Chapter 26 - Assessing Male Genitalia, Anus, and Rectum

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. Acute prostatitis The prostate is normally nontender and rubbery. A swollen and tender prostate that is firm and warm to the touch may indicate acute prostatitis. An enlarged smooth, firm, slightly elastic prostate that may not have a median sulcus suggests benign prostatic hypertrophy. A hard area on the prostate or hard, fixed, irregular nodules on the prostate suggest cancer. Hydrocele is a painless swelling of the scrotum.

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. Bear down.

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

A. Benign prostatic hypertrophy

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. Orchitis Inflammation of the testes, associated frequently with mumps.

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. Palpable and tortuous veins

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. Prostatitis The hallmarks of prostatitis are a tender, swollen, firm prostate. Tenderness is not normally present in cases of BPH or prostate cancer.

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. Scrotal

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. Steatorrhea steatorrhea is an increase in fat excretion in the stools.

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. Torsion of the spermatic cord Torsion of the spermatic cord is usually accompanied by a sudden, severe pain of the scrotum and is a urological emergency. A spermatocele is a sperm-filled cystic mass located on the epididymis. Orchitis is inflammation of the testes. A varicocele is an abnormal dilation of veins in the spermatic cord

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. Urethral stricture A urethral stricture is a narrowing of the urethra, causing obstructive symptoms.

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. urethritis. Urethritis is when the tube that carries pee from the bladder out of the body (urethra) becomes swollen and sore

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

ACD

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

ACDE

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

ADE

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

B. Alignment

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. Beaded or thickened cord

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. Benign prostatic hypertrophy

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. Cryptorchidism

A male infant is born with the urethral meatus opening on the ventral side 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. Hypospadias Hypospadias is a birth defect in boys in which the opening of the urethra is not located at the tip of the penis but on ventral surface while Epispadias is like that but the opening of the urethra is on dorsal surface. Phimosis is a condition of the male foreskin where the skin is tight and unable to retract back behind the head of the penis. Paraphimosis is a common urologic emergency that occurs in uncircumcised males when the foreskin becomes trapped behind the corona of the glans penis

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

B. Incarcerated

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. Incarcerated

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. Incomplete emptying, nocturia, weak urinary stream

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. Increased effort to void

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. Infertility Varicocele is a dilation of the veins that drain the testes.

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. Lack of bile pigment

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. Paraphimosis Paraphimosis is a common urologic emergency that occurs in uncircumcised males when the foreskin becomes trapped behind the corona of the glans penis. Hypospadias is a birth defect in boys in which the opening of the urethra is not located at the tip of the penis but on ventral surface while Epispadias is like that but the opening of the urethra is on dorsal surface. Phimosis is a condition of the male foreskin where the skin is tight and unable to retract back behind the head of the penis.

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. Pause, reassure the client, and proceed.

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. Pilonidal cyst A pilonidal (pie-low-NIE-dul) cyst is an unusual pocket in the skin that usually contains hair and skin debris

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. Prepuce

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. Rounded heart shape

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. Stand with the weight shifted to the right leg

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. Syphilitic chancre

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. Turn the hand fully counterclockwise so that the pad of the index finger faces the client's umbilicus

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. composed of skeletal muscle.

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. herpes infection.

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. suspended by the spermatic cord.

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. syphilis.

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. 4.5 cm The normal testis in the postpubertal male is oval shaped, 4-5 cm long, 3 cm high, and 2.5 cm wide

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. Anorectal fistula A small opening in the skin that surrounds the anal opening is indicative of an anorectal fistula. Perianal abscess is a painful mass that appears red and hard. Redness and excoriation may occur from scratching an area infected with fungi or pinworms. A swollen skin tag on the anal margin may indicate an anal fissure

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. Ask the client to bear down and place the lubricated finger on the anal opening

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 a contraction of the cremasteric muscle in response to stroking of the upper medial thigh, which results in contraction of the testicle

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. Epididymitis Epididymitis is an inflammation of the coiled tube, called the epididymis, at the back of the testicle.

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. Hydrocele A hydrocele (HI-droe-seel) is a type of swelling in the scrotum, the pouch of skin that holds the testicles

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. Phimosis Phimosis is a condition of the male foreskin where the skin is tight and unable to retract back behind the head of the penis. Bowen's disease is a very early form of squamous cell skin cancer. It's also called squamous cell carcinoma in situ. Peyronie's (pay-roe-NEEZ) disease is a noncancerous condition resulting from fibrous scar tissue that develops on the penis and causes curved, painful erections. Priapism is a disorder in which the penis maintains a prolonged, rigid erection in the absence of appropriate stimulation.

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. Strangulated

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. Torsion of the spermatic cord During testicular torsion a testicle rotates, twisting the spermatic cord that brings blood to the scrotum, the loose bag of skin under the penis that contains the testicles. The reduced blood flow causes sudden and often severe pain and swelling.

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. cryptorchidism. a condition in which one or both of the testes fail to descend from the abdomen into the scrotum.

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. empty into the urethra.

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. epididymitis.

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. All of the above

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. Clockwise, then counterclockwise

A 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. Fissures

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. Klinefelter's syndrome

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. Left lateral The most frequently used position for examination of the anus, rectum, and prostate is the left lateral as it is usually more comfortable for the client. Besides, this position allows adequate inspection and palpation of the anus, rectum, and prostate. The client's torso and legs should be draped during the examination to lessen the feeling of vulnerability. Lithotomy position is logical for the female client who is already in that position for the vaginal examination. In the knee-chest position the client stands and bends over the table. Some examiners find it easy to examine the client when the client is standing and bending over the examination table with his hips flexed, this position may not be comfortable for all clients.

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. Phimosis Phimosis is when a foreskin can't be pulled down (retracted) from the tip of the penis. This is a common problem in young boys. Paraphimosis is when the foreskin is retracted but can't move back up

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. Prostate cancer

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. Smegma Smegma is a harmless combination of oils, skin cells, sweat and other fluids that accumulate around your genitals

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. Spermatocele A spermatocele (SPUR-muh-toe-seel) is an abnormal sac (cyst) that develops in the epididymis.

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. Testicular tumor

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

D. foreskin.

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. intersphincteric groove.

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. primary syphilis

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

abc

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

abc

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

abe

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

adf

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/AIDSD. E. Testicular cancer F. Colorectal cancer

bc

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

bde