Health Assessment Chapter 23: Male Genitalia and Rectum
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.
The nurse notes that a male client's scrotal sac is documented as being "normal." What should the nurse expect to assess in this client? Select all that apply. A) Rugated B) Thin skin C) Scattered lesions D) Few strands of hair E) Color darker than the penis
A) Rugated B) Thin skin D) Few strands of hair E) Color darker than the penis Explanation: For a scrotal sac to be considered "normal," the skin should appear thin and rugated. There will be few strands of hair and the color of the skin is darker than the penis. Lesions on the scrotal sac indicate an infection and would not be considered "normal."
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.
While assessing the scrotum of an adult client, the nurse notes thin and rugated scrotal skin with little hair dispersion. The nurse interprets this finding as which of the following? A) Reiter's syndrome B) Normal findings C) Effects of chemotherapy D) Gonorrhea
B) Normal findings Explanation: Scrotal skin is normally thin and rugated with little hair. Inflammation of the penis and scrotum may be seen in Reiter's syndrome. Absence or scarcity of pubic hair may suggest chemotherapy. A yellow urethral discharge is usually seen with gonorrhea.
When performing the physical assessment of a client, the nurse notes the presence of a small cyst that contains hair, which is located midline in the sacrococcygeal area and has a palpable sinus tract. How should the nurse document this finding? A) External hemorrhoid B) Pilonidal cyst C) Anal fissure D) Perianal abscess
B) Pilonidal cyst Explanation: A pilonidal cyst is a congenital disorder characterized by a small dimple or cyst/sinus that contains hair. External hemorrhoids are usually painless papules below the anorectal junction, caused by varicose veins. Anal fissures are splits in the tissue of the anal canal caused by trauma. Perianal abscess is a cavity of pus, caused by infection in the skin around the anal opening.
A nurse teaches a male client how to perform testicular self-examination when the client's history reveals that he does not do it. The nurse would instruct the client to perform the self-examination at which frequency? A) Weekly B) Bimonthly C) Monthly D) Quarterly
C) Monthly Explanation: A male client should be instructed to perform testicular self-examination every month.
Which of the following is a sign or symptom of benign prostatic hypertrophy (BPH)? A) Weight loss B) Bone pain C) Fever D) Nocturia
D) Nocturia Explanation: BPH is usually not associated with systemic symptoms such as weight loss or fever. Bone pain is associated with prostate cancer, which often metastasizes to the lower axial skeleton. Nocturia, sensation of incomplete voiding, weak stream, and difficulty initiating urination are also common symptoms.
A male client has a distinctive bulge in the right inguinal area when standing. What should the nurse suspect is occurring with this client? A) hernia B) hypospadias C) testicular torsion D) epidermoid cysts
A) hernia Explanation: A noticeable bulge in the inguinal area when standing strongly suggests that the male client has a hernia. Hypospadias is a displacement of the urinary meatus. Testicular torsion would be suspected if the scrotum were edematous and painful. An epidermoid cyst is a painless mobile mass in the scrotum. It would not be observed while the client is standing.
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.
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.
he testes in the male scrotum are A) joined with the ejaculatory duct. B) suspended by the spermatic cord. C) able to produce progesterone. D) the location of the vas deferens.
B) suspended by the spermatic cord. Explanation: The testes are suspended in the scrotum by a spermatic cord.
The nurse is beginning the physical exam of a male client's genitals. The nurse is sitting on a stool in front of the client. In which position would be best to place the client? A) Lying supine B) Kneeling C) Standing D) Sitting
C) Standing Explanation: When beginning the exam, the nurse sits on a stool in front of the client while the client assumes a standing position. This allows the nurse to inspect the genitalia.
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).
A client presents to the health care clinic with reports of black stool. The client denies the ingestion of iron supplements or taking Pepto-Bismol. The nurse recognizes that the black stools could be an indication of what disease process? A) Gastrointestinal bleeding B) Lack of bile pigment C) Increased fat content D) Cancer of the colon
A) Gastrointestinal bleeding Explanation: Black stools may indicate gastrointestinal bleeding in this client who has not been receiving iron supplements or taking Pepto-Bismol. Clay-colored stool results from the lack of bile pigment. Yellow stool suggests increased fat content or steatorrhea. Cancer of the rectum or colon may be indicated by blood detected in the stool.
