Chapter 24: Male Genitourinary System
During an examination of an aging male, the nurse recognizes that normal changes to expect would be:
a decrease in the size of the penis
During an examination, the nurse notices that a male patient has a red, round, superficial ulcer with a yellowish serous discharge on his penis. On palpation, the nurse finds a nontender base that feels like a small button between the thumb and fingers. At this point the nurse suspects that this patient has:
a syphilitic chancre
A 2-year-old boy has been diagnosed with "physiologic cryptorchidism." Given this diagnosis, during assessment the nurse will most likely observe:
an absence of the testis in the scrotum, but the testis can be milked down
Which of these statements is most appropriate when the nurse is obtaining a genitourinary history from an elderly man?
"Do you need to get up at night to urinate?"
The nurse is describing how to perform a testicular self-examination to a patient. Which of these statements is most appropriate?
"If you notice an enlarged testicle or a painless lump, call your health care provider."
When the nurse is conducting sexual history from a male adolescent, which statement would be most appropriate to use at the beginning of the interview?
"Often boys your age have questions about sexual activity."
The mother of a 10-year-old boy asks the nurse to discuss the recognition of puberty. The nurse should reply by saying:
"The first sign of puberty is enlargement of the testes."
A 55-year-old man is in the clinic for a yearly check-up. He is worried because his father died of prostate cancer. The nurse knows that which tests should be done at this time? Select all that apply.
A) Blood test for prostate-specific antigen D) Digital rectal examination
A 16-year-old boy is brought to the clinic for a problem that he refused to let his mother see. The nurse examines him, and finds that he has scrotal swelling on the left side. He had the mumps the previous week, and the nurse suspects that he has orchitis. Which of the assessment findings below support this diagnosis? Select all that apply.
A) Swollen testis C) Mass does not transilluminate E) Tender upon palpation F) Scrotal skin is reddened
A 2-month-old uncircumcised infant has been brought to the clinic for a well-baby checkup. How would the nurse proceed with the genital examination?
Avoid retracting the foreskin until the infant is 3 months old.
A 55-year-old man is experiencing severe pain of sudden onset in the scrotal area. It is somewhat relieved by elevation. On examination the nurse notices an enlarged, red scrotum that is very tender to palpation. It is difficult to distinguish the epididymis from the testis, and the scrotal skin is thick and edematous. This description is consistent with which of these?
Epididymitis
When the nurse is performing a genital examination on a male patient, which of these actions is correct?
Have the patient shift his weight onto the left (unexamined) leg when palpating for a hernia on the right side.
The nurse is aware that which of these statements is true regarding the incidence of testicular cancer?
Men with a history of cryptorchidism are at greatest risk for development of testicular cancer
The nurse is examining the glans and knows that which of these is a normal finding for this area?
Smegma may be present under the foreskin of an uncircumcised male
When the nurse is performing a testicular examination on a 25-year-old man, which of these findings is considered normal?
Testes that feel oval and movable and are slightly sensitive to compression
Which of these statements is true regarding the penis?
The corpus spongiosum expands into a cone of erectile tissue called the glans.
Which of these statements about the testes is true?
The cremaster muscle contracts in response to cold and draws the testicles closer to the body.
The nurse is inspecting the scrotum and testes of a 43-year-old man. Which finding would require additional follow-up and evaluation?
The skin on the scrotum is taut
When performing a genitourinary assessment, the nurse notices that the urethral meatus is positioned ventrally. This finding is:
called hypospadias
The nurse is performing a genital examination on a male patient and notices urethral drainage. When collecting urethral discharge for microscopic examination and culture, the nurse should:
compress the glans between the examiner's thumb and forefinger and collect any discharge
When performing a genital examination on a 25-year-old man, the nurse notices deeply pigmented, wrinkled scrotal skin with large sebaceous follicles. On the basis of this information the nurse would:
consider this a normal finding and proceed with the examination
A newborn baby boy is about to have a circumcision. The nurse knows that indications for circumcision include:
cultural and religious beliefs
During an examination of an aging male, the nurse recognizes that normal changes to expect would be:
decreased penis size
The nurse is performing a genitourinary assessment on a 50-year-old obese male laborer. On examination the nurse notices a painless round swelling close to the pubis in the area of the internal inguinal ring that is easily reduced when the individual is supine. These findings are most consistent with a(n) _____ hernia.
direct inguinal
A 59-year-old patient has been diagnosed with prostatitis and is being seen at the clinic for complaints of burning and pain during urination. He is experiencing:
dysuria
A 62-year-old man states that his doctor told him that he has an "inguinal hernia." He asks the nurse to explain what a hernia is. The nurse should:
explain that a hernia is a loop of bowel protruding through a weak spot in the abdominal muscles.
During a genital examination, the nurse notices that a male patient has clusters of small vesicles on the glans, surrounded by erythema. The nurse recognizes that these lesions are:
genital herpes
When performing a genital assessment on a middle-aged man, the nurse notices multiple soft, moist, painless papules in the shape of cauliflower-like patches scattered across the shaft of the penis. These lesions are characteristic of:
genital warts
During a health history, a patient tells the nurse that he has trouble in starting his urine stream. This problem is known as:
hesitancy
When performing a genitourinary assessment on a 16-year-old boy, the nurse notices a swelling in the scrotum that increases with increased intra-abdominal pressure and decreases when he is lying down. The patient complains of pain when straining. The nurse knows that this description is most consistent with a(n) _____ hernia.
indirect inguinal
During a physical examination, the nurse finds that a male patient's foreskin is fixed and tight and will not retract over the glans. The nurse recognizes that this condition is:
phimosis
The nurse is providing patient teaching about an erectile dysfunction drug. One of the drug's potential side effects is prolonged, painful erection of the penis without sexual stimulation, which is known as:
priapism
An accessory glandular structure for the male genital organs is the:
prostate
When the nurse is performing a genital examination on a male patient, the patient has an erection. The nurse's most appropriate action or response is to:
reassure the patient that this is a normal response and continue with the examination
The external male genital structures include the:
scortum
When assessing the scrotum of a male patient, the nurse notices the presence of multiple firm, nontender, yellow 1-cm nodules. The nurse knows that these nodules are most likely:
sebaceous cysts
An older man is concerned about his sexual performance. The nurse knows that in the absence of disease, a withdrawal from sexual activity later in life may be due to:
side effects of medications
A 45-year-old mother of two children is seen at the clinic for complaints of "losing my urine when I sneeze." The nurse documents that she is experiencing
stress incontinence
When performing a scrotal assessment, the nurse notices that the scrotal contents transilluminate and show a red glow. On the basis of this finding the nurse would:
suspect the presence of serous fluid in the scrotum
A male patient with possible fertility problems asks the nurse where sperm is produced. The nurse knows that sperm production occurs in the:
testes
The nurse knows that a common assessment finding in a boy younger than 2 years old is:
the presence of a hydrocele, or fluid in the scrotum
A 15-year-old boy is seen in the clinic for complaints of "dull pain and pulling" in the scrotal area. On examination the nurse palpates a soft, irregular mass posterior to and above the testis on the left. This mass collapses when the patient is supine and refills when he is upright. This description is consistent with:
varicocele
