PrepU ch.26 assessing male genitalia
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 Explanation: 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. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 6th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 26: Assessing Male Genitalia and Rectum, p. 625. Chapter 26: Assessing Male Genitalia and Rectum - Page 625
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) Explanation: 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. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 6th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 26: Assessing Male Genitalia and Rectum, p. 608. Chapter 26: Assessing Male Genitalia and Rectum - Page 608
The nurse is assessing male genitalia and finds clusters of pimple-like clear vesicles. The nurse recognizes this as what? a.Herpes b.Syphilis c.Gonorrhea d.Chlamydia
a. Herpes Explanation: Herpes is associated with clusters of pimple-like clear vesicles. Gonorrhea has drainage. Syphilis has a chancre. Chlamydia is asymptomatic. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 6th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 26: Assessing Male Genitalia and Rectum, p. 619. Chapter 26: Assessing Male Genitalia and Rectum - Page 619
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 Explanation: 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. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 6th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 26: Assessing Male Genitalia and Rectum, p. 619. Chapter 26: Assessing Male Genitalia and Rectum - Page 619
A young homosexual client who is currently HIV negative tells the nurse that he is worried about contracting AIDS someday. What teaching would be appropriate for this client? a.Safe-sex practices and proper use of condoms b.Conversion therapy to heterosexuality c.Antiviral drugs used to fight AIDS d.New AIDS treatments in case the client contracts HIV
a. Safe-sex practices and proper use of condoms Explanation: A goal is to reduce the number of new AIDS cases among adolescent and adult men who have sex with men. To accomplish this goal, the nurse would teach safe-sex practices, including condom use. It would be inappropriate for the nurse to discuss any attempts to change the client's sexual orientation. Discussion of AIDS treatments would not be as helpful as taking action to help prevent the client from ever contracting the illness. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 6th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 26: Assessing Male Genitalia and Rectum, p. 614. Chapter 26: Assessing Male Genitalia and Rectum - Page 614
Upon inspection and palpation of the scrotum, the nurse discovers a mass. The nurse asks the client to lie down, and the bulge remains. On auscultation, the nurse finds bowel sounds. The nurse should document this finding as which type of hernia? a.Scrotal b.Incarcerated c.Strangulated d.Femoral
a. Scrotal Explanation: The nurse should document this finding as scrotal hernia if the bulge remains when the client lies down and bowel sounds can be auscultated over it. If the mass in the scrotum cannot be pushed into the abdomen, it could be an incarcerated hernia. A hernia is strangulated if the blood supply is cut off. A bulge or mass on the front of the thigh in the femoral canal area is a femoral hernia. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 6th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 26: Assessing Male Genitalia and Rectum, p. 621. Chapter 26: Assessing Male Genitalia and Rectum - Page 621
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 Explanation: Any client with scrotal pain should be presumed to have testicular torsion until another diagnosis can be proven. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 6th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 26: Assessing Male Genitalia and Rectum, p. 609. Chapter 26: Assessing Male Genitalia and Rectum - Page 609
An adult male client comes to the clinic for his annual physical examination. During the nursing assessment, the nurse asks, "Do you have any current or chronic illnesses such as diabetes, hypertension, respiratory problems, or cardiovascular disease?" Why does the nurse ask this question? a.To assess risk for erectile dysfunction b.To refer the client to a pulmonologist c.To assess risk for limited range of motion d.To determine the need for involvement from an internist
a. To assess risk for erectile dysfunction Explanation: Men with diabetes, hypertension, neurologic respiratory problems, or cardiovascular disease are at increased risk for erectile dysfunction. The other options are not related to health related issues. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 6th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 26: Assessing Male Genitalia and Rectum, p. 610. Chapter 26: Assessing Male Genitalia and Rectum - Page 610
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 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. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 6th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 26: Assessing Male Genitalia and Rectum, p. 631. Chapter 26: Assessing Male Genitalia and Rectum - Page 631
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 Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 6th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 26: Assessing Male Genitalia and Rectum, p. 629. Chapter 26: Assessing Male Genitalia and Rectum - Page 629
The inguinal canal in a male client is located... a.just above and parallel to the inguinal ligament. b.anteriorly above the symphysis pubis. c.anterior to the external inguinal ring. d.posterior to the superior iliac ring.
