Ch. 26 - Male Genitalia and Rectum

Normal prostate

*normally nontender and rubbery *it has two lateral lobes that are divided by a median sulcus *the lobes are normally smooth, 2.5 cm long, and heart-shaped.

Normal size of testes

3.5-5.5 cm long, 2.5 cm wide, 2.5 cm deep

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

A client reports the new onset of mucous in the stool. How should the nurse document this in the client's history? A. Steatorrhea B. Diarrhea C. Change in bowel habits D. Fecal incontinence

A

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. urethritis. B. gonorrhea. C. herpes infection. D. syphilis.

A

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

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

During DRE, a 46-year-old client cries out in pain as the nurse palpates his swollen, firm prostate. Which of the following problems should the nurse first suspect? A. Prostatitis B. Benign prostatic hyperplasia C. Prostate cancer D. Rectal cancer

A

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

A

During assessment of the inguinal regions for herniating masses, the nurse instructs the standing male client do which of the following? A. Bear down. B. Exhale fully. C. Bend over and bear down. D. Hold breath to the count of 10.

A

A male client seeks medical attention for a swelling in the groin area. What should the nurse consider is occurring with this client? Select all that apply. A. Hernia B. Cancer C. Infection D. Hydrocele E. Hematocele

A,B,C

Prostate cancer is the leading cancer diagnosed in men in the United States. To increase knowledge of risk factors, the nurse would teach men that (Select all that apply.) A. each decade after age 50 increases the risk B. it occurs earlier and is more advanced in African American men C. 15% have an affected first-degree relative D. testicular self-examinations can reduce the risk by 50% E. symptoms are often undetectable

A,B,C

Prostate enlargement is common in older men. The nurse should be aware of what signs and symptoms when interviewing an older male client? Select all that apply. A. Sensation of residual urine B. Straining to urinate C. Dribbling D. Increased caliber of urine stream E. Chronic kidney infection F. Erection that will not subside

A,B,C

A nurse is instructing a client on how to perform testicular self-examination (TSE). Which of the following should the nurse mention? Select all that apply. A. Perform the TSE once a month B. Perform the TSE just before showering C. Use one hand to palpate the testis D. Stand in front of a mirror and check for scrotal swelling E. If one testis is larger than the other, report it to your physician F. Roll the testis gently in a horizontal plane between thumb and fingers

A,D,F

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. herpes virus. B. syphilis. C. papilloma virus. D. gonorrhea.

B

A nurse is assessing a client who is uncircumcised. The nurse understands that this client is at greater risk for which of the following conditions? Select all that apply. A. Prostate cancer B. Cancer of the glans penis C. HIV/AIDS D. Testicular cancer E. Colorectal cancer

B,C

The nurse is teaching a class of senior citizens about the risk factors for prostate cancer. Which of the following would the nurse mention? Select all that apply. A. Age older than 65 years B. African American heritage C. Excessive alcohol use D. Diet high in animal fats E. Environmental exposure F. Low levels of PSA

B,C,D,E

What care should a nurse take when performing the hands-on assessment of the anus, rectum, and prostate? Select all that apply. A. Examine the genitalia after examining the anus, rectum, and prostate B. Explain each step of the examination and encourage the client to relax C. Examine the upper rectum and sigmoid using the finger D. Use gentle movements with the finger and ensure adequate lubrication E. Listen and watch for signs of discomfort and tensing muscles

B,D,E

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

A teenager presents at the ER with severe scrotal and abdominal pain, vomiting, and nausea. He tells the nurse that he participated in a polar bear plunge in his community (jumping into cold water off-season). What conditions would the nurse suspect? A. Hydrocele B. Phimosis C. Torsion of the spermatic cord D. Varicocele

C

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

An uncircumcised, 78 year-old male has presented at the clinic complaining that he cannot retract his foreskin over his glans. On examination it is noted that the foreskin is very constricted. What is this condition called? A. Bowen's disease B. Peyronie's disease C. Phimosis D. Priapism

C

The prostate is enlarged, smooth, firm, and slightly elastic. The median sulcus may not be palpable. It is common in men older than 50 years.

