Chapter 45: Disorders of the Female Reproductive System, Quiz Thirteen, Chapter 39: Disorders of the Male Genitourinary System-Patho Level 3, Ch. 40 Pathophysiology, Ch. 39 Pathophysiology, Patho Ch 39 Disorders of Male GU, Patho Quiz 1, Patho Final...

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The vulva area is especially prone to skin infections. The nurse knows that this occurs because of:

Constant exposure to secretions and moisture

Which of the following assessment questions is most likely to address the causation of a woman's new case of candidiasis?

"Have you been on antibiotics recently?"

"Have you ever had a sexually transmitted infection?"

A 21-year-old college student has sought out care because of the vaginal burning, itching, and redness that have become worse in recent weeks. Which of the clinician's assessment questions is most likely to apply to a diagnosis of vaginitis?

"Have you ever had a sexually transmitted infection?"

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"

"I can't shake this feeling like I've received a death sentence."

Antibody testing has confirmed that a man is positive for hepatitis A virus (HAV). Which of the client's statements suggests that he understands his new diagnosis?

"I dont know why I didnt bother to get vaccinated against this."

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"

A 66-year-old woman has been diagnosed with diverticular disease based on her recent complaints and the results of a computed tomography (CT) scan. Which of the client's statements demonstrates an accurate understanding of this diagnosis?

"I suppose I should try to eat a bit more fiber in my diet."

The nurse has taught a 30-year-old female client to perform breast self-evaluation (BSE). Which statement by the client indicates correct understanding?

"I will palpate my breasts for lumps a few days after my period."

Which of the following complaints by middle-aged women should prompt a care provider to assess for the possibility of ovarian cancer?

"I'm having a lot of indigestion and blasting, that I've never had before."

Which of the complains by middle-aged women should prompt a care provider to assess for the possibility of ovarian cancer?

"I'm having a lot of indigestion and bloating, which I've never had before."

Which of the following complaints by middle-aged women should prompt a care provider to rule out the possibility of ovarian cancer?

"I'm having a lot of indigestion and bloating, which are both new to me."

While working with a client with a fairly recent spinal cord injury, the partner asks about the couple's ability to maintain a sexual relationship. Which response by the nurse is most accurate?

"If the parasympathetic impulses can pass from the sacral segments of spinal cord through pelvic nerves, an erection should be possible"

A female client reports that her mother-in-law was just diagnosed with cervical cancer and asks the nurse about her own risk. Which response by the nurse is correct?

"If you had the human papillomavirus (HPV) vaccine, your risk is greatly reduced."

A 44-year-old woman has sought care for the treatment of headaches that have been increasing in severity and frequency and has been subsequently diagnosed with migraines. Which of the following teaching points should her care provider emphasize?

"It would be helpful for you to take control of your diet, sleep schedule, and stress levels."

A client diagnosed with endometriosis asks the nurse how it is that she did not know about this when she had it for so long. What is the nurse's best response?

"Its symptoms mimic those of other disorders "

The nurse is teaching a client with hypertension about managing erectile dysfunction (ED). What information should the nurse share with the client?

"Participating in regular exercise may help resolve the ED"

What should the nurse teach the client about assessing for possible breast cancer?

"Perform monthly self-breast exams after menses."

What will the nurse teach the client who has a cervical polyp?

"Polyps typically are asymptomatic"

"Sperm can no longer pass through the ductus deference"

A 41-year-old male client is planning on having a vasectomy. While explaining surgery to the client, the health care worker will include which physiologic principle as the basis for this contraception technique?

"Sperm can no longer pass through the ductus deferens."

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"

The parents of a baby born with hypospadias ask the nurse if the baby can be circumcised. The best response would be: a) "The condition can be treated with topical medication; circumcision is not needed." b) "The circumcision will be done when the child reaches puberty." c) "The circumcision can be performed now." d) "The circumcision will not be done now; the foreskin is needed for surgical repair."

"The circumcision will not be done now; the foreskin is needed for surgical repair." Surgery is the treatment of choice for hypospadias. Circumcision is avoided because the foreskin is used for surgical repair. Factors that influence the timing of surgical repair include anesthetic risk, penile size, and the psychological effects of the surgery on the child.

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." An inguinal hernia or "rupture" is a protrusion of the parietal peritoneum and part of the intestine through an abnormal opening from the abdominal cavity. A loop of small bowel may become incarcerated in an inguinal hernia (strangulated hernia), in which case its lumen may become obstructed and its vascular supply compromised.

A client with a family history of breast cancer has just learned that she carries the BRCA1 and BRCA2 mutation. When educating this client about follow-up care, which of the statements would be most appropriate?

"You should have more frequent breast evaluations using an MRI rather than standard mammography."

"You should have more frequent great examinations using an MRI rather than standard mammography."

A female client with uterine leiomyomas asks the nurse about her risk of uterine cancer. Which statement best answers the question?

"Your leiomyomas may cause heavy periods but will not become cancerous."

Herpes attacks can be triggered by stress to the body including:

-General illness (from mild> serious) -Fatigue -Physical or emotional stress -Immunosuppression due to AIDS or such med's as chemotherapy/steriods -Trauma to the effected area, including sexual activity -Menstruation

A 22-year-old client has presented to her primary care provider for her scheduled Pap smear. Abnormal results of this diagnostic test may imply infection with: A) Human papillomavirus (HPV) B) Chlamydia trachomatis C) Candida albicans D) Trichomonas vaginalis

A) Human papillomavirus (HPV)

Which of the following diagnoses is most likely to require surgical correction? A) Hypospadias B) Orchitis C) Erectile dysfunction D) Spermatocele

A) Hypospadias

An asymptomatic client who is worried about developing breast cancer due to the fact that it runs in her family asks the nurse if she could have a mammogram to see if she has any lumps. The nurse informs the client that a tumor usually is undetectable until it has doubled 30 times and contains more than 1 billion cells. This means that at this point it measures approximately which size?

1 cm

The 3 stages of Syphilis:

1. Primary stage= Cancre (painless ulceration) formation around the penis, vagina, mouth, & anus. 2. Secondary stage= Rash on palms and soles of feet. Also, fever, sore throat, nausea, genital lesions called condylomata. 3. Tertiary stage= (Latent phase)= Central Nervous System Lesions (brain damage); Cardiovascular damage (caused by scarring of the aorta); Gumma formation: Gummas are most commonly found in the liver, but can also be found in the brain, heart, skin, bone, testis and other tissues> a variety of potential problems including neurological disorders or heart valve disease.

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

Cervical Cancer 20% of GYN CA:

40-45 peak incidence- one cause is HPV Virus! Highest risk are females who have had >10 sexual partners & early age start of sexual activity. S/S: "Red Flag" sign is painless abnormal vaginal bleeding in 90% of cases. Dx: PAP Smear: The primary purpose of PAP is to obtain cytology (cell) samples from cervix to examine cervical cells for atypical changes. Rx: Chemotherapy, radiation (brachytherapy), hormone & other med's, and surgery. *POST menopausal women should NOT be bleeding!

Ovarian Cancer 5% of GYN CA:

40-70 peak incidence, Family history of breast and ovarian cancer, Causes vague GI symptoms, 75% of cases have metastasized before being detected. There is NO good screening tests for ovarian cancer.

A 22-year-old client has presented to her primary care provider for her scheduled Pap smear. Abnormal results of this diagnostic test may imply infection with: A. Human papillomavirus (HPV) B. Chlamydia trachomatis C. Candida albicans D. Trichomonas vaginalis

A Although a Pap smear does not test directly for HPV, dysplasia of cervical cells is strongly associated with HPV infection. An abnormal Pap smear is not indicative of chlamydial infection, trichomoniasis, or candidiasis.

A client presents to a STI clinic. Her primary complaint is related to purulent exudate and bleeding after intercourse. The health care worker will primarily focus on the diagnosis of which STI? A. Gonorrhea B. Chlamydial infection C. Human papillomavirus infection D. Genital herpes simplex virus infection

A The gonococcus is a pyogenic (i.e., pus-forming), gram-negative diplococcus that evokes inflammatory reactions characterized by purulent exudates. Internal human papillomavirus (HPV) condylomata acuminata warts are cauliflower-shaped lesions that affect the mucous membranes of the vagina, urethra, anus, or mouth. The initial symptoms of primary genital herpes (herpes simplex virus, HSV) infections include tingling, itching, and pain in the genital area, followed by eruption of small pustules and vesicles.

Which of the clients is likely at the greatest risk of developing a urinary tract infection?

