chapter 42 male reproductive all
A nurse is inspecting the scrotum and testes of a 43-year-old male client. Which finding requires additional evaluation? The skin on the scrotum is hard, taut, and shiny. The left testicle hangs lower than the right testicle. The scrotal skin has folds. The testes move close to the body in cold temperatures.
The skin on the scrotum is hard, taut, and shiny. The scrotum, which houses the testes, is made up of a thin outer layer of skin that forms rugae, or folds, and is continuous with the perineum and outer skin of the groin. Scrotal swelling may cause the skin to be taut and to display pitting edema. Normal scrotal skin have rugae, and asymmetry is normal with the left scrotal half usually lower than the right.
The nurse is performing a health history of a patient being evaluated for erectile dysfunction. Which of the following places the patient at highest risk for the disorder?
Type 2 diabetes
When caring for a group of clients, the nurse recognizes which of these individuals has increased risk for balanitis?
Client with a sexually transmitted disease
The prostate gland functions in the elimination of urine. The nurse knows that the prostate gland if enlarged can cause which dysfunction of the urinary system?
Obstruction
A 27-year-old male developed mumps and was ill for several days. The patient suddenly developed a fever and painful enlargement of the testes approximately 4 days after recovering. Which of the following should the nurse suspect has developed?
Orchitis
Screening for which disease process should be done prior to beginning testosterone replacement therapy? Prostate cancer Erectile dysfunction Any current sexually transmitted disease Any scrotal malformations
Prostate cancer Before testosterone replacement therapy is initiated, all males should be screened for prostate cancer, as it is a testosterone-dependent disease. None of the other options are relevant to testosterone replacement therapy
In the aging male, testosterone replacement may be used to improve muscle strength and vigor. The nurse would question the use of testosterone before which type of screening in this patient?
Prostate cancer screening
The fluid from both the vas deferens and the vagina are acidic. The alkaline secretions that allow mobilization of sperm come from the: Vaginal vault Genital ducts Prostate Urethra
Prostate Because sperm mobilization occurs at a pH of 6.0 to 6.5, the alkaline nature of the prostatic secretions is essential for successful fertilization of the ovum.
Two nursing students are debating the merits and demerits of infant circumcision. Which of the following statements is most accurate?
"Circumcised men tend to have a lower incidence of penile cancer."
A nurse suspects an older adult client is experiencing benign prostatic hyperplasia (BPH). Which question should the nurse ask this client? "Have you noticed any unusual discharge from your penis?" "Have you experienced a decrease in your sex drive?" "Has the force of your urinary stream decreased?" "Do you have any difficulty in achieving an erection?"
"Has the force of your urinary stream decreased?" Because the prostate surrounds the urethra, enlargement of the gland can produce urinary obstruction.
A client is admitted with secondary orchitis. Which assessment question is most relevant?
"Have you ever had mumps?"
A 68 year-old man has revealed to his care provider that he is distraught over his increasingly frequent inability to maintain an erection. Which of the following teaching points is most warranted?
"While this problem is often a part of the aging process, it might be a result of some of the medications that you take."
A 70-year-old male tells the health care provider he is now in a relationship with a younger woman who is capable of reproduction. The client asks if he may still be fertile. The best response would be:
"Yes; some 80- and 90-year-old men have been known to father children."
A nursing student is studying pathophysiology as part of the nursing curriculum. Which statement made by the student indicates a need for further instruction? A. The male testes are located inside the abdominal cavity. B. The male testes are also known as gonads. C. The male testes are located outside the abdominal cavity. D. The testes are egg-shaped structures in the scrotum.
. A.Male testes are located inside the abdominal cavity.
An 18-month-old boy is diagnosed with cryptorchidism. Based on this diagnosis, what does the nurse expect to observe during the physical assessment? Testes that are hard and difficult to palpate Absence of the testis in the scrotum bilaterally Enlargement of the scrotum Testes that migrate into the abdomen when the child squats
Absence of the testis in the scrotum bilaterally
A male client and his spouse are trying to optimize their chances of conception. The nurse understands that the ejaculate amount may increase two to four times its normal amount because of: Abstinence More frequent intercourse Erection increase within 1 to 2 minutes Rhythmic contractions
Abstinence After ejaculation, erection ceases within 1 to 2 minutes. A man usually ejaculates approximately 2 to 5 mL of semen. The ejaculate may vary with frequency of intercourse. It is less with frequent ejaculation and may increase to two to four times its normal amount during periods of abstinence.
An elderly male patient is complaining of dribbling after he urinates and feeling like he never empties his bladder. The nurse suspects the patient may have a problem with:
An enlarged prostate gland.
When caring for the client with acute bacterial prostatitis, the nurse plans for which of these interventions?
