PrepU Ch.23; Assessment

During a prostate examination, the prostate is noted to have a rubbery or boggy glandular consistency. The nurse recognizes that this is what? a. Prostate cancer b. BPH c. Prostatic calculi d. Chronic fibrosis

b. BPH

A male client is assessed for suspected benign prostatic hypertrophy (BPH). The nurse expects the client to suffer from which symptoms? (Select all that apply.) 1. Frequent urination during the night 2. Inability to empty the bladder 3. Dribbling after urination 4. Weak urinary stream 5. Bleeding and spotting in underwear

1. Frequent urination during the night 2. Inability to empty the bladder 3. Dribbling after urination 4. Weak urinary stream

Which of the following groups has the highest incidence of prostate cancer? a. African American men b. Caucasian men c. Native American men d. Asian American men

a. 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? a. Age 60 years or older b. Sexual promiscuity c. History of human papilloma virus d. Poor personal hygiene

a. Age 60 years or older

A tender painful swelling of the scrotum should suggest which of the following? a. Any of the above b. Strangulated inguinal hernia c. Acute epididymitis d. Torsion of the spermatic cord

a. Any of the above

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. Beaded or thickened cord b. Left testicle is slightly lower than the right c. Smooth, nontender cord d. Palpable and tortuous veins

a. Beaded or thickened cord

A male in college presents to the health clinic with complaints of fever, malaise, and swelling of the sides of the neck. A blood test confirms the presence of mumps. The nurse should educate the client to report which changes of his genitalia to the health care provider? a. Feelings of heaviness and pain in the scrotum b. Clear vesicles that erupt from ulcers c. Silvery lesion on the glans d. Red rash on the penis

a. Feelings of heaviness and pain in the scrotum

Upon inspection and palpation of the front of the client's thigh, the nurse discovers a bulge that appears when the client coughs. The nurse should document this finding as which type of hernia? a. Femoral b. Incarcerated c. Scrotal d. Strangulated

a. Femoral

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 a varicocele is present? a. Palpable and tortuous veins b. Smooth, nontender cord c. Beaded or thickened cord d. Left testicle is slightly lower than the right

a. Palpable and tortuous veins

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. Position the client in a left side-lying position. b. Ask the client if he is feeling anxious or fearful about the exam. c. Assist the client into the supine position. d. Administer a dose of analgesia 15 minutes before the exam.

a. Position the client in a left side-lying position.

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. Prostate cancer b. Benign prostatic hypertrophy c. Acute prostatitis d. Hydrocele

a. Prostate cancer

Mr. Jackson, 50 years old, has had discomfort between his scrotum and anus. He also has had some fevers and dysuria. Rectal examination is halted by tenderness anteriorly, but no frank mass is palpable. What is the most likely diagnosis? a. Prostatitis b. Prostate cancer c. Colonic polyp d. Colon cancer

a. Prostatitis

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 older men to avoid low-pH foods and beverages. c. Encourage the use of intravenous fluids to ensure hydration. d. Promote physical activity among older males.

a. Remove urinary catheters as soon as possible.

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. Spermatic cord d. Vas deferens

a. Scrotum

Which finding should a nurse expect to observe when inspecting the external genitalia of an elderly male client? a. Smaller penis with lower hanging testicles b. Smaller testicles c. Enlarged glans penis and scrotum d. Hardness along the ventral surface of the penis

a. Smaller penis with lower hanging testicles

A nurse is beginning the physical exam of a male client's genitals. The nurse is sitting on a stool in front of the client. Which position would be best to place the client in? a. Standing b. Sitting c. Lying supine d. Kneeling

a. Standing

The inguinal canal in a male client is located a. just above and parallel to the inguinal ligament. b. posterior to the superior iliac ring. c. anterior to the external inguinal ring. d. anteriorly above the symphysis pubis.

a. just above and parallel to the inguinal ligament.

The prostate gland consists of two lobes separated by the a. median sulcus. b. valves of Houston. c. rectovesical pouch. d. anorectal junction.

a. median sulcus.

While inspecting the genitalia of a male client, the nurse observes a chancre lesion under the foreskin. The nurse has explained this observation to the client. The nurse determines that the client understands the need for a referral when the client says that chancre lesions are associated with a. syphilis. b. papilloma virus. c. gonorrhea. d. herpes virus.

a. syphilis.

