefs." -"You should not take herbal remedies but only the medications prescribed by your physician." -"There is no evidence that any herbal products can benefit women with these symptoms."
"More research is needed on herbal remedies. Neither safety nor efficacy is guaranteed."
The parents of a baby born with hypospadias ask the nurse if the baby can be circumcised. Which response by the nurse is most accurate? -"The circumcision will not be done now; the foreskin is needed for surgical repair." -"The condition can be treated with topical medication; circumcision is not needed." -"The circumcision will be done when the child reaches puberty." -"The circumcision can be performed now."
"The circumcision will not be done now; the foreskin is needed for surgical repair."
A 57-year-old woman has been diagnosed with atrophic vaginitis and has expressed 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? -"The lower levels of estrogen since you've begun menopause make your vagina prone to infection." -"Vaginitis is not usually the direct result of any single problem, but rather an inevitability of the vaginal dryness that accompanies menopause." -"This type of vaginitis is most commonly a symptom of a latent sexually transmitted infection that you may have contracted in the distant past." -"The exact cause of this problem isn't known, but it can usually be resolved with a diet high in probiotic bacteria."
"The lower levels of estrogen since you've begun menopause make your vagina prone to infection."
A 70-year-old male tells the health care provider he is now in a relationship with a younger woman who is capable of reproduction. The client asks if he may still be fertile. The best response would be: -"Yes, some 80- and 90-year-old men have been known to father children." -"No, fertility ends at 50 years of age." -"Why do you want children at your age?" -"Have you ever fathered a child before?"
"Yes, some 80- and 90-year-old men have been known to father children."
Which teaching point by an oncologist is most appropriate for a 33-year-old male who will begin treatment shortly for his testicular cancer? -"Thanks to new treatment advances, there's a very good chance that I won't have to remove a testicle." -"If steroid treatment fails, then we can consider surgery and/or chemotherapy." -"You should know that there might be adverse effects on your sexual function after treatment is finished." -"The advantage of performing an orchiectomy over other treatments is that it rules out recurrence."
"You should know that there might be adverse effects on your sexual function after treatment is finished."
A 20-year-old male has been diagnosed with testicular cancer and is seeking information about his diagnosis from a number of websites. Which statement that he has read is most plausible? -"Testicular cancer is a leading cause of death among males who should be in the prime of their life." -"Men with cryptorchidism — the term for an undescended testicle — are known to have a higher risk of developing testicular cancer." -"For most men with testicular cancer, bloody urine is their first sign that something is wrong." -"Recent developments in the treatment of testicular cancer mean that few men now need to have a testicle removed."
"men with crptorchidism-the term for an undescended testicl-are known to have a higher risk of developing testicular cancer."
Which woman is most likely to have a sexually transmitted infection as a contributing factor to her health problem? -A 29-year-old woman with a diagnosis of localized vulvodynia -A 40-year-old with is being treated for vaginal cancer -A 32-year-old who is undergoing diagnostics to rule out endometriosis -A 41-year-old with a diagnosis of mucopurulent cervicitis
A 41-year-old with a diagnosis of mucopurulent cervicitis
The nurse is counseling a group of perimenopausal and postmenopausal women about the pros and cons of hormone therapy (HT). Which member of the group should the nurse identify as likely to benefit most from HT while incurring the least risk? -A 49-year-old who is experiencing many menopausal symptoms -A 62-year-old who continues to have menopausal symptoms -A 58-year-old who no longer experiences symptoms of menopause -A 45-year-old who is perimenopausal with few symptoms of menopause
A 49-year-old who is experiencing many menopausal symptoms
A 40-year-old woman with gray, runny vaginal discharge that has a foul, fishy odor has been told that she most likely has vaginosis. Which phenomenon most likely contributed to her present condition? -Unprotected sex with a new partner who is a carrier of the relevant bacteria. -Autoinoculation from a cold sore, wart, or oral fungal infection. -A sharp reduction in the number of lactobacilli in the client's vaginal flora. -Proliferation of sexually transmitted protozoa.
A sharp reduction in the number of lactobacilli in the client's vaginal flora.
