Health Alterations Unit 9 (Disorders of Genitourinary and Reproductive Function
The nurse is caring for a client with recurrent balanoposthitis. The nurse should teach the client about what possible complications of this condition?
Narrowing of the urethra Penile cancer Sexual dysfunction
A client requests a prescription for sildenafil to assist him with achieving and maintaining an erection. Which type of medication would contraindicate the use of sildenafil?
Nitrate
A newly pregnant woman reports to the nurse that her breasts are excessively tender and that her areolae and nipples are becoming darker and more prominent. The nurse should describe which cause of these changes?
Normal changes of pregnancy due to increased levels of estrogen and progesterone
The prostate gland functions in the elimination of urine. The nurse knows that the prostate gland if enlarged can cause which dysfunction of the urinary system?
Obstruction
A 27-year-old male developed mumps and was ill for several days. The client suddenly developed a fever and painful enlargement of the testes approximately 4 days after recovering. The nurse should suspect that the client has developed:
Orchitis
The nurse providing teaching about the female reproductive system includes which principle?
Ovaries are responsible for ovulation and hormone production.
The nurse knows that which structures are a part of the male reproductive system?
Pair of gonads Seminiferous tubules Prostate gland
The nurse is caring for a client with acute superficial balanoposthitis. The nurse assesses for which of these signs or symptoms consistent with the diagnosis?
Redness of the glans penis and malodorous discharge
Sperm production occurs in the seminiferous tubules. The nurse understands the anatomy of the testes and knows that as the tubules lead into the efferent ducts, the seminiferous tubules become which structure?
Rete testis
Which statements are accurate when it comes to changes in the male reproductive system as one ages?
Sexual energy levels decrease as one ages, with decreasing testosterone levels. The testes become smaller and lose their firmness. The prostate gland enlarges with age.
Which factor in the evaluation and treatment of benign prostatic hyperplasia (BPH) is considered to be the single most important one?
Subjective symptoms reported by the client
Primary hypogonadism can occur as a result of which physical abnormality?
Testicular failure due to a problem in the testes
The causes of infertility can be in either the male or the female. Male tests for infertility require a specimen of ejaculate that is collected when?
After 3 days of abstinence
A male client seeks treatment for erectile dysfunction. What factors contribute to this condition?
Age 65 years Cardiovascular disease Antihypertensive medications
A nurse is performing a genital examination on a 25-year-old male client. The nurse notes pigmented, wrinkled scrotal skin. Based on this information, what should the nurse do next?
Consider this a normal finding and proceed with the examination.
A couple is undergoing initial testing to determine why they are unable to conceive. One of the tests shows that the man has a testosterone level of 198.8 ng/dL (6.9 nmol/L). The man reports being tired all the time. The woman is completely healthy. Which problem is most likely?
Hypogonadism
The nurse assesses the client upon admission to the hospital. He states that he has been losing facial and body hair, has been fatigued and depressed, and has erectile dysfunction and a decreased libido. The nurse understands these symptoms to occur with which disorder?
Hypogonadism
The nurse in the urology clinic is reviewing the chart of a client with erectile dysfunction. Which factor in the client's history does the nurse recognize is a hormone-based condition that may contribute to erectile dysfunction?
Hypogonadism
The nurse is performing a newborn assessment on a 2-day-old male infant. Assessment reveals the presence of the urethral opening on the ventral side of the penis. The nurse would document this finding as being:
Hypospadias
Which diagnosis is most likely to require surgical correction?
Hypospadias
A client calls the clinic and informs the nurse that he has sustained an erection for 3 hours and that it is extremely painful. The client has a history of sickle cell disease and this has not happened to him in the past. Which instruction should the nurse give to the client?
If the client does not seek medical attention, impotence may result.
An older male client complains of inhibited sexual functioning. The nurse knows which nursing diagnosis could be a priority for his inhibited sexual function?
Impaired self-esteem
An adult male has been diagnosed with mumps orchitis. The nurse should educate the client regarding which complication associated with mumps orchitis?
Impaired spermatogenesis
Which clinical manifestations in an aging male client are due to decreased levels of testosterone?
Infertility Decreased testicular size Decreased sexual energy
The community health nurse is conducting a men's health class. Which of these does the nurse relate as the major role of the prostate?
It increases sperm motility.
Which causes can result in primary gonadal failure?
Klinefelter syndrome Cryptorchidism Trauma Mumps
The nurse is instructing a group of male clients on ways to reduce the risk of penile cancer. What instructions should the nurse include?
Maintaining good hygiene Receiving the human papillomavirus (HPV) vaccine Avoiding nude sunbathing
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."
A nurse suspects an older adult client is experiencing benign prostatic hyperplasia (BPH). Which question should the nurse ask this client?
"Has the force of your urinary stream decreased?"
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 statement by the client indicates the need for further teaching?
"I can't shake this feeling like I've received a death sentence."
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 client asks the nurse what can cause, or contributes to the development of, benign prostatic hyperplasia (BPH). The best response would be:
Dihydrotestosterone (DHT) proliferates the growth of prostatic stromal cells, leading to a reduction in the death of the epithelial cells.