A 79-year-old client with an indwelling catheter for urinary incontinence

Cystocele

A bulge of the bladder into the vagina. Symptoms include feeling pressure in the pelvis and vagina, discomfort when straining, and feeling that the bladder hasn't fully emptied after urinating. Mild cases don't need treatment, estrogen may be used.

The client has a Bartholin cyst that has developed into an abscess. The nurse explains to the client the plan of care, including which treatments?

A catheter may be inserted to drain the cyst for several weeks.

Hypospadias

A condition in which the opening of the penis is on the underside rather than the tip. May spray while urinating.

Endometriosis

A disorder in which tissue that normally lines the uterus grows outside the uterus. The most common symptoms are pain and menstrual irregularities. Effective treatments, such as hormones and excision surgery, are available.

Hydrocele

A fluid-filled sac around a testicle, often first noticed as swelling of the scrotum. Common in babies and the elderly, or an infection like epididymitis.

PCOS

A hormonal disorder causing enlarged ovaries with small cysts on the outer edges. Symptoms include menstrual irregularity, excess hair growth, acne, and obesity. May be given birth control.

Which client is at greatest risk for developing balanoposthitis?

A male who has an uncircumcised penis

Which of the clients may be experiencing the effects of neuropathic pain?

A man with pain secondary to his poorly controlled diabetes

Which client would be considered to be exhibiting manifestations of "prediabetes"?

A middle aged overweight adult with a fasting plasma glucose level of 122 with follow-up OGTT of 189 mg/dL

Priapism

A prolonged erection of the penis, usually without sexual arousal. Caused by certain antidepressants or erectile dysfunction drugs.

As a result of endocrine disorder, the client with polycystic ovary syndrome will like exhibit which of the following clinical manifestations? Select all that apply. A) Male pattern baldness B) Metabolic syndrome with insulin resistance C) Irregular menstrual cycles D) Infections of the cervix E) BP 100/70s, low normal

A) Male pattern baldness B) Metabolic syndrome with insulin resistance C) Irregular menstrual cycles

Men whose sexual partners have been diagnosed with Trichomonas vaginalis will likely exhibit: A) No symptoms of infection B) Copious amounts of frothy discharge from the penis C) Numerous pustules on the penal shaft D) Redness and pain at the urethral meatus

A) No symptoms of infection

An abnormal PAP SMEAR could detect the following STD: A- HPV B- Trichomoniasis C- Herpes Simplex D- Hepatitis B

A- HPV

The physiological reasoning behind giving acyclovir, an antiviral medication, to a client diagnosed with genital herpes would include the fact that these drugs: A. Interfere with viral DNA replication, which can decrease the frequency or recurrences B. Can be obtained without a prescription and usually applied topically C. Attach the cell wall and totally destroy the virus, thus curing the client D. Will prevent the organism from developing a resistance to the treatment protocols

A.Interfere with viral DNA replication, which can decrease the frequency or recurrences

Which of the following disorders of the skin is most likely to respond to treatment with systemic antibiotics?

Acne vulgaris

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

Absence of menses

Amenorrhea

Pain assessment is likely to be most challenging when providing care for which of the older adult clients?

An 87-year-old man with vascular dementia and other health problems like heart failure

Which of the following clients is at high risk for developing acute bacterial prostatitis?

An elderly amle diagnosed with frequent UTIs testing positive for gram-negative rods

Which of the following clients is at high risk for developing acute bacterial prostatitis?

An elderly male diagnosed with frequent UTIs testing positive for gram-negative rods

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

HPV

An infection that causes warts in various parts of the body, depending on the strain. There's no cure for the virus and warts may go away on their own. Treatment focuses on removing the warts. There is a vaccine.

When caring for the client with acute bacterial prostatitis, the nurse plans for which intervention?

Antibiotics

While breast feeding her 3-month-old infant, the mother notices the breast area is hard, inflamed, and tender to touch. The clinic nurse explains that this is likely cause by:

Ascending bacterial infection

While breast-feeding her 3-month-old infant, the mother notices the breast area is hard, inflamed, and tender to touch. The clinic nurse explains that this is likely caused by:

Ascending bacterial infection

A 33-year-old client has been admitted to the hospital for the treatment of Graces disease. Which of the assessments should the client's care team prioritize?

Assessment of the client's vision and oculomotor function

A 29-year-old client had a Papanicolaou smear performed during her most recent visit to her primary care provider. This diagnostic procedure aims to identify:

Atypical cervical cellular changes

A 29-year-old client had a Papanicolaou smear performed during her most recent visit to her primary care provider. This diagnostic procedure aims to identify:

Atypical cervix cellular changes

A 29-year-old client has a Pap smear performed during her most recent visit to het primary care provider. this diagnostic procedure aims to identify:

Atypical cervix cellular changes

The release of insulin from the pancreatic beta cells can inhibit its further release from the same cells. This is an example of which type of hormone action?

Autocrine

A female receives a PAP smear result indicating she has human papillomavirus (HPV) infection. As part of her education, the nurse will emphasize the need for continued follow-up since HPV is directly associated with: A) Uterine cancer B) Cervical dysplasia C) Genital herpes lesions D) Urinary tract infections

B) Cervical dysplasia

The most prevalent vaginal infection to be spread through sexual contact is: A) Candidiasis B) Trichomoniasis C) Vulvovaginitis D) Bacterial vaginosis

B) Trichomoniasis

Benign prostatic hyperplasia (BPH) and prostatic adenocarcinomas present differently. The nurse is aware of which difference?

BPH is commonly located in the periurethral zone of the prostate, while prostate cancer is commonly located in the peripheral zones of the prostate

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)

A woman has cut her finger while dicing onions in the kitchen, causing her to drop her knife in pain. which of the components of this pain signal was transmitted by a third-order neuron? The neurons:

Between the thalamus and the cortex

A client who has had his gallbladder removed asks the nurse, "Why do I feel sick every time I go through a drive-in fast-food restaurant and order burgers and fries?" The nurse bases the response knowing that:

Bile from the GB is needed to breakdown lipids

Based on the group that statistically has the greatest risk, the health care provider should assess which ethnic group for prostate cancer?

Black

Which of the following disorders of the male genitourinary system creates the most urgent need for prompt and aggressive surgical treatment? A. Spermatocele B. Benign prostatic hyperplasia (BPH) C. Intravaginal testicular torsion D. Erectile dysfunction

C Although all of the noted health problems warrant monitoring and possible treatment, intravaginal testicular torsion is an emergency that requires prompt surgery to save the torsed testicle.

Which of the following clients is at greatest risk for developing balanitis xerotica obliterans? A. A homosexual male with a monogamous partner B. A client who has had their pituitary gland removed due to cancer C. A male who has an uncircumcised penis D. A middle-aged male with history of chronic prostatitis

C Balanitis xerotica obliterans is a chronic, sclerosing, atrophic process of the glans penis that occurs solely in uncircumcised men. As such, the uncircumcised state supersedes the influence of sexual behavior, prostatitis, or hormonal effects of not having a pituitary gland.

Men older than age 50 are at high risk for prostatic hypertrophy with complications that include: A. Hypospadias B. Scrotal edema C. Urine retention D. Testicular cancer

C Benign prostatic hypertrophy (BPH) is a common disorder in men over 50; because the prostate encircles the urethra, BPH exerts its effect through obstruction of urinary outflow from the bladder. Hypospadias is a congenital condition in which the termination of the urethra is on the ventral surface of the penis. Scrotal edema is often the result of testicular disease or inflammation rather than prostate enlargement. Often the first sign of testicular cancer is a slight enlargement of the testicle that may be accompanied by some degree of discomfort.

When educating a group of teenagers about sexually transmitted infections (STIs), the school nurse also mentions that cervical cancer has been associated with which of the following virus infections? A- Chlamydia trachomatis B- Herpes simplex C- Human papilloma virus D- Varicella zoster

C- Human papilloma virus

A patient with acute, severe diarrhea as a result of C. difficile infection is likely to develop which acid/base imbalance: A- Respiratory Acidosis B- Respiratory Alkalosis C- Metabolic Acidosis D- Metabolic Alkalosis

C- Metabolic Acidosis

Endometriosis is characterized by painful hemorrhagic lesions in the pelvis, which may develop into which of the following potential complication? A- Endometrial cancer B- Candidiasis vaginitis C- Pelvic adhesions D- Bladder herniation

C- Pelvic adhesions

Which condition would the nurse expect a female client with human papillomavirus (HPV) to exhibit?

