PrepU CH. 39

The nursing student who is studying pathophysiology of the male genitourinary system correctly identifies which of the following to be functions of the penis? Check all that apply.

Urine elimination Sexual function

A 27-year-old male developed mumps and was ill for several days. The patient suddenly developed a fever and painful enlargement of the testes approximately 4 days after recovering. Which of the following should the nurse suspect has developed?

Orchitis

Two nursing students are debating the merits and demerits of infant circumcision. Which of the following statements is most accurate?

"Circumcised men tend to have a lower incidence of penile cancer."

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

"Have you ever had mumps?"

A 68 year-old man has revealed to his care provider that he is distraught over his increasingly frequent inability to maintain an erection. Which of the following teaching points is most warranted?

"While this problem is often a part of the aging process, it might be a result of some of the medications that you take."

When caring for the client with acute bacterial prostatitis, the nurse plans for which of these interventions?

Antibiotics

The nurse is speaking with a couple at the fertility clinic about ways to increase sperm counts. Which of these does the nurse include in the discussion?

Avoid tight undergarments

A client asks the gynecologist what gland is responsible for urethral lubrication during male sexual stimulation. The best response would be:

Bulbourethral glands

A patient complains of not being able to experience satisfactory sexual intercourse. The nurse knows that erectile dysfunction is now recognized as a marker for which of the following?

Cardiovascular disease

A nurse is performing a genital examination on a 25-year-old man 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.

The male reproductive system is comprised of two systems. The nurse knows that which system is responsible for the transportation and storage of sperm?

Ductile system

Sperm follow a prescribed route through the excretory ducts of the male reproductive system. Place the following components of the genital duct system in the order that sperm follow. Use all the options.

Efferent ductules Ductus deferens Prostatic urethra Urethra Seminiferous tubules Epididymis

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 estradial?

Enlarged breast

A male patient 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 of the following?

Glans penis

An adult client had bilateral orchiectomy (testicular removal) due to cancer. Which will be the primary effect of the disruption in testosterone synthesis?

He will likely experience an overall reduction in muscle mass.

The cremaster muscles work in concert with the pampiniform plexus that surrounds the testicular artery to:

Maintain testicular temperature

As the sperm mature and are preparing for fertilization, what length of time are sperm able to survive in the male genital tract?

Many weeks

The nurse is caring for a client with acute superficial balanitis. 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 of the following structures?

Rete testis

The nurse conducting a health promotion class for teenage boys on human reproduction determines that the participants are understanding the information when they state:

Spermatogenesis continues throughout a man's reproductive years.

A young pregnant mother is told after an ultrasound that the fetus' testes have not descended. What hormone is responsible for the descent of the testes?

Testosterone

Men who experience enlarged prostate glands often complain of difficulty urinating. The nurse will be able to explain that this symptom is caused by which of the following reasons?

The prostate gland surrounds the urethra and can produce urinary obstruction.

A client who had been utilizing pharmacologic management for BPH is now experiencing severe signs of obstruction. The client would most likely require:

Transurethral prostatectomy

The nurse is performing a health history of a patient being evaluated for erectile dysfunction. Which of the following places the patient at highest risk for the disorder?

Type 2 diabetes

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.

The gerontology nurse recognizes that aging male clients may enter a stage referred to as andropause. Which of these does the nurse recognize as characteristic of this stage?

Decline in sexual function

Screening for which of the following disease processes should be done prior to beginning testosterone replacement therapy?

Prostate cancer

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 which of the following?

Hypospadias

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

An obstetrician is explaining the differentiation of embryonic tissue into a fetus to an aspiring class of nursing students. Which hormone is primarily responsible for the development of male sex characteristics?

Testosterone

The nurse is re-enforcing information given to the client who is asking about screening for prostrate cancer. Which of these will be nurse teach the client about the PSA test?

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

A patient requests a prescription for sildenafil (Viagra) to assist him with achieving and maintaining an erection. Which of the following types of medication would contraindicate the use of sildenafil?

Nitrate

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

Orchitis with residual sterility

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

PSA level

A client is concerned that he may have mumps orchitis and asks the nurse practitioner what the symptoms would be. The best response would be:

Painful enlargement of the testes with fever 3 days after parotitis

The nurse knows that which of the following structures are a part of the male reproductive system? Select all that apply.

Pair of gonads Seminiferous tubules Prostate gland

Temperature regulation of the testes is maintained by which of the following structures?

Pampiniform plexus and cremaster muscles

A nurse is providing teaching to the parents of a child who has undergone corrective surgery for cryptorchidism. The most important information for the nurse to provide is:

Parents should be taught that their child needs frequent follow-up visits.