A male athlete admitted to the emergency room is suspected of abusing androgens. Which physical characteristic would the nurse expect to see if the testosterone has been aromatized to estradiol?
Enlarged breast
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."
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?
"Sperm can no longer pass through the ductus deferens."
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."
A client is diagnosed with an inguinal hernia. Which statement by the client indicates that the nurse's teaching about the hernia has been effective?
"The hernia is a loop of bowel protruding through a weak spot in my abdominal muscles."
The nurse is teaching a female client who has been prescribed hormone therapy. The client asks, "What does this medication do?" Which statement is an appropriate response by the nurse?
"This medication will help relieve hot flashes and other adverse symptoms of menopause."
An adolescent male comes to the urgent care clinic. Upon assessment, the following is noted: history of circumcision, erythema of the glans, and prepuce with a malodorous discharge. Based on symptoms, the probable diagnosis would be:
Acute superficial balanoposthitis
An 18-month-old boy is diagnosed with cryptorchidism. Based on this diagnosis, what does the nurse expect to observe during the physical assessment?
Absence of the testis in the scrotum bilaterally
An adult male reports painful urination, rectal pain, fever/chills, general malaise and myalgia. Vital signs are: temperature, 101.7°F (38.7°C); blood pressure, 105/74 mm Hg; pulse, 98 bpm; respiration, 22 breaths/min. What condition should the health care provider suspect?
Acute bacterial prostatitis
The nurse is caring for a client recently diagnosed with testicular cancer. The nurse evaluates the medical record for which of these diagnostic tests, typically altered in this type of malignancy?
Alpha fetoprotein test
A female client with anorexia nervosa tells the nurse that she has been experiencing amenorrhea. The nurse is aware that this is a result of:
Alteration of critical body fat-to-muscle ratio needed for menses to occur
The male reproductive system undergoes changes as aging occurs. What is the term used to describe a relative or absolute hypogonadism associated with aging?
Andropause
In the early stages of fetal development, male and female reproductive organ development is undifferentiated. The nursing student understands that in the differentiation between male and female certain hormones are secreted and the testicular cells of the male embryo begin producing which hormone?
Anti-Müllerian hormone and testosterone
The nurse is teaching an all-male class at a local middle school about reproduction. Which time frame should the nurse tell the students that spermatogenesis begins and ends?
At about 13 years and throughout the reproductive years
A female client's assessment identifies symptoms of dyspareunia and burning. The nurse is aware that the client may have developed:
Atrophic vaginitis
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 nurse is speaking with a couple at the fertility clinic about ways to increase sperm counts. Which topic does the nurse include in the discussion?
Avoid tight undergarments
A client on the urology floor who has BPH asks the nurse how the pharmacologic agent finasteride will help decrease the size of his prostate. Which principle explains the mechanism of action?
Blocking effects of androgens on the prostate
The nurse in the urology office recognizes screening men at risk for prostate cancer includes which diagnostic measures?
Blood level of prostate-specific antigen (PSA) and digital rectal exam
A client asks, "What gland is responsible for urethral lubrication during male sexual stimulation?" Which response by the health care provider would be the best reply?
Bulbourethral glands
The male reproductive system is composed of two systems. The nurse knows that which system is responsible for the transportation and storage of sperm?
Ductile system
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
A client asks the nurse practitioner what organism is considered normal vaginal flora. Which response by the practitioner would be considered the best answer?
Döderlein bacilli
Which risk factor is associated with erectile dysfunction (ED) and considered preventable?
Cigarette smoking
A 17-year-old male has developed phimosis to the point that he is having difficulty voiding. The nurse should prepare this teenager for:
Circumcision
The mother requests that a circumcision be performed on a newborn with hypospadias. Which information related to treatment of hypospadias should the nurse convey?
Circumcision is avoided as the foreskin will be used to repair the urinary opening.
A client is admitted with primary hypogonadism. The nurse understands that the diagnosis of primary hypogonadism refers to which of the following?
Decrease in testicular function Originates in the testes Subfertility or infertility
Erectile dysfunction is the inability to achieve and maintain an erection sufficient to permit satisfactory sexual intercourse. The nurse knows that there may be many causes of erectile dysfunction, and a psychogenic cause would include which of the following?
Depression
Which assessment is most likely to reveal a potential exacerbation in a 70-year-old client's diagnosis of benign prostatic hyperplasia (BPH)?
Digital rectal examination
A nurse educator is explaining the process of sexual intercourse, fertilization, and fetal development to a high school biology class. What process should the nurse describe?
Fertilization in the outer portion of the fallopian tube
A female client informs the nurse that she had intercourse yesterday evening and is wondering if she could become pregnant. She asks the nurse where the fertilization (implantation) currently would be located if she was indeed pregnant. What should the nurse tell the client?
Fertilization normally occurs in the middle to outer portion of the Fallopian tube.