Cervical intraepithelial neoplasia

Which of the physiologic changes results in menopause

Cessation of ovarian function and decreased estrogen levels

Which of the following physiologic changes results in menopause?

Cessation of ovarian function and decreased estrogen levels.

Which of the following physiologic changes results in menopause?

Cessation of the ovarian function and decreased estrogen levels

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

Which of the following sexually transmitted infections (STIs) is associated with an increased risk of infertility in women due to asymptomatic infection?

Chlamydial infection

Which risk factor is associated with erectile dysfunction (ED) and considered preventable?

Cigarette Smoking

Common risk factors associated with erectile dysfunction due to generalized penile arterial insufficiency include:

Cigarette smoking

Common risk factors for erectile dysfunction due to generalized penile arterial insufficiency include...

Cigarette smoking

A 17-year-old male has developed phimosis to the point that he is having difficulty voiding. The nurse should prepare this teenager for:

Circumcision

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?

Cremaster reflex

A patient 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 to indicate testicular torsion?

Cremasteric reflex When assessing the patient for testicular torsion, the cremasteric reflex is frequently absent. To elicit the cremasteric reflex, the medial aspect of the thigh is stroked and testicular retraction is observed. The other reflexes do not indicate testicular torsion.

A client comes to the OB/GYN clinic complaining of difficulty in emptying the bladder and frequency and urgency of urination. After examination, the health care provider will likely diagnose:

Cystocele

Symptoms of difficulty in emptying the bladder, frequency, and urgency of urination are common in women with...

Cystocele

A client comes to the OB/GYN clinic complaining of difficulty in emptying the bladder and frequency and urgency of urination. After examination, the health care provider will likely diagnose:

Cytocele

Of the following STIs, for which STI should the nurse anticipate a prescription for antibiotics such as tetracycline or doxycycline since this infection will respond to antibiotic treatment? A. Human papillomavirus (HPV) infection B. Herpes simplex virus type 2 (HSV-2) infection C. Candidiasis D. Lymphogranuloma venereum (LGV)

D Because HSV-2 and HPV infections and candidiasis have nonbacterial etiologies, these infections are insensitive to antibiotics. Lymphogranuloma venereum (LGV) is an acute and chronic venereal disease caused by Chlamydia trachomatis and is consequently sensitive to antibiotics.

Which of the following events is associated with the primary stage of syphilis? A) Development of gummas B) Development of central nervous system lesions C) Palmar rash D) Genital chancres

D) Genital chancres

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? a) Decrease in urinary output b) Decline in sexual function c) Prostate cancer d) Weight gain

Decline in sexual function Male sex hormone levels, particularly testosterone, decrease with age. The term andropause has been used to describe an ill-defined collection of symptoms in aging men, typically causing decreased muscle strength, smaller testes, erectile dysfunction, and inhibited sperm production. those older than 50 years, who may have a low androgen levels.

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

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

Which of the following assessments is most likely to reveal a potential exacerbation in a 70-year-old client's diagnosis of benign prostatic hyperplasia (BPH)?

Digital rectal examination

A client who us quadriplegic following a motor vehicle accident adheres to a bowel protocol to promote regular bowel movements and prevent constipation. Which of the actions performed by the client's caregiver is likely to promote defecation?

Digital stimulation of the client's rectum

Complex regional pain syndrome is characterized by:

Disproportionate pain with mobility

Which of the principles should underlie the pain control strategy in the care of a child with a diagnosis of cancer?

Dosing and timing should aim for a steady serum level of the prescribed drug

The male reproductive system is comprised of two systems. The nurse knows that which system is responsible for the transportation and storage of sperm?

Ductile system The ductile system (epididymides, vas deferens, and ejaculatory ducts) transports and stores sperm, and assists in their maturation; and the accessory glands (seminal vesicles, prostate gland, and bulbourethral glands) prepare the sperm for ejaculation.

Inguinal Hernia Cont.

Dx: "Turn your head and cough" exam is done while standing to palpate for inguinal canal weakness and/or tissue pushing through the weakened area. Standing and coughing *causes internal pressure to accentuate the tissue bulge so it can be detected easier. Imaging tests can possibly see the hernia. Rx: "Wait and see" if a small herniation. More severe herniation requires surgery to *prevent strangulation of an intestinal loop ("incarcerated intestine") which would cause intestinal obstruction, cutting off blood supply to the intestine, and ultimately death***a true emergency, but this is rare.

Painful menses

Dysmenorrhea

A 29-year-old patient had a Papanicolaou smear performed during her most recent visit to her primary care provider. This diagnostic procedure aims to identify...

Dysplastic cervical cells

A client who has been diagnosed with premenstrual syndrome (PMS) asks if there is anything to help alleviate the symptoms. The best response would be:

Eat a diet low in simple sugars and high in protein.

The nurse in the ER is caring for a client with lower abdominal pain that is greater on the right side and who has light vaginal spotting. When the client's human chorionic gonadroptropin (hCG) level is lower than normal, the nurse plans care for a client with:

Ectopic pregnancy

Polycystic ovary syndrome (PCOS) is ovarian dysfunction caused by a combination of hormone imbalances that include______ levels.

Elevated LH

When explaining polycystic ovary syndrome (PCOS) to a newly diagnosed client, the health care worker states, "This ovarian dysfunction is caused by:

Elevated LH

Vaginitis: (fungal infection)

Etiology: Infection (usually fingal- candidia, atrophy, chemicals Pathophys: Alteration of vaginal flora--> overgrowth of normal flora or growth of pathogen. S/S: itching, burning, abnormal vaginal discharge ("cottage cheese looking") and malodorous Rx: treat underlying cause with antifungal medication

Endometriosis:

Etiology: unknown. Growth of uterine tissue outside the uterus> ovaries, bowels, and bladder. Pathophys: Endometrial tissue goes through the same cycle that the uterus does, including bleeding. Bleeding goes into surrounding tissue causing PAIN & significant pelvic adhesions. Adhesions can cause blockages (pain on defecation), bladder constrictions (dysuria), & infertility (blockage of fallopian tubes). S/S: May be asymptomatic or cause debilitating pain. Rx: pain meds, surgery, and hysterectomy

Which of the pathophysiologic phenomena may result in a diagnosis of Cushing disease?

Excess ACTH production by a pituitary tumor

Priapism is a condition that causes ischemia as a result of...

Failure of detumescence

The dermis is the outermost layer of the skin and covers the body.

False

The epidermis is well supplied by a vascular system.

False

The structure of the skin renders it susceptible to bacterial and fungal infections but resistant to viral infections.

False

Varicella in adults is of similar significance and severity as in children.

False

When sensors detect a change in hormone level the hormonal response is regulated by which mechanism that will return level to within normal range.

Feedback

A school nurse is providing an informational session about the prevention of cervical cancer in young girls and women. The most important information for the nurse to present would be:

HPV vaccine before becoming sexually active

Which STD's are INCURABLE VIRUSES?

HPV, HERPES 1 & 2, HEPATITIS B & C.

Which assessment findings of a male client constituted a criterion for a diagnosis of metabolic syndrome? The client:

Has high blood pressure that is consistently in the range of 150/92 mm Hg

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

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 Disorders of the scrotum and testes include collection of fluid (hydrocele), blood (hematocele), or sperm (spermatocele) in the tunica vaginalis or varicosities of the veins in the pampiniform venous plexus (varicocele.

A 44-year-old man has been brought to the emergency department with severe electrical burns resulting from a workplace accident. The most immediate threat to this client's survival at this time is:

Hemodynamic instability

A 38-year-old woman with proliferative breast changes of papilloma asks the nurse about her risk for breast cancer. Which statement of risk is correct?

Higher because of your papilloma

Carcinoma of the cervix is often considered to be a sexually transmitted disease associated with_____ viral infection.

Human papilloma

When educating a group of teenagers about sexually transmitted infections (STIs), the school nurse also mentions that cervical cancer has been associated with which of the following viral infections?

Human papilloma

There are two types of vulvar cancer. One type is found in older women, and one type is found in younger women, generally less than 40 years of age. The type found in younger women is thought to be caused by:

Human papillomavirus (HPV)

Which factor in a client's history is most likely related to the diagnosis of cervical squamous dysplasia?

Human papillomavirus (HPV) infection

The nurse is assessing a 24-year-old client who states that she has infrequent menstrual periods that are approximately 40 to 42 days apart. She also states, "My periods are really light. It's almost like I hardly even need to use a pad sometimes." The nurse should document which medical terms associated with this client's menstruation? Select all that apply.

Hypomenorrhea Oligomenorrhea

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:

Hypospadias

Which diagnosis is most likely to require surgical correction?