The nurse is reviewing lifestyle changes with a client who is attempting to reduce the risk for colon and prostate cancer. Which statement by the client requires further follow-up by the nurse? a. "I am now abstaining from alcohol." b. "I am on a high-protein diet that includes red meats." c. "I have started to finally get my weight under control." d. "I have been increasing the fiber in my diet."

b. "I am on a high-protein diet that includes red meats."

A 55-year-old male presents to the health care clinic with reports of difficulty starting the urine stream, dribbling frequently, and getting up several times a night to urinate. He has decreased his fluid intake to try to control the nighttime urination. The nurse assesses a temperature of 101.5°F oral, dry skin and mucous membranes, and suprapubic tenderness. Which nursing diagnosis can the nurse confirm from this data? a. Readiness for Enhanced Self-Health Management b. Disturbed Sleep Pattern c. Ineffective Health Maintenance d. Sexual Dysfunction

b. Disturbed Sleep Pattern

What documentation in a client's history should a nurse recognize as an indication that the client has a normal prostate? a. Rubbery with two lobes, left slightly larger than the right b. Heart shaped, smooth with two distinct lobes c. Nontender, firm, and slightly tender to palpation d. Slightly tender to palpation but smooth and rubbery

b. Heart shaped, smooth with two distinct lobes

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. Heterosexual partners b. Men having sex with men c. Bisexual individuals d. Intravenous drug users

b. Men having sex with men

Which of the following is a sign or symptom of benign prostatic hypertrophy (BPH)? a. Weight loss b. Nocturia c. Bone pain d. Fever

b. Nocturia

A nurse recognizes that which finding is normal upon palpation of the prostate? a. Enlarged, smooth, firm, slightly elastic b. Nontender and rubbery c. Swollen and tender d. Hard, fixed, irregular nodules

b. Nontender and rubbery

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. Gonorrhea b. Normal findings c. Effects of chemotherapy d. Reiter's syndrome

b. Normal findings

Which of the following unexpected findings of the testes is most likely to result in painful palpation of the testes? a. Testicular tumor b. Orchitis c. Cryptorchidism d. Klinefelter's syndrome

b. Orchitis

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? a. Erectile dysfunction b. Strenuous activity c. Exposure to radiation d. Stress and inhibition

b. Strenuous activity

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. The client is an older adult b. The client is on anticoagulation medication c. All rectal bleeding requires immediate hospitalization d. The client has had a stroke in the past

b. The client is on anticoagulation medication

After teaching a client about measures to reduce his risk for colon cancer, the nurse determines that the teaching was successful when the client states which of the following? a. "I will eat a diet high with lots of red meat." b. "I need to cut back on the amount of fruit I eat." c. "I should eat a half-cup of raisins every day." d. "I should avoid eating green leafy vegetables."

c. "I should eat a half-cup of raisins every day."

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. "Do you ever experience pain when you urinate?" b. "Have you ever been screened for prostate cancer?" c. "What medications are you currently taking?" d. "How would you describe a typical day's food intake?"

c. "What medications are you currently taking?"

Which of the following male clients is most in need of immediate medical treatment? a. A 22-year-old student who has presented with a cluster of painful lesions on the shaft of his penis b. A 30-year-old who presents with palpable nodules in his left testis c. A 15-year-old boy who has been brought in by his mother for assessment of his severely painful testes that are retracted upward d. A 70-year-old retiree whose intestines are palpable in his scrotum

c. A 15-year-old boy who has been brought in by his mother for assessment of his severely painful testes that are retracted upward

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. Elevation of affected testicle does not lessen pain. b. Denies urethral irritation. c. Absence of nausea and vomiting. d. Temperature 100.4 degrees Fahrenheit.

c. Absence of nausea and vomiting.