A teenage male client comes to the ED with severe left testicular pain and vomiting. Elevation of his left testicle does not lessen the pain. What could these symptoms indicate for this client? A) Left testicular torsion B) Epididymitis C) Hydrocele D) Testicular cancer
A) Left testicular torsion Explanation: Signs of testicular torsion include acute pain that is not relieved by elevating the testicle, nausea, and vomiting. Epididymitis usually presents in adult males. The client presents with unilateral pain to one testis, but fever, dysuria, and possibly urethral discharge. Hydrocele is the accumulation of fluid around a testicle. This condition usually presents as a non-tender and soft testicle. Often testicular cancer presents lump or swelling, which may or may not be painful. The condition could also present with pain in the abdomen or low back.
The nurse is presenting a program about sexually transmitted infections, including HIV, to a group of young men. The nurse would include who as the having the highest incidence of HIV infection in the United States? A) Men having sex with men B) Heterosexual partners C) Bisexual individuals D) Intravenous drug users
A) Men having sex with men Explanation: Although transmission routes vary (male-to-male anal sex, intravenous drug use, heterosexual sex, mother-to-infant transmission, and other mechanisms of body fluid transfer), the highest incidence of HIV in the United States still occurs in men who have sex with men (MSM), followed by intravenous drug users.
The nurse is aware of the heightened risk of urinary tract infections in older males. In order to reduce this risk, the nurse should prioritize which of the following interventions? A) Remove urinary catheters as soon as possible. B) Encourage the use of intravenous fluids to ensure hydration. C) Promote physical activity among older males. D) Encourage older men to avoid low-pH foods and beverages.
A) Remove urinary catheters as soon as possible. Explanation: Urinary tract infection (UTI), a type of HAI, accounts for more than 30% of infections reported by acute care hospitals in the United States. Virtually all hospital-associated UTIs are caused by instrumentation of the urinary tract, mainly from indwelling urinary catheters. Prevention of a catheter-acquired urinary tract infection (CAUTI) is a key component of an acute-care hospital's client safety and quality improvement program.
A male client tells the nurse about experiencing problems with urination. What should the nurse assess in this client? Select all that apply. A) The number of times the client voids during the day B) If there is any blood or semen in the urine C) If there is any difficulty starting the urine stream D) If there is any pain at the base of the penis E) If the client has ever been diagnosed with a sexually transmitted infection
A) The number of times the client voids during the day B) If there is any blood or semen in the urine C) If there is any difficulty starting the urine stream D) If there is any pain at the base of the penis Explanation: For the male client with urination problems, the nurse should assess the number of times the client urinates during the day, the presence of blood or semen in the urine, if there is difficulty starting the urine stream, and for pain at the base of the penis. Assessing for sexually transmitted infections would be appropriate if the client were experiencing penile discharge or lesions.
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.
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
The prostate gland consists of two lobes separated by the A) median sulcus. B) rectovesical pouch. C) anorectal junction. D) valves of Houston.
A) median sulcus. Explanation: The prostate gland consists of two lobes separated by a shallow groove called the median sulcus.
A nurse observes that the mucosa of the rectum and the rectal wall of a female client protrudes out through the anal opening. It appears as a red, doughnut-like mass with radiating folds. How should the nurse document this condition of the rectum? A) prolapse B) Rectal polyps C) shelf D) cancer
A) prolapse Explanation: The nurse should document this condition as rectal prolapse. Soft structures like nodules that may be present in the muscular anal ring are called rectal polyps. They are rather common and occur in varying size and number. If cancer metastasizes to the peritoneal cavity, it may be felt as a nodular, hard, shelf-like structure called rectal shelf that protrudes onto the anterior surface of the rectum in the area of the rectouterine pouch in women. Rectal cancer may feel like a firm nodule, an ulcerated nodule with rolled edges, or, as it grows, a large, irregularly shaped, fixed, hard nodule.
When assessing a client during the physical examination of the genitalia, the nurse palpates the scrotal contents. Which finding should the nurse recognize as an indication that an infection or cysts are present? A) Palpable and tortuous veins B) Beaded or thickened cord C) Smooth, nontender cord D) Left testicle is slightly lower than the right
B) Beaded or thickened cord Explanation: A beaded or thickened cord indicates infection or cysts. The presence of palpable and tortuous veins indicates varicocele. A smooth, nontender, and rope-like cord is a normal finding. In most men, one testicle hangs lower than the other; in 65% of males, the left hangs lower than the right.
A 72-year-old male presents at a local clinic and states: "I have to urinate all the time, and I never feel like my bladder is emptied. It really bothers me at night." What condition might the nurse suspect related to this chief complaint? A) Chronic bacterial prostatitis (CBP) B) Benign prostatic hyperplasia (BPH) C) Orchitis D) Epididymitis
B) Benign prostatic hyperplasia (BPH) Explanation: Initial symptoms of BPH may be urinary difficulties. The client does not empty his bladder completely when he voids and finds that he must void frequently, often during the night. He may also find starting to void increasingly difficult or painful and may notice traces of blood in his urine. Cystitis may result. The client with chronic prostatitis is usually asymptomatic, but he may complain of back or perineal pain. Symptoms of orchitis include pain and swelling in the scrotum and sometimes urethral irritation. Symptoms of epididymitis include redness, pain, and various degrees of scrotal swelling.