A 68 year-old male has visited his family physician because the size of his scrotum has increased exponentially in recent months. He has subsequently been diagnosed with an inguinal hernia. Which of the following statements best captures the nature of his health problem?

Part of his intestine and parietal peritoneum are protruding through the inguinal opening.

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

Sperm begin their life in the Sertoli cells. What factor functions in releasing mature spermatozoa from the Sertoli cells?

Plasminogen activator

The nurse 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, for which of these does the nurse question the client?

Presence of arterial occlusive disease

The nurse is assigned to care for newborns and assesses a newborn male, 12 hours old. The newborn has right cryptorchidism as documented in the doctor's progress notes and noted by the nurse. Which of the following would the nurse assess for this disorder?

Scrotum

Select the structure responsible for secreting fructose that will provide energy for spermatic motility.

Seminal vesicles

A young male patient comes to the clinic and informs the nurse practitioner that he and his new bride have been trying to conceive for the last 4 months. He then states that he is afraid that he may be sterile because he read recently that jockey underwear can cause sterility. What would be the nurse's best response to this?

Sperm production requires temperatures that are 2-3 degrees C below body temperature.

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

The nurse in the urology office recognizes screening men at risk for prostate cancer includes which of these diagnostic studies?

Blood level of PSA and digital rectal exam

An 18-month-old boy is diagnosed with cryptorchidism. Based on this diagnosis, which of the following does the nurse expect to observe during the physical assessment?

Absence of the testis in the scrotum bilaterally

Following a long history of intermittent back pain and urinary urgency, a 50-year-old client has been diagnosed with chronic bacterial prostatitis. Which of the following factors is most likely to influence his healthcare provider's choice of treatment?

Antibacterial drugs penetrate poorly into the chronically inflamed prostate.

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

A newborn male has been diagnosed with hypospadias following his postpartum assessment by a pediatrician. Which of the following diagnostics and treatment options is the physician most likely to rule out first?

Circumcision

The pediatric nurse is caring for a newborn with hypospadias. The mother requests that a circumcision be performed prior to discharge. 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.

The pediactric nurse is teaching the mother of a newborn with hypospadias about this disorder. Which of these does the nurse convey?

The opening of the urethra is found on the underside of the penis.

A nurse suspects an elderly client is experiencing benign prostatic hyperplasia (BPH). Which of the following questions should the nurse ask this client?

"Has the force of your urinary stream decreased?"

While the cause of BPH is unknown, we do know that the incidence of BPH increases with age. What ethnic group is BPH highest in?

African American

Cryptorchidism, left untreated, is a high risk for testicular cancer and infertility. What are the treatment goals for boys with cryptorchidism?

Easier cancer detection

Which of the following is the final site for sperm maturation?

Epididymis

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

Hydrocele

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

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

Hypertension B. Diabetes Mellitus D. Hyperlipidemia

A 54-year-old diabetic patient has come to the urology clinic complaining of erectile dysfunction. His history includes obesity, coronary artery disease which required CABG three years ago, hypertension, and gout. The nurse practitioner is reviewing his record in order to prescribe medication. The practitioner is considering prescribing sildenafil (Viagra). Which of the following home medications is contraindicated if taken concurrently with sildenofil?

Imdur (isosorbide mononitrate), a vasodilator

A 14-year-old boy has been brought to the emergency department by his mother in excruciating pain that is radiating from his scrotum to his inguinal area. The boy's heart rate is 122 beats per minute and he has vomited twice before arrival at the hospital. Examination reveals that his scrotum is reddened and slightly swollen and the testes are firm to touch and tender, with extensive cremaster muscle contraction noted. What is the boy's most likely diagnosis?

Testicular torsion

The nursing instructor is teaching the class about the male hormone testosterone. Which of the following statements made by a student indicates a need for further instruction?

Testosterone does not have any effect on development of increased musculature during puberty

With the aging male, many changes are measurable. The measurable changes in the reproductive system of the older male are particularly attributable to which hormone?

Testosterone hormone

The nurse is caring for a client with significant benign prostatic hyperplasia (BPH)and hydronephrosis who is fearful of having corrective surgery. Which of these is important for the nurse to convey?

The obstruction is causing urine to flow backward and cause kidney dysfunction.

A male client seeks treatment for erectile dysfunction. What factors contribute to this condition? Select all that apply.

• Age 65 years • Cardiovascular disease • Antihypertensive medications

A couple is undergoing initial testing to determine why they are unable to conceive. One of the test shows that the man has a testosterone level of 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 in the urology clinic is reviewing the chart of a client with erectile dysfunction. Which of these factors in the client's history does the nurse recognize is a hormone-based conditions that may contribute to erectile dysfunction?