Antibiotics
A male patient has experienced a forceful hit to the testes. The nurse expects that the sensory nerves that transmit pain impulses are associated with which nervous system?
Autonomic nervous system
The nurse is speaking with a couple at the fertility clinic about ways to increase sperm counts. Which of these does the nurse include in the discussion?
Avoid tight undergarments
The nurse planning a community education program on abuse of androgens to enhance athletic performance should include which adverse event as a potential harmful effect? Azoospermia Decreased gynecomastia Increased testicular size Asthma
Azoospermia Potential harmful effects of androgen abuse to enhance sports performance includes azoospermia, gynecomastia (breast enlargement), decreased testicular size, and acne.
Benign prostatic hypertrophy (BPH) and prostatic adenocarcinomas presently differently. The nurse is aware of which of the following differences?
BPH is commonly located in the periurethral zone of the prostate, while prostate cancers are commonly located in the peripheral zones of the prostate.
A 60 year old male client is informed by their healthcare provider that they have an overgrowth of mucosal glands of the prostate. Based solely on this finding, what diagnosis will the provider likely document in the health record?
Benign prostate hyperplasia (BPH)
A male patient who is in his 60s comes to the clinic for his yearly checkup. After examining the patient, the physician informs him that he has an overgrowth of mucosal glands of the prostate. Based solely on this finding, what diagnosis should the nurse suspect in this case?
Benign prostate hyperplasia (BPH)
The anatomy of the prostate gland is made up of three concentric areas surrounding the prostatic urethra, into which they open. The nurse understands that an overgrowth of the mucosal glands can cause which disorder in older men?
Benign prostatic hypertrophy
A client with on the urology floor who has BPH asks the nurse how the pharmacologic agent finasteride will help decrease the size of his prostate. Which these does the nurse explain to the client is the mechanism of action?
Blocking effects of androgens on the prostate
A client asks the gynecologist what gland is responsible for urethral lubrication during male sexual stimulation. The best response would be:
Bulbourethral glands
A patient complains of not being able to experience satisfactory sexual intercourse. The nurse knows that erectile dysfunction is now recognized as a marker for which of the following?
Cardiovascular disease
A nurse is performing a genital examination on a 25-year-old man client. The nurse notes pigmented, wrinkled scrotal skin. Based on this information, what should the nurse do next?
Consider this a normal finding and proceed with the examination.
Erectile dysfunction is the inability to achieve and maintain an erection sufficient to permit satisfactory sexual intercourse. The nurse knows that there may be many causes of erectile dysfunction, and a psychogenic cause would include which of the following?
Depression
The male reproductive system is composed of two systems. The nurse knows that which system is responsible for the transportation and storage of sperm? Ductile system Accessory glands Pampiniform plexus Symphysis pubis
Ductile system The ductile system (epididymis, vas deferens, and ejaculatory ducts) transports and stores sperm, and assists in their maturation. The accessory glands (seminal vesicles, prostate gland, and bulbourethral glands) prepare the sperm for ejaculation.
Sperm follow a prescribed route through the excretory ducts of the male reproductive system. Place the following components of the genital duct system in the order that sperm follow. Use all the options.
Efferent ductules Ductus deferens Prostatic urethra Urethra Seminiferous tubules Epididymis
A 60-year-old man comes to the clinic and has been found to have a history of type 2 diabetes mellitus and cardiovascular disease. The manifestations of these diseases will warrant the nurse to assess the patient for which of the following problems?
Erectile dysfunction
In the complex interaction of the sexual act in males, the nurse is aware that there are four stages involved. Which of the following stages involves shunting of blood into the corpus cavernosum?
Erection
Of the following list of medications, which would likely be prescribed to a patient with benign prostatic hyperplasia (BPH) as a way to decrease the prostate size by blocking the effects of androgens on the prostate?
Finasteride (Proscar), a 5a-reductase inhibitor
The male reproductive system is controlled by the hypothalamus and the anterior pituitary gonadotropic hormones regulated by a negative feedback loop. What gonadotropic hormones regulate control of the male reproductive system?
Follicle-stimulating hormone and luteinizing hormone
A male patient is admitted with a spinal injury that has damaged his sacral plexus. The nurse understands that this type of injury could affect the impulse stimulation for initiating the sexual act through which of the following?
Glans penis
An adult client had bilateral orchiectomy (testicular removal) due to cancer. Which will be the primary effect of the disruption in testosterone synthesis?
He will likely experience an overall reduction in muscle mass.
Which chronic health issues increase a man's risk for developing erectile dysfunction? Select all that apply.
Hypertension B. Diabetes Mellitus D. Hyperlipidemia
A patient comes to the clinic and informs the nurse that he was playing soccer and was kicked in the scrotal area on the right side. The nurse observes that the scrotal skin on the right side is dark red. Which of the following should the nurse suspect this patient may have?