A 22-year-old unemployed roofer presents to the clinic with pain in his testicle and penis. He states the pain began last night and has steadily worsened. He states it hurts when he urinates; he has not attempted intercourse since the pain began. He has tried acetaminophen and ibuprofen without improvement. He denies any fever or night sweats. His past medical history is unremarkable. He has had four previous sexual partners and has had a new partner for the last month. She uses oral contraceptives so he has not used condoms. His parents are both in good health. Examination shows a young man lying on his side. He appears mildly ill. His temperature is 38.2°C, and his blood pressure, respirations, and pulse are normal. On visualization of the penis he is circumcised with no lesions or discharge from the meatus. Visualization of the scrotal skin appears unremarkable. Palpation of the testes shows severe tenderness at the superior pole of the normal-sized left testicle. He also has tenderness when palpating the structures superior to the testicle through the scrotal wall. The right testicle is unremarkable. An examining finger is placed through each inguinal ring without bulges being noted

c. Acute epididymitis

When inspecting the anus, to better inspect the anal opening it would be helpful to instruct the client to do which of the following? a. Deep breathe b. Squat c. Bear down d. Cough

c. Bear down

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? a. Patellar reflex b. Rooting reflex c. Cremasteric reflex d. Vasovagal reflex

c. Cremasteric reflex

When examining a newborn male infant, the nurse notes that neither testicle is descended. How would the nurse document this finding? a. Varicocele b. Orchitis c. Cryptorchidism d. Epididymitis

c. Cryptorchidism

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. Cryptorchidism b. Hydrocele c. Epididymitis d. Orchitis

c. Epididymitis

A male client is complaining of pain with urination, rectal pain and urethral discharge. The nurse suspects this is what? a. Chlamydia b. Syphilis c. Gonorrhea d. Scabies

c. Gonorrhea

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. Use of multivitamins b. Lack of exercise c. History of hypertension d. Past history of infection

c. History of hypertension

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. Prostatism b. Orchitis c. Hydrocele d. Cryptorchidism

c. Hydrocele

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. Varicocele b. Hernia c. Hydrocele d. Tumor

c. Hydrocele

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? a. Cryptorchidism b. Phimosis c. Hypospadias d. Epispadias

c. Hypospadias

Which of the following conditions consists of a tight prepuce that, once retracted, cannot be returned? a. Balanitis b. Balanoposthitis c. Paraphimosis d. Phimosis

c. Paraphimosis

Upon inspection and palpation of the scrotum, the nurse discovers a mass. The nurse asks the client to lie down, and the bulge remains. On auscultation, the nurse finds bowel sounds. The nurse should document this finding as which type of hernia? a. Incarcerated b. Strangulated c. Scrotal d. Femoral

c. Scrotal

The corpora spongiosum extends distally to form the acorn-shaped a. frenulum. b. scrotum. c. glans. d. corona.

c. glans.

The nurse identifies a cheesy white material that has accumulated under a male client's foreskin of the penis. What does this finding suggest to the nurse? a. hypospadias b. balanitis c. smegma d. sexually transmitted infection

c. smegma

A male client visits the clinic and tells the nurse that he has had a white discharge from his penis for the past few days. The nurse should refer the client to a physician for possible a. gonorrhea. b. syphilis. c. urethritis. d. herpes infection.

c. urethritis.

During the health history, a young male client asks the nurse why his scrotum rises and relaxes. The nurse would include which statement when responding to the client? a. "When the temperature is warm, it causes the scrotum to rise." b. "When the scrotum is in a relaxed state, it has many rugae." c. "When the temperature is colder, the scrotum relaxes." d. "The cremasteric reflex controls the rise and relaxation of the scrotum."

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

A 17-year-old male client expresses concern about feeling lumps on his testicles. What response by the nurse would best address the client's concerns? a. "Lumpy testicles are not going to cause a problem with sexual performance." b. "Do you think you have malformed testicles?" c. "Don't worry, that is the way normal testicles feel." d. "The normal testicle contains internal structures that cause lumps on the surface."

d. "The normal testicle contains internal structures that cause lumps on the surface."

During the physical assessment of the anus for a client, the nurse observes a small opening in the skin that surrounds the anal opening. How should the nurse document this finding? a. Perianal abscess b. Pinworm infection c. Anal fissure d. Anorectal fistula

d. Anorectal fistula

A client complains of scrotal pain, and the nurse elicits a positive Prehn sign. The nurse would refer the client for treatment of what condition? a. Scrotal mass b. Strangulated hernia c. Tortuous varicocele d. Epididymitis

d. Epididymitis

A client's electronic health record reveals that he had surgery as an infant to correct the fact that his urethra was located on the ventral side of his penis. The nurse should recognize that this client had what condition? a. Phimosis b. Epispadias c. Paraphimosis d. Hypospadias

d. Hypospadias

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. Hydrocele b. Testicular cancer c. Epididymitis d. Left testicular torsion

d. Left testicular torsion

A client with which of the following cancers is prone to developing phimosis? a. Testicular b. Prostate c. Leukemia d. Penile

d. Penile

A nurse prepares a male client for a physical assessment of the external genitalia. Which instruction is appropriate for the nurse to give the client before the examination? a. Ask the client to not empty the bladder before the examination b. Request that the client avoid talking c. Explain that he may need to lie supine d. Reassure him that it is not unusual to have an erection during the examination

d. Reassure him that it is not unusual to have an erection during the examination