Hypospadias

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 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

An adult male has been diagnosed with mumps orchitis. The nurse should educate the client regarding which complication associated with mumps orchitis?

Impaired spermatogenesis

A client has developed priapism. For which outcome is this client at risk?

Impotence

While trying to explain the physiology behind type 2 diabetes to a group of nursing students, the instructor will mention which of the accurate information?

In skeletal muscle, insulin resistance prompts decreased uptake of glucose. Following means (postprandial), glucose levels are higher due to diminished efficiency of glucose clearance.

A female client with blocked fallopian tubes seeks assistance at a fertility clinic. Which assisted reproductive technology will bring the greatest chance for conception?

In vitro fertilization (IVF)

When trying to explain to a newly diagnosed irritable bowel syndrome (IBS) client how the nervous system affects gastrointestinal disorders, the nurse mentions which in regard to IBS?

Increase in enteric nervous system activity

Which characteristics differentiates inflammatory diarrhea from the noninflammatory type?

Infection of intestinal cells

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? a) Inguinal hernia b) Benign prostatic hypertrophy c) Phimosis d) HPV infection

Inguinal hernia An inguinal hernia is when a loop of small bowel slips into the inguinal canal. -A strangulated hernia occurs when the bowel becomes trapped and blood supply to the bowel is compromised. -Phimosis is when the foreskin is constricted and cannot be easily retracted. -Human papillomavirus (HPV) is a sexually transmitted infection which can cause genital warts, and cervical and penile cancers.

The community health nurse is conducting a men's health class. Which of these does the nurse relate as the major role of the prostate?

It increases sperm motility

The health care provider suspects a diagnosis of endometriosis. Which procedure provides a definitive diagnosis?

Laparoscopy

If not treated urgently, testicular torsion can result in which complication?

Loss of testicular perfusion

Testicular torsion, a serious disorder affecting young male individuals, causes...

Loss of testicular perfusion

Which of the following STIs is most likely to respond to treatment with the antibiotics tetracycline or doxycycline?

Lymphogranuloma venereum (LGV)

A woman reports to the primary healthcare provider that she experiences monthly changes before her menstrual cycle. Which statement demonstrates understanding of premenstrual disorders?

Many women report premenstrual emotional or physical changes.

After reviewing the 24-hour intake and output of a hospital client, the nurse suspects that the client may be experiencing flaccid bladder dysfunction. Which of the diagnostic methods is most likely to confirm or rule out whether the client is retaining urine?

Measurement of postvoid residual (PVR) by ultrasound

Abnormally heavy bleeding at irregular intervals

Menometorrhagia

Cessation of menses

Menopause

Abnormally heavy and prolonged menstrual period at regular intervals

Menorrhagia

The ovaries have a dual function. The nurse is able to explain to the client that any problems with the ovaries frequently cause which problem?

Menstrual and fertility problems

Bleeding occurring irregularly

Metorrhagia

Uterine (endometrial) 40% of GYN CA:

Most common on postmenopausal women. ^ risk due to increasing age, late menopause, never giving birth, infertility, obesity, diabetes, high BP, estrogen treatment.

The nurse practitioner is reviewing risk factors for the development of pelvic inflammatory disease (PID) with a client. Which information is appropriate to include? Select all that apply.

Multiple sex partners Previous diagnosis of sexually transmitted infection Sexual intercourse before the age of 15 years

The somatosensory system consists of three types of sensory neurons. The special somatic type of afferent sensory neurons has receptors that sense:

Muscle position

Never had any children

Men whose sexual partners have been diagnosed with Trichomonas vaginalis will likely exhibit:

No symptoms of infection

Nociceptors are sensory receptors that are activated by:

Noxious stimuli

A female client is being seen in the ED with complaints of lower abdominal pain, dyspareunia, back pain, purulent cervical discharge, and the presence of adnexal tenderness and painful cervix on bimanual pelvic examination. The nurse suspects the client has pelvic inflammatory disease (PID), and will assess the client for:

Number of sexual partners

A dermatologist is explaining to a client the advantages of using a lotion that can draw out water to the skin surface. The nurse knows the technical term for this lotion is a/an:

Occlusive

A client presents to the emergency department vomiting large amounts of bright red blood. The client has a history of alcohol abuse, and the physician suspects esophageal varices. The drug that is used to reduce splanchnic and hepatic blood flow and portal pressures is:

Ocetrotide, a long-acting synthetic analog of somatostatin

Infrequently occurring menses at intervals greater then 35 days.

Oligomenorrhea

A female client presents to her primary care physician with a report of very heavy bleeding during menstrual cycles. Tests indicate the condition is not from a hormone imbalance. Which intervention option is least invasive?

Oral contraceptives

What is an Orchiopexy and how does it relate to Cryptorchidism (Undescended testicle) AND Testicular Torsion?

Orchiopexy, or orchidopexy is a surgery to move an undescended testicle into the scrotum and permanently fix it there. Orchiopexy also describes the surgery used to resolve testicular torsion.

Herpes

Pain, itching, and small sores appear first. They form ulcers and scabs. After initial infection, genital herpes lies dormant in the body. Symptoms can recur for years.

A client has been diagnosed with a Bartholin gland cyst. The nurse expects the client may experience which symptoms if this becomes infected?

Pain, tenderness, and dyspareunia

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

A client is complaining to the health care provider about several vague signs/symptoms. Which of the following raises a "red flag" indicating the client may have developed endometrial cancer?

Painless abnormal bleeding

Squamous cell cancer of the penis is characterized by which clinical manifestation?

Painless lump on the inner surface of the prepuce

Priapism cont.

Pathophys: trigger> penile erection> tissue ischemia> necrosis. Urologic emergency because of tissue death that will lead to impotence. S/S: excruciating PAINFUL ERECTION lasting >6 hrs. Rx: iced enemas, spinal anesthesia, aspiration.

What pain theory proposes that pain receptors share pathways with other sensory modalities and that different activity patterns of the dame neurons can be used to signal painful or nonpainful stimuli?

Pattern

Endometriosis is characterized by painful hemorrhagic lesions in the pelvis and complications that include...

Pelvic adhesions

Endometriosis is characterized by painful hemorrhagic lesions in the pelvis, which may develop into which of the following potential complications?

Pelvic adhesions

Pelvic Inflammatory Disease (PID):

Pelvic inflammatory disease (PID) is an infection and inflammation of the uterus, ovaries, & other female reproductive organs which cause scarring in these organs. This can lead to infertility, ectopic pregnancy, pelvic pain, Gonorrhea and chlamydia, 2 STDs, are the most common cause of PID. Risk factors: sexually active & younger than 25, multiple partners, & douching. Pain in lower abdomen, fever, smelly vaginal discharge irregular bleeding, & pain during intercourse or urination.

Opioid receptors are highly concentrated in which region of the CNS and produce pain relief through the release of endogenous opioids?

Periaqueductal gray (PAG) region

The nurse is teaching clients with diabetes about the increased risk for erectile dysfunction (ED). What factors related to diabetes does the nurse link to increased risk for ED? Select all that apply.

Peripheral artery disease and Peripheral neuropathy

The role Kupffer cells play in removing harmful substances or cells from the portal blood as it moves through the venous sinusoids is known as:

Phagocytes

A 12-year-old boy with pain in the tip of his penis and a red, swollen, tender foreskin is uncircumcised because of religious reasons. Which medical diagnosis is likely responsible for this child's manifestations?

Phimosis

Which disorder of the female genitourinary system is most likely to result from a disruption in normal endocrine function?

Polycystic ovary syndrome (PCOS)

The provider 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, which information should the provider solicit from the client?

Presence of arterial occlusive disease

Which physiologic processes is a direct effect of the release of growth hormone by the anterior pituitary?

Production of insulin-like growth factors (IGFs) by the liver

One of the first signs that indicates an infant may have congenital hypothyroidism is:

Prolonged periods of physiologic jaundice

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

Which of the following physiologic processes is caused by estrogens?

Promotion of ovarian follicle growth

The nurse is teaching a high school student about male sexual function. Which organ contains the muscle that promotes semen expulsion during ejaculation?

Prostate Gland

A nurse who works on a urology-gynecology ward of a hospital is coming on shift and will be caring for a 34-year-old woman who has been admitted overnight for the treatment of endometriosis. Which interventions should the nurse most realistically anticipate providing over the course of the shift and the next several days?

Providing pain control; preparing the client for a laparoscopic procedure or hysterectomy

Which of the following actions involves the greatest risk of skin shearing?