Hematocele
A couple is undergoing initial testing to determine why they are unable to conceive. One of the test shows that the man has a testosterone level of 6.9 nmol/l. The man reports being tired all the time. The woman is completely healthy. Which problem is most likely?
Hypogonadism
The nurse in the urology clinic is reviewing the chart of a client with erectile dysfunction. Which of these factors in the client's history does the nurse recognize is a hormone-based conditions that may contribute to erectile dysfunction?
Hypogonadism
An older male client complains of inhibited sexual functioning. The nurse knows which nursing diagnosis could be a priority for his inhibited sexual function? Impaired self-esteem Impaired comfort Ineffective childbearing process Noncompliance
Impaired self-esteem One of the greatest inhibitors of sexual functioning in older men is the loss of self-esteem and the development of a negative self-image. Premature cessation of the aforementioned esteem-building attitudes can contribute to loss of libido and zest for life in the older man.
A client has developed priapism. For which outcome is this client at risk?
Impotence
Which clinical manifestations in an aging male client are due to decreased levels of testosterone? Select all that apply. Infertility Decreased testicular size Decreased sexual energy Increased muscle strength Testicular torsion
Infertility Decreased testicular size Decreased sexual energy Decreasing levels of testosterone affect sexual energy, muscle strength, and genital tissues. The testes become smaller and lose their firmness. The seminiferous tubules, which produce spermatozoa, thicken and begin a degenerative process that finally inhibits sperm production, resulting in a decrease in viable spermatozoa. Testicular torsion is not related to level of testosterone.
A male client reports sudden pain and a bulging in the scrotal sac after lifting a heavy object. The swelling does not reduce when the client is supine and he begins to sweat profusely. What condition is the likely cause of these manifestations?
Inguinal hernia
The cremaster muscles work in concert with the pampiniform plexus that surrounds the testicular artery to:
Maintain testicular temperature
As the sperm mature and are preparing for fertilization, what length of time are sperm able to survive in the male genital tract?
Many weeks
A patient requests a prescription for sildenafil (Viagra) to assist him with achieving and maintaining an erection. Which of the following types of medication would contraindicate the use of sildenafil?
Nitrate
The nurse on the urology unit teaches the nursing student that which of these tests assists in detecting a recurrence of prostate cancer after prostatectomy?
PSA level
A client is concerned that he may have mumps orchitis and asks the nurse practitioner what the symptoms would be. The best response would be:
Painful enlargement of the testes with fever 3 days after parotitis
Sperm begin their life in the Sertoli cells. What factor functions in releasing mature spermatozoa from the Sertoli cells?
Plasminogen activator
The nurse is caring for a client with acute superficial balanitis. The nurse assesses for which of these signs or symptoms, consistent with the diagnosis?
Redness of the glans penis and malodorous discharge
Sperm production occurs in the seminiferous tubules. The nurse understands the anatomy of the testes and knows that as the tubules lead into the efferent ducts, the seminiferous tubules become which of the following structures?
Rete testis
The nurse conducting a health promotion class for teenage boys on human reproduction determines that the participants are understanding the information when they state:
Spermatogenesis continues throughout a man's reproductive years.
The nurse has just completed the admission assessment of a client diagnosed with invasive penile cancer. The most likely plan of treatment will be:
Surgical removal of the affected area
A 14-year-old boy has been brought to the emergency department by his mother in excruciating pain that is radiating from his scrotum to his inguinal area. The boy's heart rate is 122 beats per minute and he has vomited twice before arrival at the hospital. Examination reveals that his scrotum is reddened and slightly swollen and the testes are firm to touch and tender, with extensive cremaster muscle contraction noted. What is the boy's most likely diagnosis?
Testicular torsion
A client arrives in the emergency department complaining of severe testicular pain associated with nausea and vomiting. His pulse rate is 120 beats/min. Physical exam reveals an enlarged testis that is painful to palpation. The nurse suspects: Inguinal hernia Cancer of the scrotum Testicular aneurysm Testicular torsion
Testicular torsion With testicular torsion, the testis rotates about the distal spermatic cord, obstructs perfusion through the testicular arteries and spermatic veins, and obstructs nerve conduction. The torsion obstructs venous drainage, with resultant edema and hemorrhage, and subsequent arterial obstruction. Most squamous cell cancers of the scrotum occur after 60 years of age. After descent of the testes, the inguinal canal normally closes almost completely; failure of this canal to close predisposes to the development of an inguinal hernia later in life.
In the development of the testes, the nurse understands that which of the following can lead to an inguinal hernia later in life?
The inguinal canal has not closed almost completely.
A male patient is being prepared for a physical examination of his prostate gland. How will the nurse explain the location of the prostate gland?
