Ch. 39 Pathophysiology

After seeking care due to recent history of testicular enlargement and scrotal pain, a 22-year-old college student has been diagnosed with testicular cancer. Which of the client's following statements indicates the need for further teaching? A) "I can't shake this feeling like I've received a death sentence." B) "I have to admit that the prospect of losing a testicle is a bit overwhelming." C) "I really hope the cancer hasn't spread anywhere, because I've read that it's a possibility." D) "I guess there's some solace in the fact that this cancer wasn't a result of an unhealthy lifestyle."

A) "I can't shake this feeling like I've received a death sentence."

During physical exam of a newborn, the nurse palpates the scrotal sac and only locates one testicle. Which statement about undescended testicles is most accurate? A) "The child can become infertile later in life as a result of decreased sperm count." B) "This is more common in full-term infants when compared to premature births." C) "This may be a precursor to the development of prostate cancer later in life." D) "The child will need surgery to move the testes back into the scrotal sac since they rarely descend spontaneously."

A) "The child can become infertile later in life as a result of decreased sperm count."

Common risk factors associated with erectile dysfunction due to generalized penile arterial insufficiency include: A) Cryptorchidism B) Cigarette smoking C) Testicular torsion D) Benign prostate hypertrophy

B) Cigarette smoking

Which of the following diagnoses is most likely to require surgical correction? A) Hypospadias B) Orchitis C) Erectile dysfunction D) Spermatocele

A) Hypospadias

A client has been diagnosed with an anterior pituitary tumor, and synthesis and release of follicle-stimulating hormone has become deranged. What are the potential consequences of this alteration in endocrine function? A) Dysfunction of spermatogenesis B) Overproduction of luteinizing hormone C) Inhibition of testosterone synthesis D) Impaired detumescence

A) Dysfunction of spermatogenesis

Which of the following clinical manifestations are characteristic for clients with Peyronie disease? Select all that apply. A) Painful erection B) Thick, yellow discharge from the penis C) Presence of a hard mass on the tunica albuginea of the penis D) Papillary lesions on penis filled with serous-colored fluid E) Thick, nonretractable foreskin of uncircumcised male

A) Painful erection C) Presence of a hard mass on the tunica albuginea of the penis

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) Circumcision

Which of the following physiologic processes results from the synthesis and release of testosterone? A) Protein catabolism B) Musculoskeletal growth C) Release of luteinizing hormone (LH) D) Prostatic hyperplasia

B) Musculoskeletal growth

Which of the following 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) 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.

An elderly male client has been diagnosed with prostate cancer. However, because he has a history of heart failure with an ejection fraction of 20% and chronic obstructive pulmonary disease due to many years of smoking, the client is not a candidate for major surgery. Which of the following treatments should the nurse anticipate being utilized for this client? A) Transurethral prostatectomy (TURP) that only utilizes epidural blocks and small amounts of Versed and Fentanyl B) Stent placed to widen and maintain the patency of the urethra C) Teaching the client how to perform a straight catheterization every time they feel the need to empty their bladder D) Brachytherapy inserted into the penis and instilled into the prostate tissue

B) Stent placed to widen and maintain the patency of the urethra

Which of the following assessments is most likely to reveal a potential exacerbation in a 70-year-old client's diagnosis of benign prostatic hyperplasia (BPH)? A) Urine testing for microalbuminuria B) Blood test for white blood cells and differential C) Digital rectal examination D) Sperm morphology testing

C) Digital rectal examination

Which of the following clients is at greatest risk for developing balanitis xerotica obliterans? A) A homosexual male with a monogamous partner B) A client who has had their pituitary gland removed due to cancer C) A male who has an uncircumcised penis D) A middle-aged male with history of chronic prostatitis

C) A male who has an uncircumcised penis

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

C) A sixth grade male returning to school following sickle cell crisis D) A college student with complete spinal cord injury at T12 level following auto accident

Which of the following clients is at high risk for developing acute bacterial prostatitis? A) A middle-aged male with prostate hyperplasia B) A fifth grade male diagnosed with acute pyelonephritis C) An elderly male diagnosed with frequent UTIs testing positive for gram-negative rods D) A sickle cell anemia client complaining of prolonged erection lasting less than 4 hours

C) An elderly male diagnosed with frequent UTIs testing positive for gram-negative rods

Which of the following statements about screening for prostate cancer is most accurate? A) Digital rectal examination detects the majority of new cases of prostate cancer. B) A positive prostate-specific antigen (PSA) test is definitive for prostate cancer. C) BPH and prostatitis can confound prostate screening results. D) Digital rectal examination and PSA testing have been proven ineffective.

C) BPH and prostatitis can confound prostate screening results.

A client comes to the college campus nurse complaining of unilateral pain, swelling, and redness on his scrotal area. The nurse knows these clinical manifestations are likely caused by: A) Syphilis B) Testicular torsion C) Epididymitis D) Ticks bites

C) Epididymitis

Which of the following disorders of the male genitourinary system creates the most urgent need for prompt and aggressive surgical treatment? A) Spermatocele B) Benign prostatic hyperplasia (BPH) C) Intravaginal testicular torsion D) Erectile dysfunction

C) Intravaginal testicular torsion

While discussing the physiological process behind penile erection, the anatomy and physiology instructor mentions that what substance is released to facilitate smooth muscle relaxation and shunting of blood into the sinusoids? A) Norepinephrine B) Nitroglycerine C) Nitric oxide D) Nicotinic acid

C) Nitric oxide

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 Lasix 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) Order an ultrasound or biopsy to rule out testicular cancer.

Squamous cell cancer of the penis is characterized by which of the following clinical manifestations? A) Erectile dysfunction with prolonged erection B) Herpes ulcerations on the penile shaft C) Painless lump on the inner surface of the prepuce D) Smegma accumulation in uncircumcised male requiring regular reminders about hygiene

C) Painless lump on the inner surface of the prepuce

. A 30-year-old man has been diagnosed with mumps orchitis. The nurse should educate the client that which of the following complications may occur? A) Erectile dysfunction B) Hematocele formation C) Sterility D) Penile atrophy

C) Sterility

When evaluating a client with suspected benign prostatic hypertrophy (BPH), the health care worker should collect data related to which of the following signs/symptoms? Select all that apply. A) Frequency of erectile dysfunction B) Enlarged inguinal lymph nodes C) Urinary frequency issues D) Weak urine stream E) Straining to empty the bladder

C) Urinary frequency issues D) Weak urine stream E) Straining to empty the bladder

Men older than age 50 are at high risk for prostatic hypertrophy with complications that include: A) Hypospadias B) Scrotal edema C) Urine retention D) Testicular cancer

C) Urine retention

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) "Sperm can no longer pass through the ductus deferens."

A client arrives in the emergency department complaining of severe testicular pain associated with nausea and vomiting. Their pulse rate is 120 beats/minute. 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) Testicular torsion