Chapter 26 Health Assessment

You are caring for a 33 year old male who has come to the clinic for a physical examination. He states that he has not had a routine physical in five years. During the examination the physician finds that digital rectal examination (DRE) reveals extensive hardening in the posterior lobe of the prostate gland that is not mobile. The nurse recognizes that the observation typically indicates what Evidence of a more advanced lesion Metastatic disease A normal finding A sign of early prostate cancer

A sign of early prostate cancer

Francis is a middle-aged man who noted right sided lower abdominal pain after straining with yardwork. Which of the following findings would make a hernia a more likely diagnosis? Absence of bowel sounds in the scrotum Absence of symmetry of the inguinal areas with straining Absence of pain with straining Absence of a varicocele

Absence of symmetry of the inguinal areas with straining

A patient has undergone a digital rectal examination. This assessment will allow the clinician to diagnose which of the following? BPH Testicular cancer ED Urinary incontinence

BPH

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

Clockwise, then counterclockwise

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? Cremasteric reflex Vasovagal reflex Patellar reflex Rooting reflex

Cremasteric reflex

After teaching a group of student about structural abnormalities of the male reproductive system, the instructor determines that the teaching was successful when the students identify which of the following as an example? Priapism Erectile dysfunction Cryptorchidism Prostatitis

Cryptorchidism

Which of the following would the nurse expect to be done to assess the size of the prostate? Transillumination Bladder percussion Digital rectal examination Pelvic examination

Digital rectal examination

An adolescent male client is diagnosed with testicular torsion. The nurse should prepare the client for which treatment? Prostate specific antigen labwork Emergency surgery Antibiotic therapy Schedule routine follow-up appointment

Emergency surgery

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? Hydrocele Orchitis Cryptorchidism Epididymitis

Epididymitis

A nurse examines the anal area of a client and observes the presence of a varicose vein. How should the nurse document this finding? Anal fissure Anorectal fistula Perianal abscess External hemorrhoid

External hemorrhoid

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? Femoral Incarcerated Strangulated Scrotal

Femoral

The nurse is assessing male genitalia and finds clusters of pimple-like clear vesicles. The nurse recognizes this as what? Chlamydia Herpes Syphilis Gonorrhea

Herpes

The nurse is assessing male genitalia and finds clusters of pimple-like clear vesicles. The nurse recognizes this as what? Syphilis Herpes Gonorrhea Chlamydia

Herpes

A 68-year-old man comes to the clinic reporting that he is having difficulty obtaining an erection. When reviewing the patient's history what might the nurse note that contributes to impotence? Use of multivitamins Past history of infection History of hypertension Lack of exercise

History of hypertension

Which of the following should nurses teach all men, especially those who have had cryptorchidism? Need for blood tests to measure serum acid phosphate levels. How to perform a testicular self-examination. Importance of regular monitoring of prostate-specific antigen (PSA) levels. Need to undergo a baseline and follow up lymph node biopsies.

How to perform a testicular self-examination

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? Prostatism Orchitis Hydrocele Cryptorchidism

Hydrocele

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

Pause, reassure the client, and proceed

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? Priapism Peyronie's disease Bowen's disease Phimosis

Phimosis

A client comes to the Emergency Department complaining of sudden sharp testicular pain. Further examination reveals torsion of the spermatic cord. Which of the following would the nurse expect to do next? Apply a dressing over the scrotum. Prepare the client for circumcision. Apply scrotal support. Prepare the client for surgery.

Prepare the client for surgery

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? Urethral meatus Corpus spongiosum Corpus cavernosa Prepuce

Prepuce

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? Hydrocele Acute prostatitis Prostate cancer Benign prostatic hypertrophy

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? Colon cancer Colonic polyp Prostate cancer Prostatitis

Prostatitis

An adult male client comes to the clinic complaining of awakening at night to void and voiding more than once in a 2-hour time period. The client has a history of bladder irritation. What would be an appropriate nursing diagnosis for this client? Risk for infection Risk for urge incontinence Ineffective sexuality pattern Urinary retention

Risk for urge incontinence

A young homosexual client who is currently HIV negative tells the nurse that he is worried about contracting AIDS someday. What teaching would be appropriate for this client? New AIDS treatments in case the client contracts HIV Antiviral drugs used to fight AIDS Conversion therapy to heterosexuality Safe-sex practices and proper use of condoms

Safe-sex practices and proper use of condoms

A 29-year-old married computer programmer comes to the clinic complaining of "something strange" going on in his scrotum. Last month while he was doing his self-testicular examination he felt a lump in his left testis. He waited a month and felt the area again but the lump was still there. He has had some aching in his left testis but denies any pain with urination or sexual intercourse. He denies any fever, malaise, or night sweats. His past medical history consists of groin surgery when he was a baby and a tonsillectomy as a teenager. He eats a healthy diet and works out at the gym five times a week. He denies any tobacco or illegal drugs and drinks alcohol occasionally. His parents are both healthy. Examination shows a muscular healthy young man with unremarkable vital signs. On visualization the penis is circumcised with no lesions; there is a scar in his right inguinal region. There is no lymphadenopathy. Palpation of his scrotum is unremarkable on the right but has a large mass on the left. While placing a finger through the inguinal ring on the right, the examiner asks the client to bear down. Nothing is felt. The examiner attempts to place a finger through the left inguinal ring but cannot get above the mass. On rectal examination the client's prostate is unremarkable. What disorder of the testes is most likely? Scrotal edema Varicocele Scrotal hernia Hydrocele

Scrotal hernia

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

Steatorrhea

The testes in the male scrotum are suspended by the spermatic cord. able to produce progesterone. joined with the ejaculatory duct. the location of the vas deferens.