The prostate gland is located in the pelvis, inferior to the bladder.
Men who experience enlarged prostate glands often complain of difficulty urinating. The nurse will be able to explain that this symptom is caused by which of the following reasons?
The prostate gland surrounds the urethra and can produce urinary obstruction.
The client presents with symptoms consistent with hypogonadism. For a diagnosis of hypogonadism, the nurse expects which diagnostic test to be ordered? Total testosterone levels Nitric oxide level Growth releasing hormone level Thyroid stimulating hormone level
Total testosterone levels Diagnosis of hypogonadism includes measurement of total testosterone levels (ideally at 8:00 AM, when the testosterone level is at its peak) in the ambulatory man.
A client who had been utilizing pharmacologic management for BPH is now experiencing severe signs of obstruction. The client would most likely require:
Transurethral prostatectomy
A surgeon is explaining the anatomical structures of the penis during grand rounds. During his explanation the surgeon states that the cremaster muscles work in concert with the pampiniform plexus that surrounds the testicular artery to:
maintain testicular temperature.
The gerontology nurse recognizes that aging male clients may enter a stage referred to as andropause. Which of these does the nurse recognize as characteristic of this stage?
Decline in sexual function
A nurse is providing teaching to the parents of a child who has undergone corrective surgery for cryptorchidism. The most important information for the nurse to provide is:
Parents should be taught that their child needs frequent follow-up visits.
An adolescent male comes to the urgent care clinic. Upon assessment, the following is noted: history of circumcision, erythema of the glans, and prepuce with a malodorous discharge. Based on symptoms, the probable diagnosis would be:
Acute superficial balanoposthitis
The nurse is re-enforcing information given to the client who is asking about screening for prostrate cancer. Which of these will be nurse teach the client about the PSA test?
An elevated score on a PSA test does not necessarily indicate the presence of cancer.
A newborn male has been diagnosed with hypospadias following his postpartum assessment by a pediatrician. Which of the following diagnostics and treatment options is the physician most likely to rule out first?
Circumcision
The nurse is performing a newborn assessment on a 2-day-old male infant. Assessment reveals the presence of the urethral opening on the ventral side of the penis. The nurse would document this finding as being which of the following?
Hypospadias
Priapism (a prolonged painful erection not associated with sexual excitement) can occur at any age. In boys, ages 5 to 10, what are the most common causes of priapism?
Sickle cell disease or neoplasms
A young pregnant mother is told after an ultrasound that the fetus' testes have not descended. What hormone is responsible for the descent of the testes?
Testosterone
A nurse educator is explaining male reproductive physiology during grand rounds and is referring to the process of spermatogenesis. Where does spermatogenesis occur? Sertoli cells The spermatogonia The epididymis The seminiferous tubules
The seminiferous tubules Spermatogenesis occurs in the seminiferous tubules of the testes. The spermatogonia and Sertoli cells are parts of the seminiferous tubules, but they do not contain the entire process of spermatogenesis. The epididymis is a series of conducting tubules.
With the aging male, many changes are measurable. The measurable changes in the reproductive system of the older male are particularly attributable to which hormone?
Testosterone hormone
A 21-year-old university football player has acknowledged to a nurse at a campus clinic that he has been injecting androgens in an effort to increase his muscle mass and enhance his on-field performance. Which teaching point should the nurse include in a conversation with the player? A. "You run real risk of decreasing the size of your testicles and developing breasts by doing this." B. "You will indeed be able to increase your muscles, but they will rebound by shrinking smaller than they ever were within a few months." C. "Most of the people who do this cause themselves to be permanently sterile." D. "A reduction in the size of your penis and the production of mutated sperm can be an effect of steroid use."
A. "You run real risk of decreasing the size of your testicles and developing breasts by doing this."
A nurse is performing a genital examination on a male client who develops an erection. Which of the following is the nurse's most appropriate intervention?
reassure the client that this is a normal response and continue with the examination
The nurse is assessing a client with a collection of blood in the tunica vaginalis of the scrotum. How does the nurse correctly document this in the medical record?
Hematocele
A 68 year-old male has visited his family physician because the size of his scrotum has increased exponentially in recent months. He has subsequently been diagnosed with an inguinal hernia. Which of the following statements best captures the nature of his health problem?
Part of his intestine and parietal peritoneum are protruding through the inguinal opening.
A 75-year-old man presents at the clinic complaining of pain during intercourse and an upward bowing of his penis during erection. The client's history mentions an inflammation of the penis that was treated 3 months ago. The physician's physical examination of the client notes beads of scar tissue along the dorsal midline of the penile shaft. What would be the suspected diagnosis of this client?