A female client's assessment identifies symptoms of dyspareunia and burning. The nurse is aware that the client may have developed: -Atrophic vaginitis -Adenomyosis -Endometrial cancer -Cystocele
Atrophic vaginitis
The anatomy of the prostate gland is made up of three concentric areas surrounding the prostatic urethra, into which they open. The nurse understands that an overgrowth of the mucosal glands can cause which disorder in older men? -Prostate cancer -Neoplasm cells of the prostate -Testicular cancer -Benign prostatic hyperplasia
Benign prostatic hyperplasia
Laboratory analysis of vaginal discharge identifies hyphae on microscopic exam and pH of 4.2. The client most likely has: -C. albicans -T. vaginalis -C. trachomatis -N. gonorrhoeae
C. albicans
A 71-year-old man has visited his family physician for a checkup, during which the physician has initiated a discussion about the client's sexual function. Which phenomenon is the physician most likely to consider a pathologic rather than an age-related change? -The presence of relative or absolute hypogonadism -A decrease in the size and firmness of the client's testes -Cessation of follicle-stimulating hormone (FSH) production -A decrease in the force of the man's ejaculation
Cessation of follicle-stimulating hormone (FSH) production
A client with polycystic ovary syndrome (PCOS) visits a fertility clinic. Which intervention will best improve the chance for a successful pregnancy? -Weight loss -Metformin -Clomiphene -Spironolactone
Clomiphene
A client arrives in the emergency department complaining of severe pain in the left testicular area with nausea and vomiting for 2 hours. The left testicle is large and tender to palpation and radiating to the inguinal area. Which of the following reflexes can the nurse assess the absence of to indicate testicular torsion? -Fluid wave -Superficial neurologic reflex -Abdominal reflex -Cremasteric reflex
Cremasteric reflex
A nurse monitors for side effects in a female client receiving endometriosis treatment with the gonadotropin-releasing hormone (GnRH) agonist leuprolide. Which adverse effect would be caused to limit duration of treatment? -Decreased bone density -Muscle spasms -Hot flashes and night sweats -Nosebleed and cough
Decreased bone density
An 18-year-old woman presents at the clinic complaining of new-onset breakthrough bleeding, even though she is taking contraceptives. What contraceptive use, along with new-onset breakthrough bleeding, has been associated with pelvic inflammatory disease? -Intrauterine device -Depo-Provera -Spermicidal foam -Diaphragm
Depo-Provera
A client has been diagnosed with an anterior pituitary tumor. Synthesis and release of follicle-stimulating hormone (FSH) has become deranged. What are the potential consequences of this alteration in endocrine function? -Dysfunction of spermatogenesis -Overproduction of luteinizing hormone -Inhibition of testosterone synthesis -Impaired detumescence
Dysfunction of spermatogenesis
If a male has a history of impaired blood flow in his vascular system, he may be prone to developing: -Premature ejaculation -Erectile dysfunction -Penile engorgement -Vascular clots in pudendal arteries
Erectile dysfunction
Which hormone replacement therapy was traditionally prescribed for a postmenopausal woman diagnosed with an intact uterus? -Estrogen and progesterone therapy -Estrogen therapy -Progesterone therapy -Androgen therapy
Estrogen and progesterone therapy
A pregnant client who is taking risperidone, an antipsychotic prescribed for bipolar disorder, is at high risk for developing which hormonal adverse effects? -Increased growth hormone production -Decreased human chorionic gonadotropin levels -Excess prolactin secretion -Decreased follicle-stimulating hormone secretion
Excess prolactin secretion
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? -For athletes who want to increase athletic ability -For bodybuilders who want bigger muscles -For aging men with low androgen levels -For teenagers who want to get big "faster"
For aging men with low androgen levels
A nursing student studying obstetrics asks the faculty, "How does the sperm get so much energy to swim up the fallopian tubes?" The instructor responds based on which pathophysiologic principle? -Usually the ejaculation is so powerful that it propels the sperm far up into the fallopian tubes. -Fructose is secreted by the seminal vesicles and provides energy for motility of the sperm. -The seminal vesicles secrete fluid for the semen, and they can secrete catecholamines that energize the sperm. -Estrogen that is being secreted when the ova are ripe and ready for penetration assists by attracting the sperm in the right direction.
Fructose is secreted by the seminal vesicles and provides energy for motility of the sperm.