The nurse is palpating the prostate of a 55-year-old client and finds it to be enlarged, smooth, firm, and slightly elastic, without a median sulcus. Which condition should the nurse most suspect? A) Acute prostatitis B) Benign prostatic hypertrophy C) Hydrocele D) Prostate cancer
B) Benign prostatic hypertrophy 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. This condition is common in men older than 50 years. A hard area on the prostate or hard, fixed, irregular nodules on the prostate suggest cancer. Hydrocele is a painless swelling of the scrotum.
A nurse is planning to assess a male client for urethral discharge. Which technique would be best for the nurse to use? A) Have the client hold the penis while the examiner looks for discharge. B) Gently squeeze the glans between the thumb and index finger. C) Inspect the scrotal skin while holding the penis aside. D) Observe the glans of the penis for signs of abnormal discharge.
B) Gently squeeze the glans between the thumb and index finger. Explanation: To palpate for urethral discharge, the nurse would gently squeeze the glans between the thumb and index finger. Having the client hold the penis, observing the glans, or inspecting the scrotal skin would be insufficient because discharge in the urethra cannot be visualized.
A 68-year-old man comes to the clinic reporting that he is having difficulty obtaining an erection. When reviewing the client's history what might the nurse note that contributes to impotence? A) Past history of infection B) History of hypertension C) Use of multivitamins D) Lack of exercise
B) History of hypertension Explanation: Past history of infection, lack of exercise, and use of vitamins do not contribute to impotence. Vascular problems cause about half the cases of impotence in men older than 50 years
Palpation of a male client's urethra produces a yellowish-white discharge. What is the nurse's best action? A) Obtain a urine sample for culture and sensitivity testing. B) Obtain a sample of the discharge for culture. C) Ask the client to void and then repeat palpation of the client's urethra. D) Palpate the client's scrotum and testes for the presence of fluid.
B) Obtain a sample of the discharge for culture. Explanation: Any urethral discharge should be cultured. A urine sample may be indicated, but this is not always the case. Repeating palpation of the urethra after voiding will not add meaningful data. The presence of discharge does not create a direct indication for scrotal and testicular palpation, although these actions are part of the overall genitourinary assessment.
Which of the following groups has the highest incidence of prostate cancer? A) Caucasian men B) Native American men C) African American men D) Asian American men
C) African American men Explanation: African American men have the highest incidence of prostate cancer—two to three times higher than Caucasian men.
An adolescent present at the free clinic with a collection of fluid in the tunica vaginalis of the testes. The nurse knows that the term that defines this condition is what? A) Cryptorchidism B) Orchitis C) Hydrocele D) Prostatism
C) Hydrocele Explanation: A hydrocele refers to a collection of fluid in the tunica vaginalis of the testes. Cryptorchidism is the most common congenital defect in males; characterized by failure of one or both of the testes to descend into the scrotum. Orchitis is an inflammation of the testes (testicular congestion) caused by pyogenic, viral, spirochetal, parasitic, traumatic, chemical, or unknown factors. Prostatism is an obstructive and irritative symptom complex that includes increased frequency and hesitancy in starting urination, a decrease in the volume and force of the urinary stream, acute urinary retention, and recurrent urinary tract infections.
During a class, a student asks the instructor, "What does the anal canal contain?" Which of the following would the instructor include in the response? A) Hair B) Sebaceous glands C) Somatic sensory nerves D) Dentate line
C) Somatic sensory nerves Explanation: The anal canal is lined with skin that contains no hair or sebaceous glands but does contain many somatic sensory nerves, making it susceptible to painful stimuli. The anorectal junction is also known as the dentate line.
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.
During a scrotal exam, the nurse notes an enlarged scrotal sac that easily transilluminates. Which of the following would the nurse suspect? A) Tumor B) Hernia C) Varicocele D) Hydrocele
D) Hydrocele Explanation: Swelling or masses that contain serous fluid, such as hydrocele or spermatocele, light up with a red glow with transillumination. Swellings or masses that are solid, or filled with blood, such as tumors, hernias, or varicocele, do not transilluminate.
