Patho: Unit 7 GU and Reproductive function

A woman reports to the primary healthcare provider that she experiences monthly changes before her menstrual cycle. Which statement demonstrates understanding of premenstrual disorders?

Many women report premenstrual emotional or physical changes.

The ovaries have a dual function. The nurse is able to explain to the client that any problems with the ovaries frequently cause which problem?

Menstrual and fertility problems

A client has been diagnosed with acute cervicitis caused by Chlamydia trachomatis. Which clinical manifestation correlates to this diagnosis?

Mucopurulent drainage

The vulva area is especially prone to skin infections. The nurse knows that this occurs because of:

Constant exposure to secretions and moisture

A client is admitted with secondary orchitis. Which assessment question is most relevant?

"Have you ever had mumps?"

Which treatment intervention is recommended for infants who have a severe case of hypospadias?

surgical repair

Which female client is at risk for amenorrhea?

18-year-old with anorexia nervosa

Which complication is associated with prostatic hyperplasia?

Urine retention

The nurse has taught a 30-year-old female client to perform breast self-evaluation (BSE). Which statement by the client indicates correct understanding?

"I will palpate my breasts for lumps a few days after my period."

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 asks the health care provider to, "Explain brachytherapy, which is recommended for my cervical cancer." Which response by the nurse is most accurate?

"They will insert a radioactive device into your vagina and position it next to the cervix, so that curative levels of radiation are directly on the cancer site."

An asymptomatic client who is worried about developing breast cancer due to the fact that it runs in her family asks the nurse if she could have a mammogram to see if she has any lumps. The nurse informs the client that a tumor usually is undetectable until it has doubled 30 times and contains more than 1 billion cells. This means that at this point it measures approximately which size?

1 cm

Which sexually active woman most likely faces the highest risk of developing an ectopic pregnancy?

A 42-year-old who has decided to try to have one more child and has had her tubal ligation reversed

The client has a Bartholin cyst that has developed into an abscess. The nurse explains to the client the plan of care, including which treatments?

A catheter may be inserted to drain the cyst for several weeks.

What will the nurse assess in a client diagnosed with Paget disease as a cause of breast cancer?

A lesion of the nipple on the affected breast

The nurse is teaching a client about screening for prostate cancer. Which information will the nurse teach the client about the prostate-specific antigen (PSA) test?

An elevated score on a PSA test does not necessarily indicate the presence of cancer.

A client has developed a 5-cm Bartholin cyst and is experiencing pain, tenderness, and dyspareunia. Which treatment regimen is commonly prescribed for this condition? Select all that apply.

Antibiotics Moist heat applications Drainage of cyst

While breast-feeding her 3-month-old infant, the mother notices the breast area is hard, inflamed, and tender to touch. The clinic nurse explains that this is likely caused by:

Ascending bacterial infection

A 29-year-old client had a Papanicolaou smear performed during her most recent visit to her primary care provider. This diagnostic procedure aims to identify:

Atypical cervix cellular changes

A 59-year-old woman with a recent diagnosis of breast cancer has begun a course of hormone therapy. What is the goal of this pharmacologic treatment?

Blocking effects of estrogen on the growth of malignant cells

What can a female client with a palpable breast lump expect as the next diagnostic step if the mass does not appear on mammography?

Breast ultrasound

Which risk factor is associated with erectile dysfunction (ED) and considered preventable?

Cigarette smoking

A female client reports a grayish-green nipple discharge in one breast. Which additional manifestation corresponds with a diagnosis of ductal ectasia?

Ductal inflammation with thickening

The nurse in the ER is caring for a client with lower abdominal pain that is greater on the right side and who has light vaginal spotting. When the client's human chorionic gonadotropin (hCG) level is lower than normal, the nurse plans care for a client with:

Ectopic pregnancy

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

In primary dysmenorrhea, when contraception is not desired, what is the treatment of choice?

Ibuprofen

An examination of the external genitalia of a female would concentrate on which structures? Select all that apply.

Labia minora Clitoris

The health care provider suspects a diagnosis of endometriosis. Which procedure provides a definitive diagnosis?

Laparoscopy

Polycystic ovary syndrome is an endocrine disorder and a common cause of chronic anovulation. In addition to the clinical manifestations of PCOS, long-term health problems, including cardiovascular disease and diabetes, have been linked to PCOS. What drug has emerged as an important part of PCOS treatment?