A 55-year-old male has presented to the emergency department because he is alarmed at the genitourinary symptoms, he has experienced over the last several days. He reveals that he has had a few new sexual relationships during a tropical vacation that ended 5 days ago. Over the last several days, he has had increasing pain in his urethra and a creamy yellow discharge from his penis. For the last two days, the discharge has been occasionally blood tinged. What differential diagnosis would be the care team's priority? -Chancroid -Syphilis -Chlamydia -Gonorrhea
Gonorrhea
A client comes to the clinic and informs the nurse that he was playing soccer and was kicked in the scrotal area on the right side. The nurse observes that the scrotal skin on the right side is dark red. What should the nurse suspect, this client may have? -Spermatocele -Varicocele -Hematocele -Hydrocele
Hematocele
Select the factor that would increase a male's risk for the development of testicular cancer. -History of cryptorchidism -Exposure to ultraviolet A radiation -Occupational exposure to soot -Improper hygiene practices
History of cryptorchidism
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? -Human chorionic gonadotropin will be produced, preventing luteal regression. -The remaining primary follicles will provide hormonal support for the first 3 months of pregnancy. -The corpus luteum will atrophy and be replaced by corpus albicans. -The basal layer of the endometrium will be sloughed in preparation for implantation.
Human chorionic gonadotropin will be produced, preventing luteal regression.
In primary dysmenorrhea, when contraception is not desired, what is the treatment of choice? -Aspirin -Ibuprofen -Acetaminophen -Metformic acid
Ibuprofen
The ovaries secrete both estrogen and progesterone. What is one function of progesterone in the body? -Causes moderate retention of sodium and water -Increases body temperature at ovulation -Reduces levels of renin -Enhances the coagulability of blood
Increases body temperature at ovulation
A 15-year-old male client reports severe pain in the inguinal area and nausea. What action does the nurse take first? -Inspect the client's genitalia. -Assess the client's abdomen. -Request a prescription for antiemetic. -Request a prescription for analgesia.
Inspect the client's genitalia.
A 54-year-old diabetic client has come to the urology clinic complaining of erectile dysfunction. His history includes obesity, coronary artery disease which required bypass graft 3 years ago, hypertension, and gout. The nurse practitioner is reviewing his record to prescribe medication. The practitioner is considering prescribing sildenafil. Which home medication is contraindicated if taken concurrently with sildenafil? -Diltiazem, a calcium channel blocker -Amiodarone, an antiarrhythmic -Isosorbide mononitrate, a vasodilator -Furosemide, a diuretic
Isosorbide mononitrate, a vasodilator
The nurse assessing for signs and symptoms of perimenopause in a woman should assess for: -Menstrual irregularity -Cessation of menstruation -Decreased FSH level -Elevated estrogen levels
Menstrual irregularity
When counseling a client who is 3 months' pregnant and who recently went on a vacation to South America where she received several mosquito bites, the biggest complication the provider should prepare her for is delivering a child with which type(s) of defect? Select all that apply. -Bilateral hip dysplasia -Microcephaly -Eye concerns -Hearing problems -Spina bifida
Microcephaly Eye concerns Hearing problems
The nurse is conducting a community education program on menopause. Which condition will require medical follow-up? -Osteoporosis -Hypertrophic uterine -Pendulous breasts -Vaginal dryness
Osteoporosis
A 40-year-old black client is at increased risk of developing prostate cancer, because his father was diagnosed with the disease at age 60 and his brother at age 56. What diagnostic measures should be undertaken? -PSA and DRE starting before the age of 50 -Transrectal ultrasonography starting immediately -PSA and DRE starting at age 50 -Transrectal MRI starting at age 45
PSA and DRE starting before the age of 50
The nurse inserts a Foley catheter in an uncircumcised male client for the treatment of urinary retention and does not place the foreskin back over the glans penis. Several hours later, the client complains of severe pain at the catheter site and, when assessed, the nurse is unable to retract the foreskin. Which problem does the nurse know has occurred? -Phimosis -Hypospadias -Balanitis -Paraphimosis
Paraphimosis
A 75-year-old man presents at the clinic complaining of pain during intercourse and an upward bowing of his penis during erection. The client's history mentions an inflammation of the penis that was treated 3 months ago. The physician's physical examination of the client notes beads of scar tissue along the dorsal midline of the penile shaft. What would be the suspected diagnosis of this client? -Peyronie disease -Cavernosa disease -Balanitis -Paraphimosis disease
Pyronie disease
A 31-year-old client with breast cancer is concerned about being prescribed a hormonal medication to help block the effects of estrogen on the growth of breast cancer cells. The nurse should provide education about which likely medication? -Trastuzumab, a biologic therapy -Tamoxifen, a nonsteroidal antiestrogen -Progesterone, a hormone. -Anastrozole, an aromatase inhibitor.