a. just above and parallel to the inguinal ligament. Explanation: The internal inguinal ring is the internal opening of the inguinal canal. It is located 1 to 2 cm above the midpoint of the inguinal ligament and cannot be palpated. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 6th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 26: Assessing Male Genitalia and Rectum, p. 607. Chapter 26: Assessing Male Genitalia and Rectum - Page 607
Which client should a nurse recognize has the highest risk to develop prostate cancer? a.35-year-old African American male with a diet high in fat b.65-year-old Caucasian male whose father had prostate cancer at age 55 c.70-year-old Asian male who is not circumcised and eat a low fat diet d.60-year-old male who works in a tire and rubber manufacturing plant
b. 65-year-old Caucasian male whose father had prostate cancer at age 55 Explanation: Age, African American race, and having a bother or father who was diagnosed with prostate cancer before the age of 60 are the greatest risk factors. Therefore, the older male with a first-degree relative has the highest risk. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 6th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 26: Assessing Male Genitalia and Rectum, p. 611. Chapter 26: Assessing Male Genitalia and Rectum - Page 611
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 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. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 6th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 26: Assessing Male Genitalia and Rectum, p. 611. Chapter 26: Assessing Male Genitalia and Rectum - Page 611
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? a.Orchitis b.Cryptorchidism c.Epididymitis d.Hydrocele
b. 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: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 6th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 26: Assessing Male Genitalia and Rectum, p. 631. Chapter 26: Assessing Male Genitalia and Rectum - Page 631
A client presents to the health care clinic with reports of clay-colored stool. The nurse recognizes that this finding is most likely a result of which of the following? a.Gastrointestinal bleeding b.Lack of bile pigment c.Increased fat content d.Cancer of the colon
b. Lack of bile pigment Explanation: Clay-colored stool results from the lack of bile pigment. Black stools may indicate gastrointestinal bleeding in this client who has not been receiving iron supplements or taking Pepto-Bismol. Yellow stool suggests increased fat content or steatorrhea. Cancer of the rectum or colon may be indicated by blood detected in the stool. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 6th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 26: Assessing Male Genitalia and Rectum, p. 610. Chapter 26: Assessing Male Genitalia and Rectum - Page 610
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. Explanation: 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. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 6th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 26: Assessing Male Genitalia and Rectum, p. 632. Chapter 26: Assessing Male Genitalia and Rectum - Page 632
A 29-year-old married computer programmer comes to the clinic complaining of "something strange" going on in his scrotum. Last month while he was doing his self-testicular examination he felt a lump in his left testis. He waited a month and felt the area again but the lump was still there. He has had some aching in his left testis but denies any pain with urination or sexual intercourse. He denies any fever, malaise, or night sweats. His past medical history consists of groin surgery when he was a baby and a tonsillectomy as a teenager. He eats a healthy diet and works out at the gym five times a week. He denies any tobacco or illegal drugs and drinks alcohol occasionally. His parents are both healthy. Examination shows a muscular healthy young man with unremarkable vital signs. On visualization the penis is circumcised with no lesions; there is a scar in his right inguinal region. There is no lymphadenopathy. Palpation of his scrotum is unremarkable on the right but has a large mass on the left. While placing a finger through the inguinal ring on the right, the examiner asks the client to bear down. Nothing is felt. The examiner attempts to place a finger through the left inguinal ring but cannot get above the mass. On rectal examination the client's prostate is unremarkable. What disorder of the testes is most likely? a.Hydrocele b.Scrotal hernia c.Scrotal edema d.Varicocele
b. Scrotal hernia Explanation: Scrotal hernias occur when the small intestine passes through a weak spot of the inguinal ring. The examiner cannot get a finger above the hernia into the ring. Hernias are often caused by increased abdominal pressure such as in weight lifting. Clients who have a hernia on one side often have another hernia on the opposite side. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 6th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 26: Assessing Male Genitalia and Rectum, p. 621. Chapter 26: Assessing Male Genitalia and Rectum - Page 621
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 Explanation: 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. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 6th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 26: Assessing Male Genitalia and Rectum, p. 612. Chapter 26: Assessing Male Genitalia and Rectum - Page 612
