Reproductive Disorders - PrepU

While working with a client with a fairly recent spinal cord injury, the partner asks about the couple's ability to maintain a sexual relationship. Which response by the nurse is most accurate?

"If the parasympathetic impulses can pass from the sacral segments of spinal cord through pelvic nerves, an erection should be possible."

A male client has been involved in a severe accident that has caused a complete transection of his spinal cord. The client's wife is concerned about their ability to become pregnant. Which response relating to childbearing and spinal cord injury is most accurate?

"Some men with complete transection of the spinal cord are able to produce an erection and ejaculation with genital stimulation." Genital stimulation can produce erection and ejaculation in some men with complete transection of the spinal cord.

Which clients are at high risk for developing priapism? Select all that apply. A teenage cocaine abuser who has been "high" for the past 72 hours An uncircumcised male with poor hygiene habits A sixth-grade male returning to school following sickle cell crisis A college student with complete spinal cord injury at T12 level following auto accident A middle-aged adult male with recent history of myocardial infarction

- A sixth-grade male returning to school following sickle cell crisis - A college student with complete spinal cord injury at T12 level following auto accident Priapism is due to impaired blood flow in the corpora cavernosa of the penis. Priapism is classified as primary (idiopathic) or secondary to a disease or drug effect. Secondary causes include hematologic conditions (e.g., leukemia, sickle cell disease, polycythemia), neurologic conditions (e.g., stroke, spinal cord injury), and renal failure.

What is a primary intervention for the nurse to implement for a client with pelvic inflammatory disease ?

Administer antibiotic therapy. While laparoscopy can provide definitive diagnosis, cases are usually diagnosed on symptomatology. Antibiotic therapy is usually sufficient for treatment. The client does not need a hysterectomy or IV pain medication.

A male client has experienced a forceful hit to the testes. The nurse expects that the sensory nerves that transmit pain impulses are associated with which nervous system?

Autonomic nervous system The testes are innervated by fibers from both divisions of the autonomic nervous system. Associated sensory nerves transmit pain impulses, resulting in excruciating pain, especially when the testes are hit forcibly.

Epididymitis can be sexually transmitted, or it can be caused by a variety of other reasons, including abnormalities in the genitourinary tract. What are the most common causes of epididymitis in young men without underlying genitourinary disease?

Chlamydia trachomatis and Neisseria gonorrhoeae Sexually transmitted acute epididymitis occurs mainly in young men without underlying genitourinary disease and is most commonly caused by Chlamydia trachomatis and Neisseria gonorrhoeae. Candida albicans and Escherichia coli are not the most common causes of epididymitis in young men without underlying genitourinary disease.

A 45-year-old client reports "needing to bear down with urination," frequency, and occasional loss of urine when coughing. Based on symptoms, which diagnosis is most appropriate for this client?

Cystocele The symptoms described are commonly found with cystocele, which is the herniation of the bladder into the vagina resulting in urinary symptoms. The bear-down sensation is common in this disorder and not found in the other disorders. Rectocele is the herniation of the rectum into the vagina. Enterocele can be asymptomatic or cause a dull, dragging sensation and occasionally low backache. Spermatocele is a male disorder.

The endocrine system is highly involved in the female reproductive system. Which hormones are used to stimulate the primordial follicles?

FSH and LH After puberty, the pituitary gonadotropic hormones—follicle stimulating hormone (FSH) and luteinizing hormone (LH)—stimulate the primordial follicles to develop into mature Graafian follicles. The Graafian follicle produces estrogen, which begins to stimulate the thickening of the endometrium in the uterus.

The nurse is caring for a client with lichen simplex chronicus. What assessment finding does the nurse expect?

Gray-white plaques with an irregular surface Lichen simplex chronicus presents as thickened gray white plaques with an irregular surface. It is thought to be a response of the genital skin to some type of irritant. Bleeding, pain, and black patches are not seen with this disorder.