On inspection and palpation, the nurse finds that a client's testes are small, probably less than 2 cm, and firm. Which of the following conditions should the nurse most suspect in this situation? A) Atrophy B) Orchitis C) Epididymitis D) Klinefelter's syndrome
D) Klinefelter's syndrome Explanation: Testes that are less than 2 cm long and firm may indicate Klinefelter's syndrome. Testes that are less than 3.5 cm long and soft indicate atrophy. Atrophy may result from cirrhosis, hypopituitarism, estrogen administration, extended illness, or the disorder may occur after orchitis. Orchitis is inflammation of the testes, associated frequently with mumps, and in which the testes are tender on palpation. Epididymitis is infection of the epididymis and is characterized by an enlarged, reddened, and swollen scrotum.
A nurse is a preparing to assess a male client's anus and rectum. How should the nurse best prepare the client for this assessment? A) Ask the client if he is feeling anxious or fearful about the exam. B) Assist the client into the supine position. C) Administer a dose of analgesia 15 minutes before the exam. D) Position the client in a left side-lying position.
D) Position the client in a left side-lying position. Explanation: The most frequently used position for inspection and palpation of the anus, rectum, and prostate is the left lateral position. This position allows adequate inspection and palpation of the anus, rectum, and prostate (in men) and is usually more comfortable for the client. Pain control should not be necessary. Some men may be anxious or fearful during this exam, but the nurse would not normally raise this possibility unless he or she had reason to believe that the client felt this way.
When the nurse is examining a male client's genitalia, the client experiences an erection. What would be most appropriate for the nurse to do? A) Don't say anything but continue the exam. B) Stop the exam and leave the room for 10 minutes. C) As the client whether continuing the exam will embarrass him. D) Reassure the client that this is not unusual.
D) Reassure the client that this is not unusual. Explanation: If a client experiences an erection during the exam, the nurse should reassure the client that this is not unusual and continue the exam in an unhurried and unflappable manner. The nurse needs to acknowledge the event, because the client is most likely feeling embarrassed. Stopping the exam and leaving the room may promote additional embarrassment or guilt in the client. Asking if continuing will embarrass him emphasizes what the client is already feeling and would most likely make it worse.
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.
A male client is receiving chemotherapy for the treatment of cancer. Which finding should the nurse anticipate during examination of the client's genitalia? A) Sparse pubic hair B) Hardness along the ventral surface of the penis C) Cyanosis to the glans D) Tenderness on scrotal palpation
A) Sparse pubic hair Explanation: Hardness along the ventral surface may indicate a urethral stricture. Sparse pubic hair may be seen in clients receiving chemotherapy or in an older adult client. Tenderness on palpation may indicate inflammation or infection. Cyanosis to the glans is not a consequence of chemotherapy.
Which finding should a nurse expect to observe when inspecting the external genitalia of an elderly male client? A) Smaller testicles B) Enlarged glans penis and scrotum C) Smaller penis with lower hanging testicles D) Hardness along the ventral surface of the penis
C) Smaller penis with lower hanging testicles Explanation: Normal changes in the external genitalia of the aging male include a smaller penis and the testes hang lower in the scrotum. Testicles do not get smaller with age although they may decrease in size with long term illness. Enlargement of the penis is seen with inflammation and is not a normal for a male of any age. Hardness along the ventral surface of the penis may indicate cancer or a urethral stricture.
A client is being evaluated for upper gastrointestinal bleeding. The nurse would expect to observe stool that is which color? A) Red B) Clay C) Yellow D) Black
D) Black Explanation: Black stool may indicate upper gastrointestinal bleeding. Red stool may be found with hemorrhoids, polyps, cancer or colitis. Clay-colored stool suggest a biliary obstruction; yellow stool suggests steatorrhea.
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.
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.
The nurse is assessing a male client complaining of testicular pain. Which symptom helps the nurse determine that the client does not need immediate surgical intervention? A) Absence of nausea and vomiting. B) Elevation of affected testicle does not lessen pain. C) Denies urethral irritation. D) Temperature 100.4 degrees Fahrenheit.
A) Absence of nausea and vomiting. Explanation: Testicular torsion requires immediate surgical intervention. The signs of testicular torsion include: acute pain; nausea and vomiting in 50% of clients (nausea and vomiting are rare in epididymitis); rare fever; and urethral irritation. Epididymitis by contrast is characterized by gradual onset of pain; urethral discharge, and fever occurring in 50% of clients.
The exact cause of benign prostatic hypertrophy (BPH) is unknown, but the condition is believed to be associated with what factors? A) Age-related hormonal changes B) Environmental factors C) Diet D) Lifestyle
A) Age-related hormonal changes Explanation: The exact cause of BPH is unknown, but the condition is believed to be associated with age-related hormonal changes. As men age, the fibromuscular structures of the prostate gland atrophy and collagen gradually replaces the muscular element of the prostate. The other options are distracters for the question.