How should a nurse proceed with palpation of the anus to best facilitate the exam without causing the client undo discomfort? a.Use the fingertips of one hand because they are the smallest part of the finger b.Use gentle but firm force to push past the sphincter into the anal canal c.Ask the client to bear down and place the lubricated finger on the anal opening d.Spread the gluteal folds with the hands and attempt to visualize the anal opening
c. Ask the client to bear down and place the lubricated finger on the anal opening Explanation: The nurse should lubricate the index finger of the gloved hand and ask the client to bear down. As the client bears down, place the pad of the index finger on the anal opening. When the sphincter relaxes, insert the finger with the pad facing down. Do not use the fingertip because this may cause the sphincter to tighten and this will cause pain when placed into the rectum. Spread the gluteal folds with the hands and attempt to visualize the anal opening is necessary if the client reports severe pain in order to see if there is a lesion present. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 6th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 26: Assessing Male Genitalia and Rectum, p. 623. Chapter 26: Assessing Male Genitalia and Rectum - Page 623
A client has undergone a digital rectal examination. This assessment will allow the clinician to diagnose which of the following? a.Urinary incontinence b.ED c.BPH d.Testicular cancer
c. BPH Explanation: A rubbery or boggy glandular consistency may indicate BPH, a common finding in men older than 60 years of age. The gland may feel soft, tender, and boggy from infection. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 6th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 26: Assessing Male Genitalia and Rectum.
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 Explanation: 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 gastrointestinal tract in response to distension of the tract following consumption of food and drink. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 6th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 26: Assessing Male Genitalia and Rectum, p. 606. Chapter 26: Assessing Male Genitalia and Rectum - Page 606
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 Explanation: 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. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 6th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 26: Assessing Male Genitalia and Rectum, p. 619. Chapter 26: Assessing Male Genitalia and Rectum - Page 619
A nurse prepares a male client for a physical assessment of the external genitalia. Which instruction is appropriate for the nurse to give the client before the examination? a.Ask the client to not empty the bladder before the examination b.Explain that he may need to lie supine c.Reassure him that it is not unusual to have an erection during the examination d.Request that the client avoid talking
c. Reassure him that it is not unusual to have an erection during the examination Explanation: The nurse should reassure the client that it is not unusual to have an erection during the examination; this will avoid unnecessary embarrassment in the client. The nurse should ask the client to empty the bladder before the examination so that he will be comfortable during the examination. The client should be informed that he may need to stand for most of the examination. The nurse should encourage the client to ask questions during the examination, and, at the same time, ease the client's anxiety by explaining in detail the significance of each portion of the examination. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 6th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 26: Assessing Male Genitalia and Rectum, p. 617. Chapter 26: Assessing Male Genitalia and Rectum - Page 617
A 15-year-old high school football player comes to the office with his mother. He complains of severe testicular pain since 8:00 this morning. He denies any sexual activity and states that it hurts so bad he can't even urinate. He is nauseated and vomiting. He denies any recent illness or fever. Past medical history is unremarkable. He denies any tobacco, alcohol, or drug use. His parents are both in good health. Examination shows a young teenager lying on the bed with an emesis basin. He is very uncomfortable and keeps shifting his position. Blood pressure is 150/100, pulse is 110, and respirations are 24. On visualization of the penis he is circumcised; there are no lesions or discharge from the meatus. Scrotal skin is tense and red. Palpation of the left testicle causes severe pain and causes the client to cry. His prostate examination is unremarkable. His cremasteric reflex on the left is absent but normal on the right. Catheterization is necessary to get a urine sample, the analysis of which is unremarkable. The boy is admitted to the emergency department of a nearby hospital for further workup. What is the most likely cause of this young man's symptoms? a.Acute orchitis b.Acute epididymitis c.Torsion of the spermatic cord d.Prostatitis
c. Torsion of the spermatic cord Explanation: Torsion is caused by twisting of the testicle on its spermatic cord and blood vessels, leading to severe pain. The scrotum becomes red and tense. Torsion is usually seen in adolescents and is a true surgical emergency. If not quickly surgically repaired, the testicle's function is lost and it has to be removed. Presence of a cremasteric reflex is reassuring, but in this case a thorough evaluation must take place as soon as possible. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 6th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 26: Assessing Male Genitalia and Rectum, p. 631. Chapter 26: Assessing Male Genitalia and Rectum - Page 631