Tamoxifen, a nonsteroidal antiestrogen
A male client is receiving testosterone for primary hypogonadism. What assessment would indicate successful treatment? -Testosterone level increases -LH and FSH levels are low -Sperm count 10 million/mL -Elevated gonadotropin-releasing hormone
Testosterone level increases
A nurse is inspecting the scrotum and testes of a 43-year-old male client. Which finding requires additional evaluation? -The skin on the scrotum is hard, taut, and shiny. -The left testicle hangs lower than the right testicle. -The scrotal skin has folds. -The testes move close to the body in cold temperatures.
The skin on the scrotum is hard, taut, and shiny.
A 40-year-old woman has been identified to have a deficiency in estrogen. Which physiologic phenomenon is most likely to remain unaffected? -Parathyroid hormone antagonism and the rate of bone resorption. -The regulation of uterine endothelial development. -The maintenance of normal skin and blood vessel structure. -The synthesis and release of adrenal glucocorticoids.
The synthesis and release of adrenal glucocorticoids.
A nurse practitioner is examining a female client who presents with symptoms of pain during intercourse. The nurse notes the presence of small hemorrhagic areas on the cervix. Based on this observation, which sexually transmitted infection does the nurse suspect? -Trichomoniasis -Chlamydia -Gonorrhea -Syphilis
Trichomoniasis
Select the condition that contributes to the risk of infertility in males. -Trichomoniasis -Chancroid -Genital warts -Herpes simplex
Trichomoniasis
An older adult man reports recent urinary hesitation and is eventually diagnosed with benign prostatic hyperplasia (BPH). Which clinical manifestations would the health care provider expect prior to the resolution of this health problem? -Urinary frequency and urgency and pain -Development of renal calculi and renal cysts -Unilateral hydronephrosis and pain -Development of glomerulonephritis or nephritic syndrome
Urinary frequency and urgency and pain
An older adult male client is complaining of dribbling after he urinates and feeling like he never empties his bladder. The nurse suspects the client may have a problem with: -kidney stones. -an enlarged prostate gland. -blood clots clogging the urethra. -calcium sediment in the bladder.
an enlarged prostate gland.
Which statement best captures an aspect of the role of progesterone? Progesterone: -production begins shortly after conception and peaks prior to delivery. -is responsible for the stimulation of lactation in the postpartum period. -levels peak after ovulation and is present throughout the menstrual cycle. -is the primary hormone responsible for the development of female secondary sex characteristics.
levels peak after ovulation and is present throughout the menstrual cycle.
A client with a yeast infection asks the nurse how clinicians diagnose this infection. The nurse will base her response knowing this is primarily diagnosed by: -the look and smell of the secretions. -looking at the spores on a wet-mount slide using 20% potassium hydroxide. -looking for lactobacillus species under the microscope. -sending a blood test to lab for DNA testing on the specimen.
looking at the spores on a wet-mount slide using 20% potassium hydroxide.
The cremaster muscles work in concert with the pampiniform plexus that surrounds the testicular artery to: -move the testes into the scrotum. -maintain testicular temperature. -empty fluid from the seminal vesicles into the genital ducts. -move sperm from the ampulla to the penis.
maintain testicular temperature
The nurse in the urology unit is teaching about medication to treat erectile dysfunction. The mechanism of action of most of these medications is that the medication: -promotes nerve signaling to penile vessels. -promotes trapping of blood in the corpora cavernosa. -promotes arousal by eliminating depression or other psychological factors. -promotes increase in blood flow to the corpora cavernosa.
promotes increase in blood flow to the corpora cavernosa.
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? -"Tight fitting undergarments are best so sperm cannot move around too much to become deformed." -"Only plain white undergarments are best. Chemicals from colored briefs may damage the sperm." -"Since you live in your clothing the better part of the day, tight-fitting underwear is a must to prevent scrotal movement." -"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."
"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."
The nurse is screening clients for risk factors associated with ovarian cancer. Which client has the greatest risk of developing ovarian cancer? -Age 25, no children, undergoing in vitro fertilization cycles -Age 35, four children, using oral contraceptives, no cancer history -Age 55, no children, postmenopausal, two sisters with breast cancer BRCA1 positive -Age 65, three children, postmenopausal, one aunt had ovarian cancer
Age 55, no children, postmenopausal, two sisters with breast cancer BRCA1 positive