Benign Prostatic Hypertrophy

A 25-year-old client asks the nurse how often he should have a testicular examination. After instructing the client about the American Cancer Society's guidelines, the nurse determines that the client has understood the instructions when he says he should have a testicular examination every A. year. B. 2 years. C. 3 years. D. 4 years.

C

A 36-year-old married bank teller comes to the office complaining of pain with defecation and occasional blood on the toilet paper. She states that last week she had food poisoning with nausea, vomiting, and diarrhea. She had runny stools but no black or bloody stools. Since her illness, she has continued to have severe pain with bowel movements. She now tries to delay defecation as long as possible. Although she is having constipation, she denies any further diarrhea or leakage of stool. She has a past medical history of hypothyroidism and two spontaneous vaginal births. She has had no other chronic illnesses or surgeries. She does not smoke and rarely drinks. She has two children. There is no family history of breast or colon cancer. She has had no weight gain, weight loss, fever, or night sweats. On examination she is afebrile with a blood pressure of 123/70 and a pulse of 80. Abdominal examination reveals active bowel sounds, nontender in all quadrants, and no hepatosplenomegaly. Inspection of the anus reveals inflammation on the posterior side with erythema. Digital rectal examination is painful for the client, but no abnormalities are palpated. Anoscope examination reveals no inflammation or bleeding. What is the anal disorder that best describes her symptoms? A. Anorectal fistula B. External hemorrhoids C. Anal fissure D. Anorectal cancer

C

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. Anorectal fistula D. Anal fissure

C

How should a nurse proceed with palpation of the anus to best facilitate the exam without causing the client undo discomfort? A. Use the fingertips of one hand because they are the smallest part of the finger B. Use gentle but firm force to push past the sphincter into the anal canal C. Ask the client to bear down and place the lubricated finger on the anal opening D. Spread the gluteal folds with the hands and attempt to visualize the anal opening

C

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? A. 1.5 cm B. 3 cm C. 4.5 cm D. 6 cm

C

The Cowper glands A. are located inside the rectum. B. produce a substance to aid in sperm motility. C. empty into the urethra. D. can be palpated through the rectum.

C

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

The nurse is assessing the genitalia of an adult male client when he tells the nurse that his testes are swollen and painful. The nurse should refer the client to a physician for possible A. cancer. B. hydrocele. C. epididymitis. D. hematocele.

C

Upon inspection and palpation of the scrotum, the nurse discovers a mass. The client complains of tenderness in the area and nausea. The nurse is concerned that the blood supply to the mass may be cut off. The nurse should document this finding as which type of hernia? A. Scrotal B. Incarcerated C. Strangulated D. Femoral

C

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. A. Palpable and tortuous veins B. Beaded or thickened cord C. Smooth, nontender cord D. Left testicle is slightly lower than the right

C,D

*Appears as hardened nodule or ulcer on the glans. *Painless. *Occurs primarily in uncircumcised men.

Cancer of the glans penis

A hard area on the prostate or hard, fixed, irregular nodules on the prostate suggest cancer. The median sulcus may not be palpable.

Cancer of the prostate

Blood detected in the stool may indicate

Cancer of the rectum or colon

*Failure of one or both testicles to descend into scrotum. *Scrotum appears undeveloped and testis cannot be palpated. *Causes increased risk of testicular cancer.

Cryptorchidism

A tender painful swelling of the scrotum should suggest which of the following? A. Acute epididymitis B. Strangulated inguinal hernia C. Torsion of the spermatic cord D. Any of the above

D

Steatorrhea

fats in the stool

A yellow discharge is usually associated with

gonorrhea

*Bowel herniates from behind and through the external inguinal ring. *It rarely travels down into the scrotum. *This type of hernia is less common than an indirect hernia. *It occurs mostly in adult men older than age 40.

Direct inguinal hernia

Yellow stool suggests

Steatorrhea (increased fat content)

If you cannot push the mass into the abdomen, suspect an

incarcerated hernia

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? A. Gastrointestinal bleeding B. Lack of bile pigment C. Increased fat content D. Cancer of the colon

B

A male infant is born with the urethral meatus opening on the underside of the penis. When providing information to the parents, what is the correct terminology to use for this condition? A. Phimosis B. Hypospadias C. Epispadias D. Paraphimosis

B

Which client reports support a diagnosis of a prostate disorder? Select all that apply. A. "I can't seem to completely empty my bladder." B. "It burns when I urinate." C. "I sometimes have blood in my urine." D. "It is difficult to start urinating." E. "I'm up 3 to 4 times a night to urinate."