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. Explanation: Absence of a testis suggests cryptorchidism (an undescended testicle). Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 6th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 26: Assessing Male Genitalia and Rectum, p. 620. Chapter 26: Assessing Male Genitalia and Rectum - Page 620
Francis is a middle-aged man who noted right sided lower abdominal pain after straining with yardwork. Which of the following findings would make a hernia a more likely diagnosis? a.Absence of pain with straining b.Absence of bowel sounds in the scrotum c.Absence of a varicocele d.Absence of symmetry of the inguinal areas with straining
d. Absence of symmetry of the inguinal areas with straining Explanation: Even in the presence of a hernia, absolute symmetry to inspection may be preserved. The actions of straining and increasing intra-abdominal pressure cause the hernia to protrude. Hernias will not necessarily be present on CT scans unless this maneuver is undertaken. Pain with straining and bowel sounds heard in the scrotum further support the diagnosis of indirect hernia. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 6th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 26: Assessing Male Genitalia and Rectum, p. 632. Chapter 26: Assessing Male Genitalia and Rectum - Page 632
The nurse is preparing an instructional session for male clients about preventing penile cancer. Which non-modifiable risk factor should the nurse include in the teaching? a.Poor personal hygiene b.History of human papilloma virus c.Sexual promiscuity d.Age 60 years or older
d. Age 60 years or older Explanation: Age is not a modifiable risk factor for penile cancer. Phimosis, poor personal hygiene, sexual promiscuity, using tobacco products, and HPV are all modifiable risk factors for penile cancer. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 6th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 26: Assessing Male Genitalia and Rectum, p. 615. Chapter 26: Assessing Male Genitalia and Rectum - Page 615
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 Explanation: 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. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 6th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 26: Assessing Male Genitalia and Rectum, p. 633. Chapter 26: Assessing Male Genitalia and Rectum - Page 633
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 Explanation: 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. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 6th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 26: Assessing Male Genitalia and Rectum, p. 622. Chapter 26: Assessing Male Genitalia and Rectum - Page 622
The nurse is documenting current health concerns during the health history of an older adult male client. Identification of what may help most at this time? a.Number of sexual partners b.Number of sexually transmitted infections c.Sexual preference d.Previous problems
d. Previous problems Explanation: Identification of previous problems may help when documenting current health concerns. The other options would not be helpful in documenting current health concerns. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 6th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 26: Assessing Male Genitalia and Rectum, p. 608. Chapter 26: Assessing Male Genitalia and Rectum - Page 608
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 Explanation: 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. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 6th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 26: Assessing Male Genitalia and Rectum, p. 625. Chapter 26: Assessing Male Genitalia and Rectum - Page 625
The nurse suspects that a male client may have a hernia. The nurse should further assess the client for... a.bruising at the site. b.urinary tract infection. c.cysts at the spermatic cord. d.bowel sounds at the bulge.
d. bowel sounds at the bulge. Explanation: Bowel sounds auscultated over the mass indicate the presence of bowel and thus a scrotal hernia. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 6th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 26: Assessing Male Genitalia and Rectum, p. 621. Chapter 26: Assessing Male Genitalia and Rectum - Page 621
A client visits the clinic and tells the nurse that her stools have been black for the past 3 days. The nurse should assess the client for... a.gallbladder disease. b.colitis. c.polyps. d.gastrointestinal bleeding.
d. gastrointestinal bleeding. Explanation: Black stools may indicate gastrointestinal bleeding. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 6th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 26: Assessing Male Genitalia and Rectum, p. 610. Chapter 26: Assessing Male Genitalia and Rectum - Page 610
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. Explanation: 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. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 6th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 26: Assessing Male Genitalia and Rectum, p. 607. Chapter 26: Assessing Male Genitalia and Rectum - Page 607
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. Explanation: Difficulty urinating may indicate an infection or blockage, including prostatic enlargement. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 6th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 26: Assessing Male Genitalia and Rectum, p. 609. Chapter 26: Assessing Male Genitalia and Rectum - Page 609