Suspended by the spermatic cord

A patient presents at the clinic with severe scrotal pain. What is the presumptive diagnosis? Priapism Testicular torsion Varicocele Hydrocele

Testicular torsion

A male patient tells the nurse about experiencing problems with urination. What should the nurse assess in this patient? (Select all that apply.) If there is any blood or semen in the urine If there is any pain at the base of the penis If the patient has ever been diagnosed with a sexually transmitted infection The number of times the patient voids during the day If there is any difficulty starting the urine stream

The number of times the patient voids during the day If there is any blood or semen in the urine If there is any difficulty starting the urine stream If there is any pain at the base of the penis

A nurse is assessing the genitalia of a male client. The nurse finds that the client has a piercing in his penis. Why is it important to investigate details of the piercing? To call the authorities, because these piercings are illegal in most states To assess for health risks relating to how it was performed Because the nurse may also want to get a piercing there To help the client better care for the piercing

To assess for health risks relating to how it was performed

A 23 year old male comes to the clinic complaining of sudden and severe pain in his scrotum. The nurse would suspect what? Orchitis Torsion of the spermatic cord Varicocele Spermatocele

Torsion of the spermatic cord

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 cancer. hematocele. epididymitis. hydrocele.

epididymitis

The rectum is lined with folds of mucosa, and each fold contains a network of arteries, veins, and visceral nerves. When these veins undergo chronic pressure, the result may be tumors. fissures. polyps. hemorrhoids.

hemorrhoids

A male client has a distinctive bulge in the right inguinal area when standing. What should the nurse suspect is occurring with this client? epidermoid cysts hernia hypospadias testicular torsion

hernia

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

just above and parallel to the inguinal ligament.

During assessment of an elderly male client, the client tells the nurse that he has had difficulty urinating for the past few weeks. The nurse should refer the client to the physician for possible impotence. prostate enlargement. sexually transmitted disease. inguinal hernia.

prostate enlargement

The nurse is documenting current health concerns during the health history of an older adult male client. Identification of what may help most at this time? Previous problems Number of sexual partners Sexual preference Number of sexually transmitted infections

Previous problems

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

median sulcus

What ethnic group has a significantly higher incidence rate of prostate cancer? Caucasian Native American African American Asian

African American

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? Poor personal hygiene History of human papilloma virus Age 60 years or older Sexual promiscuity

Age 60 years or older

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

All of the above

A 60-year-old coach comes to the clinic complaining of difficulty starting to urinate for the last several months. He believes the problem is steadily getting worse. When asked he says he has a very weak stream, and it feels like it takes 10 minutes to empty his bladder. He also has the urge to go to the bathroom more often than he used to. He denies any blood or sediment in his urine and any pain with urination. He has had no fever, weight gain, weight loss, or night sweats. His medical history includes type 2 diabetes and high blood pressure treated with medications. He does not smoke but drinks a six pack of beer weekly. He has been married for 35 years. His mother died of a myocardial infarction in her 70s, and the client's father is currently in his 80s with high blood pressure and arthritis. Examination reveals a mildly obese alert and cooperative man. His blood pressure is 130/70 with a heart rate of 80. He is afebrile, and his cardiac, lung, and abdominal examinations are normal. Visualization of the anus shows no inflammation, masses, or fissures. Digital rectal examination reveals a smooth, enlarged prostate. No discrete masses are felt. There is no blood on the glove. An analysis of the urine shows no red blood cells, white blood cells, or bacteria. What disorder of the anus, rectum, or prostate is most likely? Prostate cancer Benign prostatic hyperplasia (BPH) Prostatitis Anorectal cancer

Benign prostatic hyperplasia (BPH)

All of the following symptoms are potential indicators of testicular disorders except: Dull ache in the lower abdomen Painless testicular swelling Scrotal discomfort Heaviness in the groin

Dull ache in the lower abdomen

Which of the following statements is true of prostate cancer? Family history does not appear to be a risk factor. Ethnicity is a risk factor. It is one of the less common forms of cancer. Survival rates are low.

Ethnicity is a risk factor

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? Phimosis Cryptorchidism Epispadias Hypospadias

Hypospadias

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

Nontender and rubbery

The nurse is documenting current health concerns during the health history of an older adult male client. Identification of what may help most at this time? Number of sexually transmitted infections Sexual preference Number of sexual partners Previous problems

Previous problems

An uncircumcised male client has just come to the recovery room following a 4-hour back surgery. Before surgery a urinary catheter was placed. During the postoperative assessment, the recovery nurse discovers that the client has developed paraphimosis. What might have happened to the client to cause this? The catheter was too taut for too long and has damaged the urethra The foreskin was not pulled back over the head of the penis after catheter placement The client is having a reaction to an anesthesia agent he received during surgery The client is having an anatomical reaction to being face down on a pillow for 4 hours

The foreskin was not pulled back over the head of the penis after catheter placement

An adult male client comes to the clinic for his annual physical examination. During the nursing assessment, the nurse asks, "Do you have any current or chronic illnesses such as diabetes, hypertension, respiratory problems, or cardiovascular disease?" Why does the nurse ask this question? To assess risk for erectile dysfunction To refer the patient to a pulmonologist To assess risk for limited range of motion To determine the need for involvement from an internist

To assess risk for erectile dysfunction

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? Phimosis Hydrocele Variocele Torsion of the spermatic cord

Torsion of the spermatic cord

The nurse suspects that a male client may have a hernia. The nurse should further assess the client for urinary tract infection. cysts at the spermatic cord. bruising at the site. bowel sounds at the bulge.

bowel sounds at the bulge

What information should nurse include in the teaching plan for a client considering a vasectomy? increases the amount of ejaculate protects from sexually transmitted infection May causes urinary incontinence offers permanent birth control

offers permanent birth control