The fallopian tubes are narrow tubes that attach bilaterally to the uterus. Within the fallopian tube, fertilization of the ovum takes place. The end of the fallopian tube nearest the ovary is funnel-like. What are the fringed, finger-like projections around the funnel-shaped opening of the fallopian tube called?
Fimbriae
A client has just become pregnant and there is a consequent increase in secretions from the columnar epithelium of her endocervix. What effect will this have?
Formation of a mucoid plug to protect her uterus
A male client is admitted with a spinal injury that has damaged his sacral plexus. The nurse understands that this type of injury could affect the impulse stimulation for initiating the sexual act through which organ?
Glans penis
An adult client had bilateral orchiectomy (testicular removal) due to cancer. What will be the primary effect of the disruption in testosterone synthesis?
He will likely experience an overall reduction in muscle mass.
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?
Hematocele
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
What clinical manifestations would the nurse caring for a female client taking a gonadotropic hormone (GnRH) inhibitor expect the client to exhibit?
Hot flashes Absent menstrual cycle
A male adolescent asks the health care provider, "What function do the testes play in my body?" Which response would be the most accurate?
Production of androgens and spermatozoa
Which hormone is responsible for breast development and the increase in body temperature that occurs with ovulation?
Progesterone
Screening for which disease process should be done prior to beginning testosterone replacement therapy?
Prostate cancer
The lactating mother of a 3-month-old infant reports to the nurse that she experiences milk leakage if she hears the child cry when it has been more than 2 hours since the last feeding. How should the nurse respond?
Reassure her that this is a normal physiologic response.
A nurse is performing a genital examination on a male client who develops an erection. What is the nurse's most appropriate intervention?
Reassure the client that this is a normal response and continue with the examination
A client arrives in the emergency department complaining of severe testicular pain associated with nausea and vomiting. His pulse rate is 120 beats/min. Physical exam reveals an enlarged testis that is painful to palpation. The nurse suspects:
Testicular torsion
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
The nursing instructor is teaching the class about the male hormone testosterone. Which statement made by a student indicates a need for further instruction?
Testosterone does not affect development of increased musculature during puberty.
In the development of the testes, the nurse understands that which of the following can lead to an inguinal hernia later in life?
The inguinal canal has failed to almost completely close.
A nursing student is studying pathophysiology as part of the nursing curriculum. Which statement made by the student indicates a need for further instruction?
The male testes are located inside the abdominal cavity.
The nurse is caring for a client with significant benign prostatic hyperplasia (BPH) and hydronephrosis who is fearful of having corrective surgery. Which information is important for the nurse to convey?
The obstruction is causing urine to flow backward and cause kidney dysfunction.
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 client presents with symptoms consistent with hypogonadism. For a diagnosis of hypogonadism, the nurse expects which diagnostic test to be ordered?
Total testosterone levels
The nurse is performing a health history of a client being evaluated for erectile dysfunction. Which disorder places the client at highest risk for the erectile dysfunction?
Type 2 diabetes
Which factor places a male client at risk for balanitis?
Uncircumcised penis
A client asks, "What caused my acute prostatitis?" Which response by the nurse explains the most common cause of acute prostatitis?
Urethral infection with Escherichia coli
The nursing student who is studying pathophysiology of the male genitourinary system correctly identifies which of these as functions of the penis?
Urine elimination Sexual function
The nurse is reviewing the history of an older adult female client who was recently diagnosed with coronary heart disease. What factors are known to contribute to this condition?
Used hormone therapy for 5 years Smoked 1 pack/day for 20 years Has hypertension for 15 years
The connecting tube between the cervix and the vestibule is referred to as:
Vagina
A client is suspected to have small varicoceles in his left scrotum. Which assessment technique may help accentuate small varicosities?
Valsalva maneuver
A 40-year-old male client with multiple health problems has been diagnosed with a testosterone deficiency. Which assessment finding(s) correlates with a testosterone deficiency? Select all that apply.
a high-pitched voice a low muscle mass in proportion to total body weight hot flashes and diaphoresis
The nurse planning care for a menopausal woman should include interventions to decrease risk for:
atherosclerosis.
Tertiary hypogonadism occurs due to which dysfunction of the endocrine system?
decreased or absent gonadotropin hormone-releasing hormone (GnRH) secretion from the hypothalamus
The nurse assessing an adult male client with impaired testosterone. Which finding does the nurse expect?
fatigue
The nurse is explaining the process of conception to a group of middle-school students and points out that fertilization occurs:
in the middle to outer portion of the fallopian tube.
A surgeon is explaining the anatomical structures of the penis during grand rounds. During his explanation the surgeon states that the cremaster muscles work in concert with the pampiniform plexus that surrounds the testicular artery to:
maintain testicular temperature.
A 20-year-old client has come to the clinic reporting severe menstrual cramps. Dysmenorrhea occurs when which muscle group contracts?
myometrium
The nurse is checking the pH of a client's vaginal tissue and finds the pH to be 4.3. The nurse interprets this finding as:
normal.
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:
order an ultrasound or biopsy to rule out testicular cancer.