Pulling the client up in bed

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

Candidiasis Yeast Infection: Continued (S/S & Rx)

S/S: Thick white (creamy) or "clumpy" or "cottage-cheese looking" vaginal discharge, itching, redness, burning pain with urination, dyspareunia. Rx: anti-fungal medications and prevention.

Menopause:

S/S: dyspareunia, vaginal atrophy/dryness, vasomotor instability (HOT FLASHES), osteoporosis, depression/mood swings.

Pelvic inflammatory disease, an inflammation of the female upper reproductive tract, is caused by...

STD polymicrobial infection

Sexually Transmitted Diseases: STD's can be caused by: viruses, bacteria, and parasites (protozoa, scabies, lice, and other critters). ALL STD's can lead to INFERTILITY. Most can be transferred to a fetus prior or during birth.

STD's are on the rise because of multiple sex partners during a life time and early age when beginning sexual activity. Serious *REPRODUCTIVE ORGAN SCARRING and INFERTILITY* can result from STD's if left untreated. It is not uncommon for a person to be infected with more than one STD at a time, so when S/S of one is present they will tested for other types as well.

A client visits the OB/GYM clinic complaining of low abdominal pain, purulent cervical discharge, and painful intercourse. the health care worker diagnoses pelvic inflammatory disease. The HCW educates the client about the fact that his disease may be associated with:

STI polymicrobial infection

A client visits the OB/GYN clinic complaining of low abdominal pain, purulent cervical discharge, and painful intercourse. The health care worker (HCW) diagnoses pelvic inflammatory disease. The HCW educates the client about that fact that this disease may be associated with:

STI polymicrobial infection

Spermatogenesis, or generation of spermatozoa or sperm, begins at approximately 13 years of age and continues as long as a man remains fertile. It is in the seminiferous tubules that spermatogenesis takes place. Of what is the inner lining of the seminiferous tubules composed? a) Cowper cells b) Leydig cells c) Sertoli cells d) Epididymal cells

Sertoli cells The outer layer of the seminiferous tubules is made up of connective tissue and smooth muscle; the inner lining is composed of Sertoli cells, which are embedded with sperm in various stages of development. The other answers are incorrect.

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 Priapism can occur at any age, in the newborn as well as other age groups. Sickle cell disease or neoplasms are the most common cause in boys between 5 and 10 years of age. Hemophilia and hypospadias are not linked to priapism in any age group.

When a person is stung on the index finger by a bee, the thalamus interprets the pain as:

Somewhere on the hand

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. Spermatogenesis typically begins around 13 years of age and continues throughout the reproductive years of a man's life. Spermatogenesis occurs in the seminiferous tubules of the testes. Sperm in various stages of development are embedded in the sertoli cells.

Which factor places a male client at risk for balanitis?

Uncircumcised penis

An elderly male client has been diagnosed with prostate cancer. However, because he has history of heart failure with an ejection fraction of 20% and chronic obstructive pulmonary disease due to many years of smoking, the client is not a candidate for major surgery. Which of the following treatments should the nurse anticipate being utilized for this client?

Stent placed to widen and maintain the patency of the urethra

A 30-year-old man has been diagnosed with mumps orchitis, a disease that has the potential to result in...

Sterility

Testicular torsion

Sudden, severe pain and swelling in the testicle are symptoms. A testicle rotates, twisting the spermatic cord that brings blood to the scrotum

Following the analysis of a recent barium enema and colonoscopy with biopsy, a client has been diagnosed with colorectal cancer. Which treatment modalities will be the mainstay of this client's treatment?

Surgery

Which treatment intervention is recommended for infants who have a severe case of hypospadias?

Surgical repair

Gonorrhea

Symptoms include painful urination and abnormal discharge from the penis or vagina. Men may experience testicular pain and women may experience pain in the lower belly. In some cases, gonorrhea has no symptoms. Gonorrhea can be treated with antibiotics such as ceftriaxone, azithromycin, and doxycycline.

What is the most important discharge instruction for a female client with pelvic inflammatory disease (PID)?

Take all of the antibiotic

A client arrives in the emergency department complaining of severe testicular pain associated with nausea and vomiting. Their pulse rate is 120 beats/minute. Physical exam reveals an enlarged testis that is painful to palpation. The nurse suspects:

Testicular Torsion

A diagnostic test is to elevate the scrotum- If it causes MORE pain it is ______ if it RELIEVES pain it is _______

Testicular Torsion Epididymitis

Leiomyomas are smooth muscle fibroid tumors that usually develop in...

The corpus of the uterus

The nurse is caring for a client with significant benign prostatic hyperplasia (BPH) and hydronephrosis who is fearful of having corrective surgery. Which information 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? a) The opening of the urethra is found on the underside of the penis. b) The foreskin of the penis is unable to be fully retracted. c) Medication will be given to correct this problem. d) Undescended testes are frequently associated with hypospadias.

The opening of the urethra is found on the underside of the penis. In hypospadias, which affects approximately 1 in 350 male infants, the termination of the urethra is on the ventral or underside surface of the penis.

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. The prostate is a fibromuscular and glandular organ lying just inferior to the bladder.

A malignant lesion extending into the endocervical canal was found on the yearly gynecological exam of a 20-year-old woman. Which treatment option would be most appropriate for this client?

Therapeutic conization

The nurse is teaching the client about pharmacologic treatment for benign prostatic hyperplasia (BPH). Which explanation of the action of these alpha-adrenergic blocking medications is best?

They relax the smooth muscle to relieve prostatic obstruction

The nurse working on an inpatient adolescent pediatric unit must prioritize which parents to teach first. Which diagnosis directs the nurse to provide teaching for the parents first due to the need for prompt treatment to prevent long-term complications?

Undescended testis

Fun fact:

Up to 75% of abdominal hernias are inguinal hernias> simple same day surgery to close the opening in the abdominal wall.

A client asks the health care provider to, "Explain this brachytherapy they want to do for my cervical cancer again." The response should include which of the following statements?

They will insert a radioactive device in your vagina, position it next to the cervix, so that curative levels of radiation are directly on the cancer site

Lymphogranuloma venereum

This condition is characterized by self-limited genital papules or ulcers followed by painful inguinal and/or femoral lymphadenopathy, which may be the only clinical manifestation at presentation. Caused by chlamydia and common in Africa.

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 TURP is the most commonly used treatment for BPH. Late complications of a TURP include erectile dysfunction, incontinence, and bladder neck contractures. Immediate complications of TURP include the inability to urinate, postoperative hemorrhage or clot retention, and urinary tract infection. A catheter would provide only short-term relief and predispose the client to infection. Radiation would be a palliative measure. The condition is not malignant and does not require chemotherapy

A weak urinary stream, postvoid dribbling, frequency of urination, and nocturia are classic symptoms of an enlarged prostate.

True

Cancer of the breast is the most common cancer in females.

True

The condition of having undescended testes is also known as cryptorchidism.

True

The pattern of menstrual bleeding tends to be fairly consistent in most healthy women with regard to frequency, duration, and amount of flow.

True

Fibrocystic changes in the breast are not uncommon. How is the diagnosis of fibrocystic changes made?

Ultrasonography and mammography

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

Men older than age 50 are at high risk for prostatic hypertrophy with complications that include...

Urine retention

A college student does to the campus health office complaining of diarrhea, lower right abdominal pain, and weight loss. Suspecting Crohn disease, the nurse will asses for which complication associated with this diagnosis?

Urine that has the look and smell of feces

In addition to mucous, the intestinal mucosa produces two other types of secretions. Copious amounts of the serous-type fluid are secretes to act as a:

Vehicle for absorption

Which characteristics differentiates a migraine with aura from a migraine without aura?

Visual symptoms that precede the headache

Biopsy result reveal that a client has a deficit amount of parietal (oxyntic) cells in their stomach. The client asks the nurse to explain what this means. The nurse explains the parietal cells secrete HCl and intrinsic factor, which is needed for absorption of:

Vitamin B12

Which clinical manifestation is most likely to accompany a diagnosis of vulvodynia?

Vulvar pain

QUIZ: 1. Bleeding occurring irregularly 2. Abnormally heavy bleeding at irregular intervals 3. Absence os menses 4. Cessation of menses

WORD BANK: A. Metrorrhagia B. Menopause C. Amenorrhea D. Oligomenorrhea E. Menonetrorrhagia F. Dysmenorrhea G. Polymenorrhea H. Menorrhagia Answers: 1. A 2. E 3. C 4. B

Renal dysplasia

abnormal kidney structure

Renal Agenesis

absence of one or both kidneys

Anuria

absence of urine

A 29-year-old client had a Papanicolaou smear performed during her most recent visit to her primary care provider. This diagnostic procedure aims to identify:

atypical cervical cellular changes

Hematuria

blood in the urine

Oliguria

decreased urine output

When explaining polycystic ovary syndrome (PCOS) to a newly diagnosed client, the health care worker states, "This ovarian dysfunction is caused by:

elevated LH.