A,C,D,E

Induration along the ventral surface of the penis suggests which of the following? A. Urethral stricture B. Testicular carcinoma C. Peyronie's disease D. Epidermoid cysts

A

The corpora spongiosum extends distally to form the acorn-shaped A. glans. B. frenulum. C. corona. D. scrotum.

A

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. Scrotal B. Incarcerated C. Strangulated D. Femoral

A

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. Beaded or thickened cord C. Smooth, nontender cord D. Left testicle is slightly lower than the right

A

Which of the following unexpected findings of the testes is most likely to result in painful palpation of the testes? A. Orchitis B. Cryptorchidism C. Klinefelter's syndrome D. Testicular tumor

A

During a health assessment interview, a nurse learns that the client has a family history of colorectal cancer. What information should the nurse give the client about reducing the risk for colorectal cancer? Select all that apply. A. Get regular exercise for at least 30 minutes every day B. Limit exposure to cadmium and sheet metal work C. Avoid taking vitamin A supplements D. Fecal occult blood test (FOBT) should be done yearly E. Consume foods with adequate folic acid

A,D,E

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,B,C,D

Ejaculation occurs with the emission of semen from which of the following? Select all that apply. A. Epididymides B. Vas deferens C. Prostate D. Seminal vesicles E. Corona F. Corpus spongiosum

A,B,C,D

The nurse is asked to prepare material on erectile dysfunction to be placed in a urologist's office waiting room. What should the nurse include as reasons for the development of this disorder? Select all that apply. A. Diabetes B. Depression C. Alcohol use D. Myocardial infarction E. Antihypertensive medications

A,B,C,E

The nurse prepares material to teach a group of adolescent male students on testicular self-examination. What should the nurse include in this teaching? Select all that apply. A. Stand in front of a mirror B. Perform the examination one a month C. Complete the examination after a warm bath or shower D. Apply lotion to the hands before beginning the examination E. Use the thumb, and index and middle finger for the examination

A,B,C,E

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,B,D,E

A 55-year-old client presents to the health care clinic with reports of decreased bowel movements with the passing of hard, dry stool for the past 2 weeks. The client states that he has noticed a small amount of bleeding from the rectum and on the stool. He states he has had trouble with his bowels all his adult life. He admits to drinking a lot of coffee and works in a high-stress job. The nurse observes a large external hemorrhoid upon examination of the anus. Which nursing diagnoses can be confirmed with this data? Select all that apply. A. Constipation B. Ineffective Health Maintenance C. Readiness for Enhanced Bowel Elimination D. Acute pain E. Risk for Impaired Skin Integrity

A,B,E

While conducting a complete bed bath for a male client, the nurse inspects the scrotum for: (Select all that apply.) A. Swelling B. Lumps C. Discharge D. Wrinkled skin E. Veins

A,B,E

A young male adult has come to the emergency department with purulent drainage from an area on his penis that was pierced 48 hours ago. What would be important for the nurse to discuss with the client? (Select all that apply.) A. Ways to avoid infection B. Significance of the piercing to the client C. Care of the piercing D. Sensation in the area of the piercing E. Where the piercing was done

A,C

A nurse educates a young male client on human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS). Which of the following should the nurse identify as potential risk factors? Select all that apply. A. Sharing intravenous needles B. Using water-based lubricant with latex-based condoms C. Mixing of sex and alcohol or drugs D. Indulging in anal intercourse with men E. Previous treatment for a sexually transmitted disease

A,C,D

How should the testis feel to the nurse's fingers when performing palpation of the scrotal contents? Select all that apply. A. Smooth B. Hard C. Firm D. Rubbery E. Left larger than right F. Soft

A,C,D

The nurse notes that a male client is having problems urinating because of benign prostatic hypertrophy. Which medication should the nurse expect to be prescribed for this client? Select all that apply. A. Terazosin B. Verapamil C. Finasteride D. Dutasteride E. Furosemide

A,C,D

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.) A. Inability to empty the bladder B. Bleeding and spotting in underwear C. Weak urinary stream D. Dribbling after urination E. Frequent urination during the night

A,C,D,E

*The prostate is swollen, tender, firm, and warm to the touch. *Caused by a bacterial infection.