Metformin

Which manifestation will the nurse expect a woman with nonproliferative fibrocystic breast changes to report? Select all that apply.

Nodular or lumpy breast tissue Tenderness during the luteal phase

Polycystic ovary syndrome (PCOS) is a common endocrine disorder. The nurse understands that about 50% of the women who are diagnosed with PCOS have which problem?

Obesity

A female client is being evaluated for abdominal pain and unusual menstrual bleeding. What factors in her history will the nurse identify as increasing the risk for endometrial cancer? Select all that apply.

Obesity Estrogen therapy Diabetes mellitus Polycystic ovary syndrome

Which disorder of the female genitourinary system is most likely to result from a disruption in normal endocrine function?

Polycystic ovary syndrome (PCOS)

Fibrocystic changes in the breast are not uncommon. How is the diagnosis of fibrocystic changes made?

Ultrasonography and mammography

Ectopic pregnancies are true gynecologic emergencies and are considered the leading cause of maternal death in the first trimester. What diagnostic test would the nurse expect to have ordered for a suspected ectopic pregnancy?

Ultrasonography followed by serial hCG tests

A client has been diagnosed with breast cancer following a suspicious mammogram followed by biopsy. The nurse who is planning this client's care should recognize that her prognosis is primarily dependent on the:

extent to which lymph nodes are involved.

What will the nurse teach the client who has a cervical polyp?

"Polyps typically are asymptomatic"

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

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

Benign prostatic hyperplasia (BPH) and prostatic adenocarcinomas present differently. The nurse is aware of which difference?

BPH is commonly located in the periurethral zone of the prostate, while prostate cancers are commonly located in the peripheral zones of the prostate.

An overweight 50-year-old client presents with reports of erectile dysfunction (ED). What aspect of the client's health should the nurse prioritize as most important to assess?

Cardiovascular

Select the factor that would increase a male's risk for the development of testicular cancer.

History of cryptorchidism

For males between 5 and 10 years of age, which cause of priapism is most common?

Sickle cell anemia

Which condition would the nurse expect a female client with human papillomavirus (HPV) to exhibit?

Cervical intraepithelial neoplasia

There are many cancers of the female reproductive system. The nursing student knows that the most readily detected and most easily cured cancer—if detected early—is:

Cervical

Which client is at greatest risk for the impairment of spermatogenesis?

A 15-year-old male who is diagnosed with mumps orchitis

The nurse is caring for a client with cancer of the scrotum. When performing a health history, which of these does the nurse explore as a risk for this type of malignancy?

Exposure to tar and soot

The nurse on the urology unit teaches the nursing student that which test assists in detecting a recurrence of prostate cancer after prostatectomy?

prostate-specific antigen (PSA) level

A female client with uterine leiomyomas asks the nurse about her risk of uterine cancer. Which statement best answers the question?

"Your leiomyomas may cause heavy periods but will not become cancerous."

A client complains of not being able to experience satisfactory sexual intercourse. The nurse knows that erectile dysfunction is now recognized as a marker for:

Cardiovascular disease

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 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

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

Which of these complications does the nurse recognize may occur after illness with parotitis (mumps) in young men?

Orchitis with residual sterility

A client has been diagnosed with a Bartholin gland cyst. The nurse expects the client may experience which symptoms if this becomes infected?

Pain, tenderness, and dyspareunia

When assessing the client with chronic inflammatory bacterial prostatitis, the nurse recognizes which findings are typically present? Select all that apply.

Painful urination Frequency of urination Low back pain Bacteriuria

The parents of a newborn boy have decided against circumcision. The nurse emphasizes that, as the child grows, the mother must properly cleanse the area beneath the foreskin and to return the foreskin to the original position to prevent:

Paraphimosis

A 75-year-old man presents at the clinic complaining of pain during intercourse and an upward bowing of his penis during erection. The client's history mentions an inflammation of the penis that was treated 3 months ago. The physician's physical examination of the client notes beads of scar tissue along the dorsal midline of the penile shaft. What would be the suspected diagnosis of this client?

Peyronie disease

A client has been diagnosed with endometriosis. What assessment finding does the nurse expect? Select all that apply.