A client comes to the college campus nurse complaining of unilateral pain, swelling, and redness on his scrotal area. The nurse knows these clinical manifestations are likely caused by:

epididymus

Which of the following processes is a component of the pathogenesis of proliferative breast lesions without atypia?

growth of ductile or lobular epithelial cells

Incontinence

inability to control bladder and/or bowels

glomerulonephritis

inflammation of the glomeruli of the kidney

pyelonephritis

inflammation of the renal pelvis and the kidney

A client is experiencing oligomenorrhea. The nurse interprets this as:

infrequent menstruation with periods more than 35 days apart.

Which of the following disorders of the male genitourinary system creates the most urgent need for prompt and aggressive surgical treatment?

intravaginal testicular torsion

never had any children

A client is complaining to the health care provider about several vague signs/symptoms. Which of the following raises a "red flag" indicating the client may have developed endometrial cancer?

painless abnormaal bleeding

Squamous cell cancer of the penis is characterized by which of the following clinical manifestations?

painless lump on the inner surface of the prepuce

Endometriosis is characterized by painful hemorrhagic lesions in the pelvis, which may develop into which of the following potential complications?

pelvic adhesions

Which of the following physiologic processes is caused by estrogens?

promotion of ovarian follicle growth

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 Emission and ejaculation, which constitute the culmination of the male sexual act, are a function of the sympathetic nervous system. Genital stimulation can produce erection. In the flaccid or detumescent state, sympathetic discharge through ?-adrenergic receptors maintains contraction of the arteries that supply the penis and vascular sinuses of the corpora cavernosa and corpus spongiosum. Parasympathetic stimulation produces erection by inhibiting sympathetic neurons that cause detumescence and by stimulating the release of nitric oxide to effect a rapid relaxation of the smooth muscle in the sinusoidal spaces of the corpus cavernosum.

stent placed to widen and maintain the patency of the urethra

Calculi

stones in urine (calcified)

Renal hypoplasia

underdeveloped kidney

A 40 year-old male client with multiple health problems has been diagnosed with a testosterone deficiency. The nurse knows that which of the following 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. Vulnerability to infection and hip dysplasia would likely not be a manifestation of low testosterone. Low muscle mass, hot flashes and diaphoresis, and a lack of male voice characteristics could develop secondary to testosterone deficiency.

The vaginal discharge characteristic of trichomoniasis is described as...

Frothy green

A client on the urology floor who has BPH asks the nurse how the pharmacologic agent finasteride will help decrease the size of his prostate. Which principle explains the mechanism of action?

Blocking effects of androgens on the prostate

A client comes to the college campus nurse complaining of unilateral pain, swelling, and redness on his scrotal area. The nurse knows these clinical manifestations are likely caused by: A. Syphilis B. Testicular torsion C. Epididymitis D. Ticks bites

C Epididymitis is characterized by unilateral pain and swelling, accompanied by erythema and edema of the overlying scrotal skin that develops over a period of 24 to 48 hours. Initially, the swelling and induration are limited to the epididymis. Syphilis is a sexually transmitted disease that is contagious and caused by a spirochete (Treponema pallidum). If left untreated it can produce chancres, rashes, and systemic lesions in a clinical course with three stages continued over many years. Twisting of the spermatic cord (which is very painful) with a resulting compromise of the blood supply to the testis is known as testicular torsion. There is no indication that the client has experienced a tick bite.

During a visit to the health care provider, a client complains of swelling in the scrotum. The health care worker suspects a hydrocele and performs an exam by shining a light through the scrotum. If the hydrocele is dense, the health care worker should: A. Continue to monitor the client every 6 months to see if there is a change in size. B. Prescribe diuretics like Lasix to help remove excess fluid. C. Order an ultrasound or biopsy to rule out testicular cancer. D. Gently try to express the fluid out of the scrotal sac.

C Hydroceles are palpated as cystic masses that may attain massive proportions. If there is enough fluid, the mass may be mistaken for a solid tumor. Transillumination of the scrotum (i.e., shining a light through the scrotum to visualize its internal structures) or ultrasonography can help to determine whether the mass is solid or cystic and whether the testicle is normal. A dense hydrocele that does not illuminate should be differentiated from a testicular tumor. The fluid cannot be removed by diuretics or by trying to express the fluid out of the scrotum.

A client's primary care provider has ordered an oral glucose tolerance test (OGTT) as a screening measure for diabetes. Which of the instructions should the client be given?

"The lab tech will give you a sugar solution then measure your blood sugar levels at specified intervals."

Azotemia

Waste products in the urine

After an office visit with her primary health provider, a female client with an elevated CA-125 test result asks the nurse if that means she has ovarian cancer. What is the nurse's best response?

"The test is not specific for ovarian cancer but suggests further evaluation to find the cause of the elevation."

"There is a chance that these will clear up on their own without any treatment."

A hospital client has been reluctant to accept morphine sulfate despite visible signs of pain. Upon questioning, the client reveals that he is afraid if becoming addicted to the drug. How can a member of the care team best respond to the client's concern?

"Theres only a minute chance you will become addicted to these painkillers."

A client asks the health care provider to, "Explain brachytherapy, which is recommended for my cervical cancer." Which response by the nurse is most accurate?

"They will insert a radioactive device into your vagina and position it next to the cervix, so that curative levels of radiation are directly on the cancer site."

A client asks the health care provider to, "Explain this brachytherapy they want to do for my cervical cancer again." The response should include which of the following statements?

"They will insert a radioactive device into your vagina, position it next to the cervix, so that curative levels of radiation are directly on the cancer site."

A client with vulvodynia tells the nurse, "This is not getting better. I just can't live like this." What is the best response by the nurse?

"What bothers you the most about your condition?"

A female college student is distressed at the recent appearance of genital warts, an assessment finding that her care provider has confirmed as attributable to human papillomavirus (HPV) infection. Which of the following information should the care provider give the client? A. "There is a chance that these will clear up on their own without any treatment." B. "It's important to start treatment soon, so I will prescribe you pills today." C. "Unfortunately, this is going to greatly increase your chance of developing pelvic inflammatory disease." D. "I'd like to give you an HPV vaccination if that's okay with you."

A Genital warts may resolve spontaneously, although this does not preclude recurrence. Many individuals will clear the virus and become negative within 1 to 2 years; it is unclear if development of an effective immune response completely clears the infection. Pharmacologic treatments are topical, and vaccination is ineffective after infection has occurred. HPV infection is not correlated with pelvic inflammatory disease (PID).

Which of the following diagnoses is most likely to require surgical correction? A. Hypospadias B. Orchitis C. Erectile dysfunction D. Spermatocele

A Hypospadias is a congenital disorder of the penis resulting from embryologic defects in the development of the urethral groove and penile urethra; surgery is the treatment of choice for hypospadias. Orchitis, erectile dysfunction (ED), and spermatocele rarely require surgical intervention.

Men whose sexual partners have been diagnosed with Trichomonas vaginalis will likely exhibit: A. No symptoms of infection B. Copious amounts of frothy discharge from the penis C. Numerous pustules on the penal shaft D. Redness and pain at the urethral meatus

A Men harbor the Trichomonas vaginalis in the urethra and prostate and are largely asymptomatic. Chlamydia, gonorrhea, and syphilis cause active infection and symptoms in both men and women.

During physical exam of a newborn, the nurse palpates the scrotal sac and only locates one testicle. Which statement about undescended testicles is most accurate? A. "The child can become infertile later in life as a result of decreased sperm count." B. "This is more common in full-term infants when compared to premature births." C. "This may be a precursor to the development of prostate cancer later in life." D. "The child will need surgery to move the testes back into the scrotal sac since they rarely descend spontaneously."

A The consequences of cryptorchidism include infertility, testicular torsion, testicular (rather than prostate) malignancy, and the possible psychological effects of an empty scrotum. Males with cryptorchidism usually have decreased sperm counts, poorer-quality sperm, and lower fertility rates than do men whose testicles descend normally. Spontaneous descent often occurs during the first 3 months of life, and by 6 months of age, the incidence decreases to 0.8%. Spontaneous descent rarely occurs after 4 months of age.