Peyronie disease
The health care provider is caring for an older adult male client who reports fatigue and decreased strength. The nurse anticipates which treatment may be prescribed? Estrogens Testosterone Aldosterone Finasteride
Testosterone Testosterone and other synthetic androgens may be used in older men with low androgen levels to improve muscle strength and vigor. Finasteride is a medication used mainly to treat an enlarged prostate or scalp hair loss in men. Estrogen is the primary female sex hormone. It is responsible for the development and regulation of the female reproductive system and secondary sex characteristics. Aldosterone also directly affects the heart and blood vessels. The aldosterone from adrenal glands aids in the conservation of sodium, secretion of potassium, water retention, and to stabilize blood pressure.
Which of the following statements best captures an aspect of the neural control of sexual function?
The spinal cord plays a central role, with the limbic system and cerebral cortex also contributing.
A 74-year-old male client is seeking testosterone supplement for low libido and erectile dysfunction. Which tests should the nurse inform the client will likely be recommended prior to starting testosterone therapy? Select all that apply. A. Testosterone level B. Prostate specific antigen (PSA) C. Lipid profile D. Sperm count E. Luteinizing hormone (LH) & follicle-stimulating hormone (FSH) level
A. Testosterone level B. Prostate specific antigen (PSA) C. Lipid profile Given the client's age, routine treatment with testosterone is not recommended. The client's testosterone level would need to be known, as treatment is not recommended unless the testosterone is less than 300 ng/dL (10.4 nmol/L). The client's prostate health would need to be known, and thus the prostate specific antigen level is part of this screening process. Finally, side effects of replacement therapy may include reduced high-density lipoprotein cholesterol levels; therefore, the health care provider would want to establish a baseline as part of the risk versus benefit assessment. Sperm count is not relevant unless the client wishes to conceive a child, and LH and FSH levels are not needed for the treatment in a client of this age.
Tertiary hypogonadism occurs due to which dysfunction of the endocrine system? A. lack of secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) from the anterior pituitary B. increased production of growth releasing hormone secretion from the hypothalamus C. underdevelopment of the testes leading to decreased production of androgens and a low sperm count D. decreased or absent gonadotropin hormone-releasing hormone (GnRH) secretion from the hypothalamus
D. decreased or absent gonadotropin hormone-releasing hormone (GnRH) secretion from the hypothalamus Tertiary means at the level of hypothalamus Primary hypogonadism problem in the testes leading to decreased production of androgens and a low sperm count, secondary hypogonadism is due to the lack of secretion of LH and FSH from the anterior pituitary, and tertiary hypogonadism is due to the lack of stimulation of LH and FSH secretion from the anterior pituitary due to decreased/absent GnRH secretion from the hypothalamus.
An adult client had bilateral orchiectomy (testicular removal) due to cancer. What will be the primary effect of the disruption in testosterone synthesis? His voice will likely increase in pitch. He will develop some secondary female sex characteristics. He will likely experience an overall reduction in muscle mass. He will likely develop acne on his face and trunk.
He will likely experience an overall reduction in muscle mass. The loss of muscle mass will be the primary effect of reduced testosterone production. He will not develop female characteristics, acne, or an increase in voice pitch.
The nurse explains to a client that temperature can affect sperm production. Which factors can affect temperature and sperm production? Select all that apply. Dartos muscle Pampiniform plexus Tight-fitting undergarments Cryptorchidism Descended testicles
Pampiniform plexus Tight-fitting undergarments Cryptorchidism The location of the testes in the scrotum is important for sperm production, which is optimal at 2ºC to 3ºC below body temperature. Two systems maintain the temperature of the testes at a level consistent with sperm production. One system is the pampiniform plexus of testicular veins that surrounds the testicular artery. This plexus absorbs heat from the arterial blood, cooling it as it enters the testes. The other system is the cremaster muscles, which respond to decreases in testicular temperature by moving the testes closer to the body. Some tight-fitting undergarments hold the testes against the body and are thought to contribute to a decrease in sperm counts and infertility. Cryptorchidism, the failure of the testes to descend into the scrotum, also exposes the testes to the higher temperature of the body. The dartos muscle responds to changes in temperature. When it is cold, the muscle contracts, bringing the testes closer to the body and the scrotum becomes shorter and heavily wrinkled. When it is warmer, the muscle relaxes, allowing the scrotum to fall away from the body.
A male client seeks treatment for erectile dysfunction. What factors contribute to this condition? Select all that apply.
• Age 65 years • Cardiovascular disease • Antihypertensive medications
The nurse in the urology office recognizes screening men at risk for prostate cancer includes which of these diagnostic studies?
Blood level of PSA and digital rectal exam
The mother requests that a circumcision be performed on a newborn with hypospadias. Which information related to treatment of hypospadias should the nurse convey?
Circumcision is avoided as the foreskin will be used to repair the urinary opening.