Acute prostatitis

These splits in the tissue of the anal canal are caused by trauma. A swollen skin tag ("sentinel tag") is often present below the fissure on the anal margin. They cause intense pain, itching, and bleeding.

Anal fissure

This is evidenced by 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.

Anorectal fistula

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 with bearing down. His prostate examination is unremarkable. Urine analysis shows white blood cells and bacteria. What diagnosis of the male genitalia is most likely in this case? A. Acute orchitis B. Acute epididymitis C. Torsion of the spermatic cord D. Prostatitis

B

A client is concerned about his risk for developing testicular cancer. Which of the following should the nurse mention as a risk factor for this type of cancer? A. Being uncircumcised B. Cryptorchidism C. Smoking D. Sedentary lifestyle

B

A nurse is performing palpation of a client's prostate gland. Which of the following indicates proper procedure? A. Turn the hand fully clockwise so that the tip of the index finger faces the client's umbilicus B. Turn the hand fully counterclockwise so that the pad of the index finger faces the client's umbilicus C. Turn the hand fully clockwise so that the tip of the finger faces the client's lumbar region D. Turn the hand fully counterclockwise so that the pad of the finger faces the client's side

B

How should a nurse ask a client to position himself to best facilitate palpation of the left inguinal canal and inguinal nodes? A. Side lying with the left leg slightly raised B. Stand with the weight shifted to the right leg C. Stand with the weight evenly distributed and knees relaxed D. Bend the left leg and place it on a stool to expose the inguinal canal

B

If the anal sphincter tightens as the nurse palpates it, what should he or she do? A. Instruct the client to mouth breathe. B. Pause, reassure the client, and proceed. C. Proceed only if the client's internal sphincter muscle relaxes. D. Put two fingers on the client's anus and instruct the client to relax.

B

On inspecting a client's external genitalia, a nurse notes that he is uncircumcised. This means that which of the following covers the glans of the penis? A. Urethral meatus B. Prepuce C. Corpus cavernosa D. Corpus spongiosum

B

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? A. Herpes progenitalis B. Syphilitic chancre C. Cancer of the glans penis D. Hypospadias

B

Specific characteristics the nurse assesses when palpating the anal canal include all the following except: A. Scarring B. Alignment C. Ulceration D. Induration

B

Symptoms of prostate disorder include which of the following? A. Nocturia, daytime polyuria, strong urinary stream B. Incomplete emptying, nocturia, weak urinary stream C. Elevated PSA level, daytime polyuria, low back pain D. Decreased urination, painful urination, elevated PSA level

B

The external sphincter of the anus is A. composed of smooth muscle. B. composed of skeletal muscle. C. composed of striated muscle. D. under involuntary control.

B

The nurse caring for a client with a varicocele explains the side effects of this condition. With what disorder is this condition associated? A. Thyroid disorder B. Infertility C. Undescended testicle D. Epididymitis

B

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

The physician explains to the client that they have an inflammation of the Cowper's glands. Where are the Cowper glands located? A. Within the epididymis B. Below the prostate within the posterior aspect of the urethra C. Within the anterior aspect of the urethra just above the prostate D. Near the urethra, alongside the vas deferens

B

The prostate functions to A. store sperm until ejaculation occurs. B. secrete a milky substance that neutralizes female acidic secretions. C. produce the ejaculate that nourishes and protects sperm. D. produce mucus-like fluid to assist in lubrication.