A client has been diagnosed with an anterior pituitary tumor, and synthesis and release of follicle-stimulating hormone has become deranged. What are the potential consequences of this alteration in endocrine function? A. Dysfunction of spermatogenesis B. Overproduction of luteinizing hormone C. Inhibition of testosterone synthesis D. Impaired detumescence

A Two gonadotropic hormones are secreted by the pituitary gland: FSH and 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, and impaired detumescence is unlikely to be a direct consequence of changes in FSH synthesis and release.

A couple presents to an infertility clinic. The health care provider will focus testing on which of the following sexually transmitted infections (STIs) that is very damaging to the reproductive system but rarely exhibits symptoms of infection? A. Chlamydial infection B. Herpes simplex virus infection C. Gonorrhea D. Syphilis

A Women with chlamydial infection may be asymptomatic and may unknowingly experience damage to the reproductive system. A large number of cases go unreported because most people with chlamydial infection are asymptomatic and do not seek testing. Herpes simplex virus (HSV), syphilis, and gonorrhea consistently produce symptoms in infected women.

A nurse who works in a fertility clinic is conducting a program on options for various fertility issues. The nurse judges that the participants understand the education when they identify that donor eggs are the best option for which woman?

A 42-year-old

Trichomoniasis

A sexually transmitted infection caused by a parasite. Risk factors include multiple sexual partners and not using condoms during sex. Trichomoniasis causes a foul-smelling vaginal discharge, genital itching, and painful urination in women. Men typically have no symptoms. Given an antibiotic.

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 of the client's following statements indicates the need for further teaching? A) "I can't shake this feeling like I've received a death sentence." B) "I have to admit that the prospect of losing a testicle is a bit overwhelming." C) "I really hope the cancer hasn't spread anywhere, because I've read that it's a possibility." D) "I guess there's some solace in the fact that this cancer wasn't a result of an unhealthy lifestyle."

A) "I can't shake this feeling like I've received a death sentence."

Men older than age 50 are at high risk for prostate hypertrophy with complications that include: A. Urine retention B. Scrotal edema C. Hypospadias D. Testicular cancer

A. Urine retention

A 29-year-old client had a Papanicolaou smear performed during her most recent visit to her primary care provider. This diagnostic procedure aims to identify: A) Atypical cervix cellular changes B) Human papillomavirus (HPV) antibodies C) Cervical polyps D) Lesions at the transformation zone

A) Atypical cervix cellular changes

A couple presents to an infertility clinic. The health care provider will focus testing on which of the following sexually transmitted infections (STIs) that is very damaging to the reproductive system but rarely exhibits symptoms of infection? A) Chlamydial infection B) Herpes simplex virus infection C) Gonorrhea D) Syphilis

A) Chlamydial infection

While undergoing annual breast exam assessing for any manifestations of breast cancer, the nurse will discuss which of the following factors that place the client at high risk for cancer? Select all that apply. A) Late menopause B) First child born when she was 40 years old C) History of STIs and frequent vaginitis D) Multiple pregnancies E) Currently smokes approximately 2 packs/day of cigarettes

A) Late menopause B) First child born when she was 40 years old E) Currently smokes approximately 2 packs/day of cigarettes

While taking the history of a female client complaining of irregular, very painful bleeding occurring after menopause, the health care provider is alert to which of the following high-risk indicators of ovarian cancer? A) Never had any children B) Lactation history C) Mammary duct ectasia D) Oral contraceptive use for many years

A) Never had any children

Which of the following clinical manifestations are characteristic for clients with Peyronie disease? Select all that apply. A) Painful erection B) Thick, yellow discharge from the penis C) Presence of a hard mass on the tunica albuginea of the penis D) Papillary lesions on penis filled with serous-colored fluid E) Thick, nonretractable foreskin of uncircumcised male

A) Painful erection C) Presence of a hard mass on the tunica albuginea of the penis

A college student presents to the nurse's office complaining of premenstrual syndrome. Which of the following clinical manifestations would confirm this diagnosis? Select all that apply. A) Painful, edematous breasts B) Burning during urination C) Abdominal bloating D) Thick, cheesy vaginal secretions E) Painful intercourse

A) Painful, edematous breasts C) Abdominal bloating

Endometriosis is characterized by painful hemorrhagic lesions in the pelvis, which may develop into which of the following potential complications? A) Pelvic adhesions B) Endometrial cancer C) Candidiasis vaginitis D) Bladder herniation

A) Pelvic adhesions

A woman who has developed vulvovaginal candidiasis will likely go to her health care provider complaining of: Select all that apply. A) Redness B) Edema C) Frothy, foul-smelling discharge D) Painful urination E) Pustules on labia

A) Redness B) Edema D) Painful urination

An elderly female has slowly developed dementia and loss of vision. She is being evaluated for nursing home placement. Routine admission blood work reveals that the client tested positive for which STI associated with her current symptoms? A) Tertiary syphilis B) Chlamydial C) Gonorrhea D) Human papillomavirus infection

A) Tertiary syphilis

Which of the following clinical manifestations is most likely to accompany a diagnosis of vulvodynia? A) Vulvar pain B) Purulent discharge C) Urinary incontinence D) Open lesions on the surface of the vulva

A) Vulvar pain

A woman who has developed vulvovaginal candidiasis will likely go to her health care provider complaining of: Select all that apply. A. Redness B. Edema C. Frothy, foul-smelling discharge D. Painful urination E. Pustules on labia

A, B, D Women with vulvovaginal candidiasis commonly complain of vulvovaginal pruritus accompanied by irritation, erythema, swelling, dysuria, and dyspareunia. The characteristic discharge, when present, is usually thick, white, and odorless. Trichomoniasis manifestations include presentation with copious, frothy, malodorous green or yellow discharge.

A 22-year-old client has presented to her primary care provider for her scheduled Pap smear. Abnormal results of this diagnostic test may imply infection with: A- Human papillomavirus B- Chlamydial trachomatis C- Candida albicans D- Trichomonas vaginalis

A- Human Papillomavirus

When comparing the differnces between Peyronie's Disease and Priapism, which of the following are characteristics for clients with Priapism? (select all that apply) A- Prolonged painful involuntary erection lasting longer than 6 hours. B- Thick, yellow discharge from the penis C- Most common in sickle cell disease D- Presence of a hard mass on the tunica albuginea of the penis E- Can be caused by spinal cord injury

A- Prolonged painful involuntary erection lasting longer than 6 hours. C- Most common in sickle cell disease E- Can be caused by spinal cord injury (B- STD and D- Peyronies disease)

A woman who has developed vulvovaginal candidiasis will likely go to her health care provider complaining of: (select all that apply) A- Pruritis (itching) B- Dyspareunia (pain during sexual intercourse) C- Frothy, foul smelling discharge D- Painful urination E- Pustules on labia

A- Pruritis (itching) B- Dyspareunia (pain during sexual intercourse) D- Painful urination (C- is with Trichomoniasis)

Which of the following disorders of the male genitourinary system creates the most urgent need for a prompt and aggressive surgical treatment? A- Testicular torsion B- Benign prostatic hyperplasia C- Spermatocele D- Erectile dysfunction

A- Testicular torsion

During physical exam of the newborn, the nurse palpates the scrotal sac and only locates one testicle. Which statement about undescended testicles is most accurate? A. "The child can become infertile later in life as a result of decreased sperm count" B. "The child will need surgery to move the testes back into the scrotal sac since they rarely descent spontaneously" C. "This is more common in full-term infants when compared to premature births D. "This may be a precursor to the development of prostate cancer later in life"

A. "The child can become infertile later in life as a result of decreased sperm count"

The primary reason genital herpes has reached epidemic proportions throughout the world relates to the fact that: A. A large percentage (70%) of those infected experience no symptoms of the disease B. Lesions take a long time to incubate and the small papules are usually located inside the vagina C. The organism spreads upward to the prostate gland in males and fallopian tubes in females D. The lesions (LSILs) occur on the cervix and can be detected by a Pap test.