Premenstrual pain Back pain Pelvic pain

The provider is assessing a client with a history of erectile dysfunction (ED) who is requesting a prescription for treatment. When assessing for additional information related to causes of ED, which information should the provider solicit from the client?

Presence of arterial occlusive disease

A client in the urology clinic asks the nurse how the doctor will determine if his prostate lesion is due to benign prostatic hyperplasia (BPH) or prostate cancer. Which response should the nurse convey?

Presence of cancers are determined through a biopsy.

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

The nurse is performing an assessment on a newborn, 12 hours old. The newborn has right cryptorchidism as documented in the health records and assessed by the nurse. Where will the nurse assess for this disorder?

Scrotom

Priapism (a prolonged painful erection not associated with sexual excitement) can occur at any age. In boys, ages 5 to 10, what are the most common causes of priapism?

Sickle cell disease or neoplasms

A 42-year-old man reports testicular tenderness. He is concerned also because he found a mass that moves around within the scrotal sack. Upon examination, the physician determines that the mass is near the end of the epididymis, lights up uniformly when illuminated, and is above the testes. Which condition does this client most likely have?

Spermatocele

The nurse has just completed the admission assessment of a client diagnosed with invasive penile cancer. The most likely plan of treatment will be:

Surgical removal of the affected area

A female client reports to the health care provider that she has noticed a release of urine when she laughs or sneezes. Which interventions should the provider implement first?

Teach the client to do pelvic floor exercises

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

When caring for a group of clients, the nurse recognizes which of these individuals has increased risk for balanitis?

Client with a sexually transmitted infection

A client with polycystic ovary syndrome (PCOS) visits a fertility clinic. Which intervention will best improve the chance for a successful pregnancy?

Clomiphene

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?

Cremasteric reflex

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 mother of a 5-year-old boy brings him into the clinic because there is a firm feeling and swelling around one of his testes. What would the suspected diagnosis be?

Hydrocele

Which chronic health issues increase a man's risk for developing erectile dysfunction? Select all that apply.

Hypertension Hyperlipidemia Diabetes mellitus

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 adult male has been diagnosed with mumps orchitis. The nurse should educate the client regarding which complication associated with mumps orchitis?

Impaired spermatogenesis

A client has developed priapism. For which outcome is this client at risk?

Impotence

Cryptorchidism, or undescended testes, is associated with which complication?

Infertility

Which disorder of the male genitourinary system creates the most urgent need for prompt and aggressive surgical treatment?

Intravaginal testicular torsion

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.

The nurse is caring for a client who has just given birth to a premature neonate with cryptorchidism. What information does the nurse provide to the client?

It is likely the testes will descend by the age of 2 months.

Which statement(s) is true regarding priapism? Select all that apply.

It is not always related to sexual stimulation. Having sickle cell disease is a risk factor. It can result in ischemia of the erectile tissue of the penis.

A client is diagnosed with vulvar carcinoma, which appears as an inconspicuous thickening of the skin resembling eczema or dermatitis and may produce few symptoms other than pruritus, local discomfort, and exudation. The nurse understands that the cancer metastasizes readily through which mode?

Multiple lymph channels

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."

A client informs the nurse that he has been having difficulty sustaining an erection. Which statement made by the client demonstrates to the nurse that the client understands what a contributing factor to his erectile dysfunction is?

"I should stop smoking cigarettes. I have been smoking for 20 years."

A client who has been diagnosed with premenstrual syndrome (PMS) asks if there is anything to help alleviate the symptoms. The best response would be:

Eat a diet low in simple sugars and high in protein.

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 diagnosed with endometriosis asks the nurse how it is that she did not know about this when she had it for so long. What is the nurse's best response?

"Its symptoms mimic those of other disorders "

What should the nurse teach the client about assessing for possible breast cancer?

"Perform monthly self-breast exams after menses."

After an office visit with her primary health provider, a female client with an elevated CA-125 test result asks the nurse if that means she has ovarian cancer. What is the nurse's best response?

"The test is not specific for ovarian cancer but suggests further evaluation to find the cause of the elevation."

A client with vulvodynia tells the nurse, "This is not getting better. I just can't live like this." What is the best response by the nurse?

"What bothers you the most about your condition?"

A female client with endometrial hyperplasia asks the nurse about her risk of endometrial cancer. Which statement by the nurse best answers the question?

