Male Genitalia and Rectal Assessment

Which question would be most important to ask a married male client with a varicocele?

"Have you and your wife attempted a pregnancy together?"

On palpating a client's scrotum and testes, the nurse notes that the testes appear to be of normal shape and size. Which of the following would indicate a normal length for testes?

4.5 cm

An older adult client comes to the ED bleeding from the rectum. The client has a history of atrial fibrillation and has had two small strokes. The client is currently taking blood pressure medication and anticoagulation therapy at home. Why might this client need to be hospitalized?

A client is on anti-coagulating medication

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?

Absence of symmetry of the inguinal areas with straining

Which of the following groups has the highest incidence of prostate cancer?

African American men

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?

Age 60 years or older

The exact cause of benign prostatic hypertrophy (BPH) is unknown, but the condition is believed to be associated with what factors?

Age-related hormonal changes

A nurse is preparing to examine a client's inguinal area. The nurse understands that this area is contained by which structure laterally?

Anterior superior iliac spine

A patient has undergone a digital rectal examination. This assessment will allow the clinician to diagnose which of the following?

BPH

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?

Benign prostatic hyperplasia (BPH)

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?

Benign prostatic hyperplasia (BPH)

A client is being evaluated for upper gastrointestinal bleeding. The nurse would expect to observe stool that is which color?

Black

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?

Cremasteric reflex

Which of the following would the nurse expect to be done to assess the size of the prostate?

Digital rectal examination

A client complains of scrotal pain, and the nurse elicits a positive Prehn sign, in which passive elevation of the testes relieves the scrotal pain. The nurse should refer the client for treatment of which of the following?

Epididymitis

A male client presents to the health care clinic with reports of pain with ejaculation. The nurse should be prepared to inspect which part of the anatomy to determine the likely cause of the client's pain?

Epididymus

The scrotum of a male patient appears inflamed. The nurse should assess the femoral nodes.

False

A nurse is planning to palpate for a urethral discharge in a male client. Which technique would be best for the nurse to use?

Gently squeeze the glans between the thumb and index finger.

A male client is complaining of pain with urination, rectal pain and urethral discharge. The nurse suspects this is what?

Gonorrhea

The nurse is providing an educational event at the local PTO on prostate cancer. A 53-year-old male attendee asks about the prevention and detection of prostate cancer. What information should the nurse provide to this patient that would assist in the early identification of prostate cancer?

Have a digital rectal examination and prostate-specific antigen (PSA) test done yearly.

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

Hemorrhoids

The nurse is assessing male genitalia and finds clusters of pimple-like clear vesicles. The nurse recognizes this as what?

Herpes

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

Herpes infection

During the physical examination of a male client's genitalia, the nurse observes that the urinary meatus is displaced to the ventral surface of the penis. How should the nurse document this condition?

Hypospadias

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?

Hypospadias

A client presents to the health care clinic with reports of yellow stool. Which condition should the nurse most suspect?

Increased fat content Yellow stool suggests increased fat content or steatorrhea. 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. Cancer of the rectum or colon may be indicated by blood detected in the stool.

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?

Lack of bile pigment

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 patient?

Left testicular torsion

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?

Monthly

Which of the following is a sign or symptom of benign prostatic hypertrophy (BPH)?

Nocturia

When palpating the prostate, the nurse detects a nontender, rubbery prostate with lateral lobes that are 2.5 cm and heart-shaped. The nurse would interpret this finding as indicating which of the following?

Normal prostate

Palpation of a male client's urethra produces a yellowish-white discharge. What is the nurse's best action?

Obtain a sample of the discharge for culture.

A client has a family history of prostate cancer and is committed to regular screening. What should the nurse teach the client about prostate-specific antigen (PSA) blood testing?

PSA blood testing is not recommended for most clients.

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?

Prepare the client for surgery.

An adult client has sought care because he has a two-day history of stool that is "black like road tar." How should the nurse best respond to this aspect of the client's history?

Promptly refer the client for treatment of a possible gastrointestinal bleed.

A nurse is assisting a healthcare provider perform a digital rectal examination of a 65-year-old African American client. This test, along with the PSA blood test is used as an early detection of what disease?

Prostate cancer

A male client reports hesitancy when urinating. The nurse would further assess this client for which of the following?

Prostate enlargement

A nurse prepares a male client for a physical assessment of the external genitalia. Which instruction is appropriate for the nurse to inform the client of before the examination?

Reassure him that it is not unusual to have an erection

Which finding should a nurse expect to observe when inspecting the external genitalia of an elderly male client?

Smaller penis with lower hanging testicles

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?

Somatic sensory nerves

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?

Standing

During the assessment of a client, the nurse recognizes that which of the client's lifestyle practices may predispose to the development of an inguinal hernia?

Strenuous activity

On inspection of a client's penis, the nurse observes a small, silvery-white papule. Which of the following conditions should the nurse suspect in this client?

Syphilitic chancre

A male public health nurse is teaching a health class for the male students at the local high school. The nurse is teaching the boys to perform monthly testicular self-examinations. What points would be appropriate to emphasize?

Testicular caner is a highly curable type of cancer.

A patient presents at the clinic with severe scrotal pain. What is the presumptive diagnosis?

Testicular torsion

During the health history a young male client asks the nurse why his scrotum rises and relaxes. The nurse would incorporate knowledge of which of the following when responding to this client?

The cremasteric reflex controls the rise and relaxation of the scrotum.

During the health history, a young male client asks the nurse why his scrotum rises and relaxes. The nurse would incorporate knowledge of which of the following when responding to this client?

The cremasteric reflex controls the rise and relaxation of the scrotum.

After teaching a group of students about the anal canal, the instructor determines that the teaching was successful when the students state which of the following?

The internal sphincter is under involuntary control.

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

cryptorchidism.

While reviewing the medical record before examining a male clinic patient, 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

epispadias

During assessment of an adult client, which of the following lifestyle practices would indicate to the nurse that the client may be at high risk for HIV/AIDS? A client who

has anal intercourse with other males

A male client tells the nurse that his occupation requires heavy lifting and a great deal of strenuous activity. The nurse should assess the client for

inguinal hernia.

During the physical examination of the genitalia for an uncircumcised client, the nurse asks the client to retract the foreskin of the penis. The nurse observes that the foreskin is tight and cannot be retracted. How should the nurse document this condition?

phimosis

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?

prolapse 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.

The testes in the male scrotum are

suspended by the spermatic cord.

Ejaculation occurs with the emission of semen from which of the following? Select all that apply.

• Epididymides • Vas deferens • Prostate • Seminal vesicles

When assessing a client during the physical examination of the genitalia, the nurse palpates the scrotal contents. Which finding should the nurse recognize as normal? Select all that apply.

• Smooth, nontender cord • Left testicle is slightly lower than the right

While conducting a complete bed bath for a male patient, the nurse inspects the scrotum for: (Select all that apply.)

• Swelling • Lumps • Veins