A 50-year-old truck driver comes to the clinic for a work physical. He has had no upper respiratory, cardiac, pulmonary, gastrointestinal, urinary, or musculoskeletal system complaints. Past medical history is significant for mild arthritis and prior knee surgery in college. He is married and just changed jobs, working for a different company. He smokes one pack of cigarettes a day, drinks fewer than six beers a week, and denies any illegal drugs. His mother has high blood pressure and arthritis; his father died of lung cancer in his 60s. On examination, the client's blood pressure is 130/80 and pulse is 80. Cardiac, lung, and abdominal examinations are normal. He has no inguinal hernia, but digital rectal examination reveals a soft, smooth, nontender, pedunculated mass on the posterior wall of the rectum. What anal, rectal, or prostate disorder best fits his presentation? a. Prostate cancer b. Internal hemorrhoid c. Anorectal cancer d. Rectal polyp

d. Rectal polyp

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? a. Encourage the client to increase his intake of fluids and soluble fiber. b. Tell the client to use an over-the-counter laxative for the next 2 to 3 days. c. Refer the client to a dietitian for treatment of a possible vitamin deficiency. d. Refer the client for treatment of a possible gastrointestinal bleed.

d. Refer the client for treatment of a possible gastrointestinal bleed.

A 28-year-old musician comes to the clinic complaining of a "spot" on his penis. He states his partner noticed it 2 days ago and it hasn't gone away. He says it doesn't hurt. He has had no burning with urination and no pain during intercourse. He has had several partners in the last year and uses condoms occasionally. His past medical history consists of nongonococcal urethritis from Chlamydia and prostatitis. He denies any surgeries. He smokes two packs of cigarettes a day, drinks a case of beer a week, and smokes marijuana and occasionally crack. He has injected IV drugs before but not in the last few years. His mother has rheumatoid arthritis; he doesn't know anything about his father. Examination shows a young man appearing deconditioned but pleasant. His vital signs are unremarkable. Visualization of his penis reveals a 6-mm red, oval ulcer with an indurated base just proximal to the corona. There is no prepuce because of neonatal circumcision. On palpation the ulcer is nontender. In the inguinal region there is nontender lymphadenopathy. What disorder of the penis is most likely? a. Genital herpes b. Condylomata accuminata c. Penile carcinoma d. Syphilitic chancre

d. Syphilitic chancre

A client presents at the clinic with severe scrotal pain. What is the presumptive diagnosis? a. Hydrocele b. Varicocele c. Priapism d. Testicular torsion

d. Testicular torsion

After discovering an abnormal mass in the scrotum, a nurse performs transillumination of the client's testicles and observes no red glow within the scrotal sac. The nurse recognizes that this client may be experiencing what type of condition? a. Testicular torsion b. Spermatocele c. Hydrocele d. Testicular tumor

d. Testicular tumor

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? a. The anus ends at the intersphincteric groove. b. The anus contains three sphincters. c. The external sphincter contains smooth muscle. d. The internal sphincter is under involuntary control.

d. The internal sphincter is under involuntary control.

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. Prostat

d. Torsion of the spermatic cord

A young man feels something in his scrotum and comes to you for clarification. On your examination, you feel what feels like a "bag of worms" in the left scrotum, superior to the testicles. Which of the following is most likely? a. Hydrocele of the spermatic cord b. Normal vas deferens c. Testicular carcinoma d. Varicocele

d. Varicocele

During a focused genital assessment of an older adult client, the nurse observes a skin tag that protrudes through the rectum. How should the nurse document this finding? a. pinworms b. an external hemorrhoid c. perianal abscess d. a previously thrombosed hemorrhoid

d. a previously thrombosed hemorrhoid