A patient informs the nurse that he has been having difficulty sustaining an erection. Which of the following statements made by the patient demonstrates to the nurse that the patient understands what a contributing factor to his erectile dysfunction is?
"I should stop smoking cigarettes. I have been smoking for 20 years."
A 20-year-old male has been diagnosed with testicular cancer, and is seeking information about his diagnosis from a number of websites. Which of the following statements that he has read is most plausible?
"Men with cryptorchidism - the term for an undescended testicle - are known to have a higher risk of developing testicular cancer."
The nurse is caring for a client with cancer of the scrotum. When performing a health history, which of these does the nurse explore as risks for this type of malignancy?
Exposure to tar and soot
The nurse knows that which of the following structures are a part of the male reproductive system? Select all that apply.
Pair of gonads Seminiferous tubules Prostate gland
The parents of a baby born with hypospadias ask the nurse if the baby can be circumcised. Which response by the nurse is most accurate?
"The circumcision will not be done now; the foreskin is needed for surgical repair."
A male client is diagnosed with an inguinal hernia. Which statement by the client indicates that the nurse's teaching about the hernia has been effective?
"The hernia is a loop of bowel protruding through a weak spot in my abdominal muscles."
Which of the following teaching points by an oncologist is most appropriate for a 33-year-old male who will begin treatment shortly for his testicular cancer?
"You should know that there might be adverse effects on your sexual function after treatment is finished."
A 40 year-old male client with multiple health problems has been diagnosed with a testosterone deficiency. The nurse knows that which assessment findings would correlate with a testosterone deficiency? Select all that apply.
-A high-pitched voice. - A low muscle mass in proportion to his total body weight.
The nursing student who is studying pathophysiology of the male genitourinary system correctly identifies which of these as functions of the penis? Select all that apply. A. Urine elimination B. Production of androgens C. Sexual function D. Production of sex hormones
A. Urine elimination C. Sexual function The functions of the penis include urine elimination and sexual function. The function of the testes is to produce androgens and spermatozoa.
A 40-year-old man presents at the clinic complaining of painful urination and rectal pain. His vital signs are temperature, 101.7°F; blood pressure, 105/74; pulse, 98; respiration, 22. While taking a history, the nurse notes the client has had chills, malaise, and myalgia. What would the nurse suspect as a diagnosis?
Acute bacterial prostatitis
A nurse practitioner has a 30-year-old male patient presenting with fever/chills, urinary frequency/urgency and pain with urination. A urine sample displays cloudy and foul-smelling urine. During digital rectal exam of the prostate, the nurse notes a thick white discharge. A likely diagnosis would be which of the following?
Acute bacterial prostatitis requiring antimicrobial therapy
While the cause of BPH is unknown, we do know that the incidence of BPH increases with age. What ethnic group is BPH highest in?
African American
Spermatozoa are produced in the seminiferous tubules of the testes and are moved through the genital ducts to be stored in the ampulla of the vas deferens before ejaculation through the penis. Unlike the female egg, which remains briefly fertile, spermatozoa can remain fertile for up to 42 days. Where are the spermatozoa stored so they maintain their fertility?
Ampulla
The male reproductive system undergoes changes as aging occurs. What is the term used to describe a relative or absolute hypogonadism associated with aging? Male menopause Testosterone deficiency Atherogenesis Andropause
Andropause The term andropause has been used to describe an ill-defined collection of symptoms in aging men, typically those older than 50 years, who have a relative or absolute hypogonadism associated with aging.
Following a long history of intermittent back pain and urinary urgency, a 50-year-old client has been diagnosed with chronic bacterial prostatitis. Which of the following factors is most likely to influence his healthcare provider's choice of treatment?
Antibacterial drugs penetrate poorly into the chronically inflamed prostate.
The nursing student is teaching an all-male class at a local middle school about reproduction. When should she tell the students that spermatogenesis begins and ends?
At about 13 years and throughout the reproductive years
A older adult male asks the nurse about factors that affect his ability to sustain an erection. The nurse will assess for which kinds of disorders that may be responsible for secondary impotence? Select all that apply. Cardiovascular Respiratory Hormonal Digestive Hematologic
Cardiovascular Respiratory Hormonal Hematologic Aging is a major etiologic factor in this condition. Diseases that accompany aging can have a direct bearing on male reproductive function. Various cardiovascular, respiratory, hormonal, neurologic, and hematologic disorders can be responsible for secondary impotence. For example, vascular disease affects male potency because it may impair blood flow to the pudendal arteries or their tributaries, resulting in loss of blood volume with subsequent poor distention of the vascular spaces of erectile tissue.
Epididymitis can be sexually transmitted, or it can be caused by a variety of other reasons, including abnormalities in the genitourinary tract. What are the most common causes of epididymitis in young men without underlying genitourinary disease?