"Your cancer risk is decreased by taking progesterone, rather than by taking oral contraceptives."

The nurse is providing teaching about benign prostatic hyperplasia to a client who would like medication to avoid surgery. Which drug category is primarily prescribed to reduce prostate size by blocking the effects of androgens?

5 alpha-reductase inhibitors

A nurse who works in a fertility clinic is conducting a program on options for various fertility issues. The nurse judges that the participants understand the education when they identify that donor eggs are the best option for which woman?

A 42-year-old

A 32-year-old is being treated for an abnormal menstrual cycle with excessive bleeding, endometrial hyperplasia, and fertility problems. Which is a possible cause of these symptoms?

A granulosa cell tumor

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

Which client is at highest risk for developing acute bacterial prostatitis?

An older adult male diagnosed with frequent urinary tract infections testing positive for Gram-negative rods

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 client reports frequent urination, difficulty starting to urinate, and dribbling after he has finished urinating. Which diagnosis correlates with this client's manifestations?

Benign prostatic hyperplasia (BPH)

Based on the group that statistically has the greatest risk, the health care provider should assess which ethnic group for prostate cancer?

Black

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

There are two types of vulvar cancer. One type is found in older women, and one type is found in younger women, generally less than 40 years of age. The type found in younger women is thought to be caused by:

Human papillomavirus (HPV)

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

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.

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 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

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

A 38-year-old woman with proliferative breast changes of papilloma asks the nurse about her risk for breast cancer. Which statement of risk is correct?

Higher because of your papilloma

The nurse is teaching a high school student about male sexual function. Which organ contains the muscle that promotes semen expulsion during ejaculation?

Prostate gland

A nurse who works on a urology-gynecology ward of a hospital is coming on shift and will be caring for a 34-year-old woman who has been admitted overnight for the treatment of endometriosis. Which interventions should the nurse most realistically anticipate providing over the course of the shift and the next several days?

Providing pain control; preparing the client for a laparoscopic procedure or hysterectomy

A 52-year-old male diagnosed with erectile dysfunction (ED) asks the nurse what will be implemented as a first option for treatment. The best response would be:

Psychosexual counseling and PDE-5 inhibitor medications

A nurse is performing a genital examination on a male client who develops an erection. Which action is the nurse's most appropriate intervention?

Reassure the client that this is a normal response and continue with the examination

The nurse is assessing a client with suspected acute bacterial prostatitis. Which aspects of the client's clinical history should the nurse inquire about related to the client's risk factors for this condition? Select all that apply.

Recent biopsy of the prostate Current immunosuppressive therapy Having a diagnosis of benign prostatic hyperplasia

In the neonatal and pediatric population, there can be many physiologic problems with the male genitourinary system. What is the most common acute scrotal disorder in the pediatric population?

Testicular torsion

A client with symptoms of benign prostatic hyperplasia (BPH) is assessed according to the American Urological Association Symptom Index (AUASI). However, which factor is considered the single most important to assess when evaluating and treating BPH?

The man's own experiences

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.

The nurse is teaching the client about pharmacologic treatment for benign prostatic hyperplasia (BPH). Which explanation of the action of these alpha adrenergic blocking medications is best?

They relax the smooth muscle to relieve prostatic obstruction.

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

A client is suspected to have small varicoceles in his left scrotum. Which assessment technique may help accentuate small varicosities?

Valsalva maneuver

Which clinical manifestation is most likely to accompany a diagnosis of vulvodynia?

Vulvar pain

A client who has a history of untreated cervicitis tells the nurse that she is concerned about the risk of experiencing problems with fertility. The nurse explains that problems may result from:

ascending infection of the fallopian tubes.

The nurse in the urology clinic is teaching the client about the signs and symptoms of epididymitis. Which will the nurse include in the discussion? Select all that apply.

groin tenderness fever pain with urination

A client is admitted with a prolonged and painful erection that has lasted longer than 4 hours. The nurse knows that this is a true urologic emergency, and that the cause is:

impaired blood flow in the corpora cavernosa of the penis.

A client is experiencing oligomenorrhea. The nurse interprets this as:

infrequent menstruation with periods more than 35 days apart.

The nurse in the urology unit is teaching about medication to treat erectile dysfunction. The mechanism of action of most of these medications is that the medication:

promotes increase in blood flow to the corpora cavernosa.