A school nurse is providing an informational session about the prevention of cervical cancer in young girls and women. The most important information for the nurse to present would be:

HPV vaccine before becoming sexually active Two types of HPV vaccines are currently available to prevent HPV infection: a quadrivalent vaccine to prevent infection by HPV subtypes 16, 18, 6, and 11 and a bivalent vaccine to prevent infection by subtypes 16 and 18. The quadrivalent vaccine has been approved for females and males between the ages of 9 and 26 years, optimally before initiation of sexual activity. Abstinence and condoms may help, but the vaccine is recommended.

The nurse is assessing a client with a collection of blood in the tunica vaginalis of the scrotum. How does the nurse correctly document this in the medical record?

Hematocele Disorders of the scrotum and testes include collection of fluid (hydrocele), blood (hematocele), or sperm (spermatocele) in the tunica vaginalis; another disorder involves varicosities of the veins in the pampiniform venous plexus (varicocele).

A female client is being seen in the ED with complaints of lower abdominal pain, dyspareunia, back pain, purulent cervical discharge, and the presence of adnexal tenderness and painful cervix on bimanual pelvic examination. The nurse suspects the client has pelvic inflammatory disease (PID), and will assess the client for:

Number of sexual partners

A female client presents to her primary care physician with a report of very heavy bleeding during menstrual cycles. Tests indicate the condition is not from a hormone imbalance. Which intervention option is least invasive?

Oral contraceptives The least invasive treatment options for non hormonal causes of excessive menstrual bleeding include oral contraceptives, cyclic progesterone therapy, or long-acting progesterone injection. Endometrial ablation is more invasive and eliminates the basement layer of the endometrium through use of heat, cold, microwaves, chemicals, or radiofrequency energy sources. D&C is a surgical scraping of the uterine lining. A hysterectomy, whether vaginal or abdominal, is the most invasive procedure to eliminate uterine bleeding.

The nurse is caring for a 34-year-old woman undergoing treatment for large endometrial lesions. What interventions should the nurse anticipate providing the client?

Providing pain control; preparing the client for a laparoscopic procedure or hysterectomy. Pain control is central to treatment of endometriosis and surgical treatment is ideally performed laparoscopically, though hysterectomy is sometimes indicated. Bleeding is not a common symptom of endometriosis, and neither corticosteroids nor male androgens are common treatments.

The pediatric nurse is teaching the parent of a newborn with hypospadias about the disorder. Which information does the nurse provide?

The opening of the urethra is found on the underside of the penis. In hypospadias, which affects approximately 1 in 350 male newborns, the termination of the urethra is on the ventral or underside surface of the penis.There is no medication for the condition and treatment is surgical, if required. It is normal for a newborn's foreskin to not retract and this should not be attempted. Over a period of about 5 years, the foreskin gradually becomes retractable. Undescended testes (cryptorchidism) is not associated with hypospadias.

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 in order to indicate testicular torsion?

cremaster reflex

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?

Testosterone In the male embryo, testosterone is essential for the appropriate differentiation of the internal and external genitalia and it is necessary for descent of the testes in the fetus.

An obstetrician is explaining the differentiation of embryonic tissue into a fetus to an aspiring class of nursing students. Which hormone is primarily responsible for the development of male sex characteristics?

Testosterone Testosterone is the most abundant and most active of these hormones. In the male embryo, testosterone is essential for the appropriate differentiation of the internal and external genitalia. Testosterone also is the precursor of dihydrotestosterone (DHT), which functions in the formation of the male urethra, prostate, and external genitalia. Androstenedione and DHEA exert only weak androgenic activity, but their main purpose is to act as a key precursor for testosterone after peripheral conversion.

Which statements regarding prostate cancer are true? Select all that apply.

- Prognosis has improved because of PSA diagnostic screenings. - Black males are at highest risk for developing the disease. - Age is a risk factor of this cancer.

A female client, age 35, reports finding a firm rubbery mass in her breast. Which additional findings will support the diagnosis of fibroadenoma? Select all that apply.

- The mass is round. - The mass changes size with menses. - The mass is freely movable. Fibroadenomas are a noncancerous type of growth that occurs in premenopausal women during their third or fourth decade. The mass is round, rubbery, firm, sharply defined, and slides freely through the fingers on palpation. The lesion is not painful and is often found by accident. Multiple lesions are uncommon. Fibrocystic breast lesions change size in response to the hormones of the menstrual cycle.