Chlamydia trachomatis and Neisseria gonorrhoeae
A client has been diagnosed with an anterior pituitary tumor. Synthesis and release of follicle-stimulating hormone (FSH) has become deranged. What are the potential consequences of this alteration in endocrine function? Dysfunction of spermatogenesis Overproduction of luteinizing hormone Inhibition of testosterone synthesis Impaired detumescence
Dysfunction of spermatogenesis 2 gonadotropic hormones are secreted by the pituitary gland: FSH & luteinizing hormone (LH). In the male, LH also is called interstitial cell-stimulating hormone. The production of testosterone by the interstitial cells of Leydig is regulated by LH. FSH binds selectively to Sertoli cells surrounding the seminiferous tubules, where it functions in the initiation of spermatogenesis. FSH does not directly affect the production of LH, since both are produced by the anterior pituitary. FSH does not stimulate testosterone synthesis. Impaired detumescence is unlikely to be a direct consequence of changes in FSH synthesis and release.
Cryptorchidism, left untreated, is a high risk for testicular cancer and infertility. What are the treatment goals for boys with cryptorchidism?
Easier cancer detection
A male athlete admitted to the emergency room is suspected of abusing androgens. Which physical characteristic would the nurse expect to see if the testosterone has been aromatized to estradial?
Enlarged breast
While teaching a health class to junior and senior male high school students, the school nurse educates them that which of the following is the first sign of testicular cancer?
Enlargement of the testicle
Which of the following is the final site for sperm maturation?
Epididymis
The nurse assessing an adult male with impaired testosterone should evaluate which of the following as an expected finding? Anxiety Fatigue Increased libido Loss of fat mass
Fatigue Clinical manifestation of impaired testosterone secretion in an adult client include fatigue, depression, decreased libido, increased fat mass, and loss of muscle mass. The nurse should consider these to be expected findings in an adult male with impaired testosterone secretion.
The mother of a 5-year-old boy brings him into the clinic because there is a firm feeling swelling around one of his testes. What would the suspected diagnosis be?
Hydrocele
A 54-year-old diabetic patient has come to the urology clinic complaining of erectile dysfunction. His history includes obesity, coronary artery disease which required CABG three years ago, hypertension, and gout. The nurse practitioner is reviewing his record in order to prescribe medication. The practitioner is considering prescribing sildenafil (Viagra). Which of the following home medications is contraindicated if taken concurrently with sildenafil?
Imdur (isosorbide mononitrate), a vasodilator
A patient is admitted with a prolonged and painful erection that has lasted longer than four hours. The nurse knows that this is a true urologic emergency, and that the cause is which of the following?
Impaired blood flow in the corpora cavernosa of the penis
Ejaculation represents expulsion of sperm from the urethra. The nurse understands that which muscles are involved in this process? Ischiocavernosus & bulbospongiosus muscles at base of the penis Ischiocavernosus & bulbospongiosus muscles at the tip of the penis Hypogastric plexus and pelvis muscle at the base of the penis Hypogastric plexus and pelvis muscle at the tip of the penis
Ischiocavernosus & bulbospongiosus muscles at base of the penis Ejaculation represents the expulsion of the sperm from the urethra. It involves contraction of the seminal vesicles and prostate gland, which add fluid to the ejaculate and propel it forward. Ejaculation is accompanied by contraction of the ischiocavernosus and bulbospongiosus muscles at the base of the penis.
Which of these complications does the nurse recognize may occur after illness with parotitis (mumps)in young men?
Orchitis with residual sterility
Temperature regulation of the testes is maintained by which structure? Pampiniform plexus and cremaster muscles Vas deferens and bulbourethral gland Corpora cavernosa and prostate Epididymis and urethra
Pampiniform plexus and cremaster muscles The venous network known as the pampiniform plexus absorbs heat from the arterial blood, cooling it before it enters the testes. The cremaster muscles respond to decreases in testicular temperature by moving the testes closer to the body. The other options are not involved in temperature regulation.
The nurse inserts a Foley catheter in an uncircumcised male patient for the treatment of urinary retention and does not place the foreskin back over the glans penis. Several hours later, the patient complains of severe pain at the catheter site and, when assessed, the nurse is unable to retract the foreskin. Which of the following problems does the nurse know has occurred?
Paraphimosis
The nurse is assessing a client with a history of erectile dysfunction (ED) who is requesting a prescription for treatment. When assessing for additional information related to causes of ED, for which of these does the nurse question the client?
Presence of arterial occlusive disease
A male adolescent asks the health care provider, "What function do the testes play in my body?" Which response would be the most accurate? Production of androgens and spermatozoa Aids in the storage and transport of spermatozoa Produces the fluid constituents of semen Functions in both urine elimination and sexual function
Production of androgens and spermatozoa The testes function in the synthesis of androgens (male sex hormones) and the production of spermatozoa. The ductile system aids in the storage and transport of spermatozoa, and the accessory genital organs produce the fluid constituents of semen. The penis functions in both urine elimination and sexual function.