B

The prostate gland is characterized by which of the following? A. Coronal groove B. Rounded heart shape C. Palpable median lobe D. Palpable anterior surface

B

The 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

Upon inspection and palpation of the scrotum, the nurse discovers a mass. The nurse finds that the mass cannot be pushed back into the abdomen. The nurse should document this finding as which type of hernia? A. Scrotal B. Incarcerated C. Strangulated D. Femoral

B

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

B

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

When assessing a client with benign prostatic hypertrophy, which of the following would the nurse expect the client to report as the initial complaint? A. Urinary frequency B. Increased effort to void C. Narrowing of urinary stream D. Nocturia

B

When invaginating the skin of the scrotum to assess the inguinal regions, which of the following is an expected finding? A. Intestinal contents in the inguinal canal B. Inability to introduce the index finger into the inguinal ring C. Movement of the examiner's finger anteriorly when the client coughs D. Inability to follow the spermatic cord from the client's scrotum to inguinal ligament

B

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

Which of the following conditions consists of a tight prepuce that, once retracted, cannot be returned? A. Phimosis B. Paraphimosis C. Balanitis D. Balanoposthitis

B

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

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

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. Internal hemorrhoid B. Prostate cancer C. Anorectal cancer D. Rectal polyp

D

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. Hydrocele B. Spermatocele C. Testicular torsion D. Testicular tumor

D

An Advanced Practice Nurse is preparing to do a rectal examination on a 77-year-old client. The client complains of pain as soon as the examination begins. What might this client have? A. Constipation B. Scrotal enlargement C. Benign prostatic hyperplasia (BPH) D. Fissures

D

During the physical assessment of a client's genitalia, the nurse notes an abnormal mass or swelling. The nurse performs transillumination by shining a light from the back of the scrotum through the mass. In which condition should the nurse see a red glow? A. Tumor B. Hernia C. Varicocele D. Spermatocele

D

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? A. Paraphimosis B. Epispadias C. Hypospadias D. Phimosis

D

If a male client is uncircumcised, the glans of the penis is covered by the A. epididymis. B. frenulum. C. corona. D. foreskin.

D

Important techniques in performing the rectal examination include which of the following? A. Lubrication B. Waiting for the sphincter to relax C. Explaining what the client should expect with each step before it occurs D. All of the above

D

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

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

The external sphincter and internal sphincter of the rectum are divided by the A. anorectal junction. B. rectovesical pouch. C. median sulcus. D. intersphincteric groove.

D

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. Balanitis B. Hypospadias C. Sexually transmitted infection D. Smegma

D

The nurse notes that a client has a small red papule that is clean, smooth, and glistening on the penis. What should the nurse suspect is causing this lesion? A. gonorrhea B. genital warts C. genital herpes D. primary syphilis

D

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. Scrotal B. Incarcerated C. Strangulated D. Femoral

D

When palpating the rectal mucosa, how does the nurse rotate the examining hand? A. From the nurse's left, then to the right B. Anteriorly, then posteriorly C. Counterclockwise, then clockwise D. Clockwise, then counterclockwise

D

Which position should a nurse assist a client to assume to ensure comfort during the examination of the anus, rectum, and prostate of a male client? A. Knee-chest B. Lithotomy C. Standing D. Left lateral

D

*Infection of the epididymis. *Client usually complains of sudden pain. *Scrotum appears enlarged, reddened, and swollen; tender epididymis is palpated. *Usually associated with prostatitis or bacterial infection.

Epididymitis

*The urethral meatus is located on the top of the glans (dorsal side); occurs rarely. *This condition is a congenital defect.

Epispadias

*Bowel herniates through the femoral ring and canal. It never travels into the scrotum, and the inguinal canal is empty. *This is the least common type of hernia. *It occurs mostly in women.

Femoral hernia

*Single or multiple, moist, fleshy papules. *Painless. *STI caused by the human papillomavirus.

Genital warts

*Clusters of pimple-like, clear vesicles that erupt and become ulcers. *Painful. *Initial lesions of this STI—typically caused by HSV-1 or HSV-2—disappear, and the infection remains dormant for varying periods of time. Recurrences can be frequent or minimally episodic.

Herpes progentalis

*Collection of serous fluid in the scrotum, outside the testes within the tunica vaginalis. *Appears as swelling in the scrotum and is usually painless. *Usually the examiner can get fingers above this mass during palpation. *Will transilluminate

Hydrocele

*Urethral meatus is located underneath the glans (ventral side). *This condition is a congenital defect. *A groove extends from the meatus to the normal location of the urethral meatus.

Hypospadias

*Bowel herniates through internal inguinal ring and remains in the inguinal canal or travels down into the scrotum (scrotal hernia). *This is the most common type of hernia. *It may occur in adults but is more frequent in children.