A group of students is reviewing information about the male genitalia in preparation for a test. The students demonstrate understanding of the material when they identify which of the following as external genitalia? A) Scrotum B) Testis C) Vas deferens D) Spermatic cord
A) Scrotum Explanation: The external genitalia include the penis and scrotum. The testis, vas deferens, and spermatic cord are internal genitalia
A client has admitted to the nurse that he has been having difficulty obtaining and maintaining erections for many months. Which of the nurse's assessment questions most clearly addresses a potential cause for the client's problem? A) "How would you describe a typical day's food intake?" B) "What medications are you currently taking?" C) "Have you ever been screened for prostate cancer?" D) "Do you ever experience pain when you urinate?"
B) "What medications are you currently taking?" Explanation: Erectile dysfunction is sometimes attributable to medication use. Nutritional factors are not normally related. ED is not a symptom of prostate cancer and is unrelated to urinary function in most cases.
The nurse is assessing a 12-year-old boy and finds the following: sparse growth of pubic hair, beginning penile enlargement, and beginning textural changes on the scrotum. The nurse would document which Tanner stage? A) 1 B) 2 C) 3 D) 4
B) 2 Explanation: Tanner stage 2 for males consists of sparse growth and slightly curly pubic hair, slight or no enlargement of the penis, and both the testes and scrotum larger, reddened, and beginning to exhibit textural changes. Tanner stage 1 is characterized by no pubic hair and a penis, testes, and scrotum of the same size and proportion as in childhood. Tanner stage 3 is characterized by darker, coarse curly sparse pubic hair over the symphysis pubis, a larger and longer penis, and continued enlargement of the testes and scrotum. Tanner stage 4 is characterized by coarse, curly pubic hair that does not extend to the medial thighs, increased penile length and width with development of the glans, and continued enlargement of the testes and scrotum with a darkening of the scrotal skin.
While assessing an adult male client, the nurse detects pimple-like lesions on the client's glans. The nurse explains the need for a referral to the client. The nurse determines that the client has understood the instructions when the client says he may have A) venereal warts. B) herpes infection. C) syphilis. D) gonorrhea.
B) herpes infection. Explanation: Pimple-like lesions from herpes are sometimes detected on the glans.
The nurse is describing various terms related to the male reproductive system. Which term would the nurse use to describe the discharge of semen from the penis? A) Erection B) Emission C) Ejaculation D) Engorgement
C) Ejaculation Explanation: Ejaculation refers to the discharge of semen from the penis. Erection refers to the state in which the penis becomes elongated and rigid. Dilation of the penile arteries compresses the veins within the penis causing engorgement of blood within the tissue. Emission refers to the movement of sperm and their mixture with fluid forms the seminal vesicles and prostate gland into the urethra.
A nurse examines the external genitalia of a client and observes that the scrotum is enlarged, reddened, and swollen. On palpation, the epididymis is tender and the client complains of sudden pain. How should the nurse document this condition? A) Orchitis B) Cryptorchidism C) Epididymitis D) Hydrocele
C) Epididymitis Explanation: The nurse should document this condition as epididymitis, which is an infection of the epididymis. In this condition, the scrotum appears enlarged, reddened, and swollen, and a tender epididymis is palpated. Cryptorchidism is a condition in which the scrotum appears underdeveloped and the testis cannot be palpated. It occurs when one or both testicles fail to descend into the scrotum. Orchitis is the inflammation of the testes, associated frequently with mumps; the scrotum appears enlarged and reddened. Hydrocele appears as a swelling in the scrotum and is usually painless.
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.
During a client's genitourinary exam, the nurse notes that the client's scrotum is enlarged and easily transilluminates. What should the nurse suspect? A) Tumor B) Hernia C) Varicocele D) Hydrocele
D) Hydrocele Explanation: Swelling or masses that contain serous fluid, such as hydrocele or spermatocele, light up with a red glow with transillumination. Swellings or masses that are solid, or filled with blood, such as tumors, hernias, or varicocele, do not transilluminate.
When examining a newborn male infant, the nurse notes that neither testicle is descended. How would the nurse document this finding? A) Epididymitis B) Orchitis C) Cryptorchidism D) Varicocele
C) Cryptorchidism Explanation: Absence of a testis in the scrotum suggests cryptorchidism. Epididymitis is an infection of the epididymis. Orchitis is an inflammation of the testes. Varicocele is an abnormal dilation of veins in the spermatic cord.