The nurse in the urology unit is teaching about medication to treat erectile dysfunction. The nurse teaches the client that the mechanism of action of most of these medications is which of these?
Promotes increase in blood flow to the corporus cavernosa
Spermatozoa are mobile in environments with a pH of 6.0-6.5. The nurse knows that secretions from which accessory organ help to neutralize the strongly acidic vaginal secretions?
Prostate gland
A nurse is evaluating diagnostic tests for a client suspected of having prostate cancer. Which of the following results requires further evaluation?
Prostate-specific antigen (PSA) of 12 ng/mL
A 52-year-old male diagnosed with erectile dysfunction (ED) asks the nurse what will be implemented as a first option for treatment. The best response would be:
Psychosexual counseling and PDE-5 inhibitor medications
The nurse is assigned to care for newborns and assesses a newborn male, 12 hours old. The newborn has right cryptorchidism as documented in the doctor's progress notes and noted by the nurse. Which of the following would the nurse assess for this disorder?
Scrotum
Select the structure responsible for secreting fructose that will provide energy for spermatic motility. Seminal vesicles Prostate gland Hypothalamus Bulbourethral gland
Seminal vesicles The seminal vesicles are the only structure that secretes fructose to provide energy for sperm motility.
Sperm follow a prescribed route through the excretory ducts of the male reproductive system. Place the following components of the genital duct system in the order that sperm follow. Use all the options. 1Seminiferous tubules 2Efferent ductules 3Epididymis 4Ductus deferens 5Prostatic urethra 6Urethra
Seminiferous tubules Efferent ductules Epididymis Ductus deferens Prostatic urethra Urethra
A young male patient comes to the clinic and informs the nurse practitioner that he and his new bride have been trying to conceive for the last 4 months. He then states that he is afraid that he may be sterile because he read recently that jockey underwear can cause sterility. What would be the nurse's best response to this?
Sperm production requires temperatures that are 2-3 degrees C below body temperature.
An obstetrician is explaining the differentiation of embryonic tissue into a fetus to an aspiring class of nursing students. Which hormone is primarily responsible for the development of male sex characteristics?
Testosterone
The testes secrete several male sex hormones. Which of these hormones is the most abundant and considered the main testicular hormone?
Testosterone
Which of the following hormones is responsible for the development of male facial hair and change in voice to a deeper level?
Testosterone
An obstetrician is explaining the differentiation of embryonic tissue into a fetus to an aspiring class of nursing students. Which hormone is primarily responsible for the development of male sex characteristics? Testosterone Dihydrotestosterone Androstenedione Dehydroepiandrosterone
Testosterone Testosterone is the most abundant and most active of these hormones. In the male embryo, testosterone is essential for the appropriate differentiation of the internal and external genitalia. Testosterone also is the precursor of dihydrotestosterone (DHT), which functions in the formation of the male urethra, prostate, and external genitalia. Androstenedione and DHEA exert only weak androgenic activity, but their main purpose is to act as a key precursor for testosterone after peripheral conversion.
The nursing instructor is teaching the class about the male hormone testosterone. Which of the following statements made by a student indicates a need for further instruction?
Testosterone does not have any effect on development of increased musculature during puberty
A nursing student is studying pathophysiology as part of her nursing curriculum. Which of the following statements made by the student indicates a need for further instruction?
The male testes are located inside the abdominal cavity.
The nurse is caring for a client with significant benign prostatic hyperplasia (BPH)and hydronephrosis who is fearful of having corrective surgery. Which of these is important for the nurse to convey?
The obstruction is causing urine to flow backward and cause kidney dysfunction.
The pediactric nurse is teaching the mother of a newborn with hypospadias about this disorder. Which of these does the nurse convey?
The opening of the urethra is found on the underside of the penis.
Sperm production by the testes is optimal at 3.6°F to 5.4°F (2°C to 3°C) below body temperature. Two systems of the body maintain the temperature of the testes at a level that allows sperm production. What is the system that assists in maintaining the testes at a temperature lower than body temperature? pampiniform plexus testicular artery cremaster veins tunica vaginalis
pampiniform plexus Two systems maintain the temperature of the testes at a level consistent with sperm production. One is the pampiniform plexus of testicular veins that surround the testicular artery. This plexus absorbs heat from the arterial blood, cooling it as it enters the testes. The cremaster muscle, which responds to decreases in testicular temperature by moving the testes closer to the body. The testicular artery and the tunica vaginalis are not used by the body to maintain optimal temperature in the testes for sperm production. The cremaster is a muscle, not a vein.