Hypogonadism

A patient is admitted with a prolonged and painful erection that has lasted longer than four hours. The nurse knows that this is a true urologic emergency, and that the cause is which of the following?

Impaired blood flow in the corpora cavernosa of the penis

An older male patient complains of inhibited sexual functioning. The nurse knows which of the following nursing diagnoses could be a priority for his inhibited sexual function?

Impaired self-esteem

A male client has developed priapism. The nurse is aware that the client is at risk for:

Impotence

A 20-year-old male has been diagnosed with testicular cancer, and is seeking information about his diagnosis from a number of websites. Which of the following statements that he has read is most plausible?

"Men with cryptorchidism - the term for an undescended testicle - are known to have a higher risk of developing testicular cancer."

A male 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."

A 70-year-old male tells the health care provider he is now in a relationship with a younger woman who is capable of reproduction. The client asks if he may still be fertile. The best response would be:

"Yes; some 80- and 90-year-old men have been known to father children."

Which of the following teaching points by an oncologist is most appropriate for a 33-year-old male who will begin treatment shortly for his testicular cancer?

"You should know that there might be adverse effects on your sexual function after treatment is finished."

A nurse practitioner has a 30-year-old male patient presenting with fever/chills, urinary frequency/urgency and pain with urination. A urine sample displays cloudy and foul-smelling urine. During digital rectal exam of the prostate, the nurse notes a thick white discharge. A likely diagnosis would be which of the following?

Acute bacterial prostatitis requiring antimicrobial therapy

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

A 40-year-old man presents at the clinic complaining of painful urination and rectal pain. His vital signs are temperature, 101.7°F; blood pressure, 105/74; pulse, 98; respiration, 22. While taking a history, the nurse notes the client has had chills, malaise, and myalgia. What would the nurse suspect as a diagnosis?

Acute bacterial prostatitis

Spermatozoa are produced in the seminiferous tubules of the testes and are moved through the genital ducts to be stored in the ampulla of the vas deferens before ejaculation through the penis. Unlike the female egg, which remains briefly fertile, spermatozoa can remain fertile for up to 42 days. Where are the spermatozoa stored so they maintain their fertility?

Ampulla

An elderly male patient is complaining of dribbling after he urinates and feeling like he never empties his bladder. The nurse suspects the patient may have a problem with:

An enlarged prostate gland.

The nursing student is teaching an all-male class at a local middle school about reproduction. When should she tell the students that spermatogenesis begins and ends?

At about 13 years and throughout the reproductive years

While teaching a health class to junior and senior male high school students, the school nurse educates them that which of the following is the first sign of testicular cancer?

Enlargement of the testicle

Benign prostatic hypertrophy (BPH) and prostatic adenocarcinomas presently differently. The nurse is aware of which of the following differences?

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

A male patient who is in his 60s comes to the clinic for his yearly checkup. After examining the patient, the physician informs him that he has an overgrowth of mucosal glands of the prostate. Based solely on this finding, what diagnosis should the nurse suspect in this case?

Benign prostate hyperplasia (BPH)

A client with on the urology floor who has BPH asks the nurse how the pharmacologic agent finasteride will help decrease the size of his prostate. Which these does the nurse explain to the client is the mechanism of action?

Blocking effects of androgens on the prostate

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

Client with a sexually transmitted disease

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

Of the following list of medications, which would likely be prescribed to a patient with benign prostatic hyperplasia (BPH) as a way to decrease the prostate size by blocking the effects of androgens on the prostate?

Finasteride (Proscar), a 5a-reductase inhibitor

The male reproductive system is controlled by the hypothalamus and the anterior pituitary gonadotropic hormones regulated by a negative feedback loop. What gonadotropic hormones regulate control of the male reproductive system?

Follicle-stimulating hormone and luteinizing hormone

A patient 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. Which of the following should the nurse suspect this patient may have?

Hematocele

The fluid from both the vas deferens and the vagina are acidic. From where do the alkaline secretions that allow mobilization of sperm come?

Prostate

Spermatozoa are mobile in environments with a pH of 6.0-6.5. The nurse knows that secretions from which accessory organ help to neutralize the strongly acidic vaginal secretions?

Prostate gland

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

Ejaculation represents expulsion of sperm from the urethra. The nurse understands that which of the following muscles are involved in this process?

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

The testes secrete several male sex hormones. Which of these hormones is the most abundant and considered the main testicular hormone?

Testosterone

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 not closed almost completely.

A nursing student is studying pathophysiology as part of her nursing curriculum. Which of the following statements made by the student indicates a need for further instruction?

The male testes are located inside the abdominal cavity.

Which of the following statements best captures an aspect of the neural control of sexual function?

The spinal cord plays a central role, with the limbic system and cerebral cortex also contributing.

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

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