Indirect inguinal hernia

Gray, clay, or tan stool results from

Lack of bile pigment

*Begins within 2-4 weeks of infection *Small, solitary, silvery papule the erodes to a red, round or oval ulcer with a yellowish serous discharge *Painless *A sign of primary syphilis (a sexually transmitted infection [STI]) that spontaneously regresses. *May be misdiagnosed as herpes.

Syphilitic chancre

A rectal carcinoma is usually asymptomatic until it is quite advanced. Thus, routine rectal palpation is essential. A cancer of the rectum may feel like a firm nodule, an ulcerated nodule with rolled edges, or, as it grows, a large, irregularly shaped, fixed, hard nodule.

rectal cancer

*Inflammation of the testes, associated frequently with mumps. *Client complains of pain, heaviness, and fever. *Scrotum appears enlarged and reddened. *Swollen, tender testis is palpated. The examiner may have difficulty differentiating between testis and epididymis.

Orchitis

A foreskin that is left in a retracted position leads to venous congestion and edema of the foreskin.

Paraphimosis

A cavity of pus, caused by infection in the skin around the anal opening. It causes throbbing pain and is red, swollen, hard, and tender.

Perianal abscess

The foreskin cannot be retracted over the penis tip.

Phimosis

This congenital disorder is characterized by a small dimple or cyst/sinus that contains hair. It is located midline in the sacrococcygeal area and has a palpable sinus tract.

Pilonidal cyst

These soft structures are rather common and occur in varying sizes and numbers. There are two types: pedunculated (on a stalk) and sessile (on the mucosal surface).

Rectal polyps

This occurs when the mucosa of the rectum protrudes out through the anal opening. It may involve only the mucosa or the mucosa and the rectal wall. It appears as a red, doughnut-like mass with radiating folds.

Rectal prolapse

*A loop of bowel protrudes into the scrotum to create what is known as an indirect inguinal hernia. *Hernia appears as swelling in the scrotum. *Palpable as a soft mass and fingers cannot get above the mass.

Scrotal hernia

*Sperm-filled cystic mass located on epididymis. *Palpable as small and nontender, and movable above the testis. *This mass will appear on transillumination.

Spermatocele

*Initially a small, firm, nontender nodule on the testis. *As the tumor grows, the scrotum appears enlarged and the client complains of a heavy feeling. *When palpated, the testis feels enlarged and smooth—tumor replaces testis. *Will not transilluminate.

Testicular tumor

*Very painful condition caused by twisting of spermatic cord. *Scrotum appears enlarged and reddened. *Palpation reveals thickened cord and swollen, tender testis that may be higher in scrotum than normal. *This condition requires immediate referral for surgery because circulation is obstructed.

Torsion of the spermatic cord

If cancer metastasizes to the peritoneal cavity, it may be felt as a nodular, hard, shelf-like structure that protrudes onto the anterior surface of the rectum in the area of the seminal vesicles in men and in the area of the rectouterine pouch in women.

rectal shaft

Swellings or masses that contain serous fluid—hydrocele, spermatocele—light up with a

red glow

What type of rectal polyp is on the mucosal surface?

sessile

A hernia is _______ when its blood supply is cut off. The client typically complains of extreme tenderness and nausea.

strangulated

Black stool may indicate

Upper gastrointestinal bleeding

*Abnormal dilation of veins in the spermatic cord. *Client may complain of discomfort and testicular heaviness. *Tortuous veins are palpable and feel like a soft, irregular mass or "a bag of worms," which collapses when the client is supine. *Infertility may be associated with this condition.

Variocele

The external sphincter of the anus is

composed of skeletal muscle, voluntary

The internal sphincter of the anus is

composed of smooth muscle, involuntary

The base of the glans is called?

corona

Perineal itching is seen with

crab lice (Pediculosis pubis)

Any discharge should be

cultured

Swellings or masses that are solid or filled with blood—tumor, hernias, or varicocele—

do not light up with a red glow

What type of rectal polyp is on a stalk?

pedunculated, seen in midsigmoid colon

The external genitalia consist of the:

penis and scrotum

A clear or white discharge is usually associated with

urethritis

A _________ is an enlargement of the veins within the scrotum, which may cause low sperm production and decreased sperm quality, which can cause infertility.

varicocele