Chapter 43: Disorders of the Male Reproductive System
Which client is at greatest risk for developing balanoposthitis?
A male who has an uncircumcised penis
If not treated urgently, testicular torsion can result in which complication?
Loss of testicular perfusion
The nurse is reinforcing information given to the client who is asking about screening for prostrate cancer. Which of these will be nurse teach the client about the prostate-specific antigen (PSA) test?
An elevated score on a PSA test does not necessarily indicate the presence of cancer.
A client informs the nurse that he has been having difficulty sustaining an erection. Which statement made by the client demonstrates to the nurse that the client understands what a contributing factor to his erectile dysfunction is?
"I should stop smoking cigarettes. I have been smoking for 20 years."
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."
An adult male reports painful urination, rectal pain, fever/chills, general malaise and myalgia. Vital signs are: temperature, 101.7°F (38.7°C); blood pressure, 105/74 mm Hg; pulse, 98 bpm; respiration, 22 breaths/min. What condition should the health care provider suspect?
Acute bacterial prostatitis
Which client is at highest risk for developing acute bacterial prostatitis?
An older adult male diagnosed with frequent urinary tract infections testing positive for Gram-negative rods
When caring for the client with acute bacterial prostatitis, the nurse plans for which intervention?
Antibiotics
A 55-year-old man presents with whitish plaques on the surface of the glans penis and prepuce. His foreskin is fibrous and unretractable. Which diagnosis is most likely?
Balanitis xerotica obliterans
The nurse in the urology office recognizes screening men at risk for prostate cancer includes which diagnostic measures?
Blood level of prostate-specific antigen (PSA) and digital rectal exam
A client complains of not being able to experience satisfactory sexual intercourse. The nurse knows that erectile dysfunction is now recognized as a marker for:
Cardiovascular disease
Which risk factor is associated with erectile dysfunction (ED) and considered preventable?
Cigarette smoking
A client arrives in the emergency department complaining of severe pain in the left testicular area with nausea and vomiting for 2 hours. The left testicle is large and tender to palpation and radiating to the inguinal area. Which of the following reflexes can the nurse assess the absence of in order to indicate testicular torsion?
Cremasteric reflex
Which assessment is most likely to reveal a potential exacerbation in a 70-year-old client's diagnosis of benign prostatic hyperplasia (BPH)?
Digital rectal examination
Cryptorchidism, left untreated, is a high risk for testicular cancer and infertility. What is one of the treatment goals for boys with cryptorchidism?
Easier cancer detection
A client 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. What should the nurse suspect this client may have?
Hematocele
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
Select the factor that would increase a male's risk for the development of testicular cancer.
History of cryptorchidism
The mother of a 5-year-old boy brings him into the clinic because there is a firm feeling and swelling around one of his testes. What would the suspected diagnosis be?
Hydrocele
The nurse in the urology clinic is reviewing the chart of a client with erectile dysfunction. Which factor in the client's history does the nurse recognize is a hormone-based condition that may contribute to erectile dysfunction?
Hypogonadism
A client calls the clinic and informs the nurse that he has sustained an erection for 3 hours and that it is extremely painful. The client has a history of sickle cell disease and this has not happened to him in the past. Which instruction should the nurse give to the client?
If the client does not seek medical attention, impotence may result.
A client has developed priapism. For which outcome is this client at risk?
Impotence
The nurse is reviewing the laboratory results of a client who has non-inflammatory prostatitis. The nurse would expect the results to include:
Normal leukocyte count
The nurse on the urology unit teaches the nursing student that which test assists in detecting a recurrence of prostate cancer after prostatectomy?
PSA level
A client is concerned about having mumps orchitis and asks the nurse about the symptoms. What is the nurse's best response?
Painful enlargement of the testes with fever 3 days after infection
The nurse inserts a Foley catheter in an uncircumcised male client for the treatment of urinary retention and does not place the foreskin back over the glans penis. Several hours later, the client complains of severe pain at the catheter site and, when assessed, the nurse is unable to retract the foreskin. Which problem does the nurse know has occurred?
Paraphimosis
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
A client is admitted with a prolonged and painful erection that has lasted longer than 4 hours. The nurse knows that this is a true urologic emergency, and that the cause is:
impaired blood flow in the corpora cavernosa of the penis.
The nurse in the urology unit is teaching about medication to treat erectile dysfunction. The mechanism of action of most of these medications is that the medication:
promotes increase in blood flow to the corpora cavernosa.
A client is admitted with secondary orchitis. Which assessment question is most relevant?
"Have you ever had mumps?"
After seeking care due to recent history of testicular enlargement and scrotal pain, a 22-year-old college student has been diagnosed with testicular cancer. Which statement by the client indicates the need for further teaching?
"I can't shake this feeling like I've received a death sentence."
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.
A client in the urology clinic asks the nurse how the doctor will determine if his prostate lesion is due to benign prostatic hyperplasia (BPH) or prostate cancer. Which response should the nurse convey?
Presence of cancers are determined through a biopsy.
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
A nurse is performing a genital examination on a male client who develops an erection. Which action is the nurse's most appropriate intervention?
Reassure the client that this is a normal response and continue with the examination
The nurse is caring for a client with acute superficial balanoposthitis. The nurse assesses for which of these signs or symptoms consistent with the diagnosis?
Redness of the glans penis and malodorous discharge
Which statement about screening for prostate cancer is most accurate?
BPH and prostatitis can confound prostate screening results.
A male client reports frequent urination, difficulty starting to urinate, and dribbling after he has finished urinating. Which diagnosis correlates with this client's manifestations?
Benign prostatic hyperplasia (BPH)
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 client with symptoms of benign prostatic hyperplasia (BPH) is assessed according to the American Urological Association Symptom Index (AUASI). However, which factor is considered the single most important to assess when evaluating and treating BPH?
The man's own experiences
The nurse is caring for a baby with phimosis. Which of these does the nurse explain to the mother is the key feature of this disorder?
Tightening of the foreskin preventing full retraction over the penis
The nurse is assessing a client in the urology clinic with suspected benign prostatic hyperplasia (BPH). Which client symptoms are consistent with BPH?
Urinary frequency Dribbling after urination Awakening at night to void
Which complication is associated with prostatic hyperplasia?
Urine retention
Which treatment intervention is recommended for infants who have a severe case of hypospadias?
surgical repair