A. A large percentage (70%) of those infected experience no symptoms of the disease

Which of the following clients is at high risk for developing acute bacterial prostatitis? A. An elderly man diagnosed with frequent UTIs testing positive for gram negative rods B. A middle aged male with prostate hyperplasia C. A sickle-cell anemia client complaining of prolonged erection lasting less than four hours D. A fifth grade male diagnosed with acute pyelonephritis

A. An elderly man diagnosed with frequent UTIs testing positive for gram negative rods

Which of the following would be considered a structural abnormality or disease process that could cause menstrual pain known as secondary dysmenorrhea? Select all that apply. A. Endometriosis B. Rectocele C. Uterine fibroids D. Cystocele

A. Endometriosis, C. Uterine fibroids

During infertility work up, the client is diagnosed with chlamydial infection. The health care provider will especially be looking for which complication of chlamydial infections that can interfere with egg transportation? A. Fallopian tube damage B. Vaginal adhesions C. Uterine cancer D. Amenorrhea

A. Fallopian tube damage

Endometriosis is characterized by painful hemorrhage lesions in the pelvis, which may develop into which of the following potential complications? A. Pelvic adhesions B. Candidiasis vaginitis C. Bladder herniation D. Endometrial cancer

A. Pelvic adhesions

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

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 The incidence of BPH increases with advanced age and is highest in African Americans and lowest in native Japanese. The other answers are incorrect.

Prostatic hypertrophy

Age-associated prostate gland enlargement that can cause urination difficulty. The urinary stream may be weak, or stop and start. In some cases, it can lead to infection, bladder stones, and reduced kidney function.

A decrease in serum level of which of the following substances is suggestive of liver injury?

Albumin

An otherwise healthy client has been referred to a pain clinic because she claims to experience exquisite pain from the friction of her clothes on her torso. The client is likely to be diagnosed with chick health problem?

Allodynia

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 positive PSA test indicates only the possible presence of prostate cancer. It can also be positive in cases of BPH and prostatitis. In fact, every man who has an elevated PSA will not necessarily have prostate cancer. PSA levels normally increase with age.

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: a) An enlarged prostate gland. b) Blood clots clogging the urethra. c) Calcium sediment in the bladder. d) Kidney stones.

An enlarged prostate gland. Symptoms of obstruction, including dribbling after urinating and the continuous sensation of having to urinate are most likely due to enlargement of a prostate gland. Kidney stones cause intense flank pain; blood clots are usually associated with trauma or surgery; calcium sediment could imply a kidney stone or be a result of a procedure to break up kidney stones into smaller segments.

One of the best products for extremely dry skin on the elbows would be to apply which type of dressing?

An occlusive with petroleum material mixed in the cream

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

A client is admitted into the emergency department with a sustained erection lasting 4 hours. Which initial treatments does the nurse anticipate administering? Select all that apply.

Analgesics, Sedation, Hydrating Measures

A woman comes to the clinic with complains of vague, lower abdominal symptoms. Upon physical exam, the healthcare provider recognizes the woman has symptoms of leiomyomas based on which assessment findings? Select all that apply.

Anemia Urinary frequency Rectal pressure Menorrhagia Abdominal distention

A female receives a PAP smear result indicating she has human papillomavirus (HPV) infection. As part of her education, the nurse will emphasize the need for continued follow-up since HPV is directly associated with: A. Uterine cancer B. Cervical dysplasia C. Genital herpes lesions D. Urinary tract infections

B A relation between HPV and genital neoplasms has become increasingly apparent since the mid-1970s. HPV infection can be detected in cervical Papanicolaou (Pap) smears, with the first neoplastic changes noted on the Pap smear termed dysplasia. Testicular cancer is not associated with HPV. Although genital herpes (HSV) is also a sexually transmitted disease, it is a common cause of genital ulcers rather than cancer. Bacteria are the usual cause of urinary tract infections, rather than anogenital warts.

Which of the following physiologic processes results from the synthesis and release of testosterone? A. Protein catabolism B. Musculoskeletal growth C. Release of luteinizing hormone (LH) D. Prostatic hyperplasia

B Among the numerous effects of testosterone are the promotion of musculoskeletal growth in particular and protein anabolism in general. LH and FSH precede the synthesis and release of testosterone, whereas prostatic hyperplasia is not a normal effect of testosterone.

When educating a teenager diagnosed with genital herpes (herpes simplex virus type 2, HSV-2), the health care provider needs to inform her of the importance of careful follow-up since she may be at greater risk for future development of: A. Cervical cancer B. HIV transmission C. Localized necrosis D. Urinary tract infection

B As with other ulcerative STIs, genital herpes (HSV-2) increases the risk of HIV transmission and is believed to play an important role in the heterosexual spread of HIV. There is no known cure for genital herpes, and the methods of treatment are largely symptomatic. Human papillomavirus (HPV), rather than HSV, is considered a cause of cervical cancer. Although HSV can reoccur, the lesions resolve and heal completely without tissue necrosis or scarring. Urinary tract infections are associated with bacterial vaginosis/vaginitis STIs.

The most prevalent vaginal infection to be spread through sexual contact is: A. Candidiasis B. Trichomoniasis C. Vulvovaginitis D. Bacterial vaginosis

B Candidiasis is a yeast infection with a white cheesy discharge that causes vulvovaginitis. Bacterial vaginosis is a nonspecific type of infection that produces a characteristic fishy-smelling discharge, the result of an imbalance of the normal vaginal flora. These infections are not normally spread by sexual contact. Trichomoniasis is usually spread through sexual contact.

During infertility workup, the client is diagnosed with chlamydial infection. The health care provider will especially be looking for which complication of chlamydial infections that can interfere with egg transportation? A. Uterine cancer B. Fallopian tube damage C. Amenorrhea D. Vaginal adhesions

B Chlamydia causes a wide variety of genitourinary infections; Chlamydia trachomatis infection is the most common reportable sexually transmitted infection (STI) in the United States. In women, untreated infection can lead to severe reproductive complications, including infertility, pelvic inflammatory disease, ectopic pregnancy, and chronic pelvic pain, and in men, it can cause prostatitis and epididymitis with subsequent infertility. Chlamydial infections are not associated with any reproductive cancers or amenorrhea.

Common risk factors associated with erectile dysfunction due to generalized penile arterial insufficiency include: A. Cryptorchidism B. Cigarette smoking C. Testicular torsion D. Benign prostate hypertrophy

B Common risk factors for generalized penile arterial insufficiency include hypertension, hyperlipidemia, cigarette smoking, diabetes mellitus, and pelvic irradiation. Cigarette smoking induces vasoconstriction and penile venous leakage because of its effects on cavernous smooth muscle. Cryptorchidism is a major risk factor for testicular cancer. Benign prostate hypertrophy (BPH) is a risk factor for ejaculatory pathway obstruction rather than erectile difficulties. With testicular torsion, testicular arterial perfusion is impaired.

A 17-year-old male has developed phimosis to the point that he is having difficulty voiding. The nurse should prepare this teenager for: A. Radiation therapy to loosen the foreskin B. Circumcision C. Injection of lidocaine into the head of the penis D. Traumatic retraction of the foreskin

B Phimosis refers to a tightening of the prepuce or penile foreskin that prevents its retraction over the glans. If symptomatic phimosis occurs after childhood, it can cause difficulty with voiding or sexual activity. Circumcision is then the treatment of choice. Radiation therapy is utilized for cancer treatment. Lidocaine and forceful retraction of the foreskin is not a standard treatment for phimosis.

Which of the following assessment questions is most likely to address the causation of a woman's new case of candidiasis? A. "Have you recently begun a new sexual relationship?" B. "Have you been on antibiotics recently?" C. "Have you noticed any new growths on your vagina in recent months?" D. "Do you use condoms during sexual activity?"

B Recent antibiotic therapy frequently underlies causes of candidiasis. The disease is not normally transmitted by sexual contact, and tissue growth is not an associated sign.

A client with herpes simplex virus (HSV) presents to the clinic stating, "I can stop taking my drugs because I'm cured. My lesions are gone." The health care provider bases his or her response knowing the pathophysiology behind the disappearance of HSV symptoms infection relates to: A. Replication of the squamous epithelium B. Periods of latency in the nervous system C. Inhibition of cell-mediated immunity D. Production of exotoxins

B The clinical course of HSV infection is a product of the virus's ability to remain latent in the dorsal root ganglia for long periods. Latency refers to the ability to maintain disease potential in the absence of clinical signs and symptoms. When latent, the immune system is ineffective, but the virus does not actively inhibit the cell-mediated immune system. HSV does not produce exotoxins, and replication of squamous epithelium accounts for the warts caused by HSV.

An elderly male client has been diagnosed with prostate cancer. However, because he has a history of heart failure with an ejection fraction of 20% and chronic obstructive pulmonary disease due to many years of smoking, the client is not a candidate for major surgery. Which of the following treatments should the nurse anticipate being utilized for this client? A. Transurethral prostatectomy (TURP) that only utilizes epidural blocks and small amounts of Versed and Fentanyl B. Stent placed to widen and maintain the patency of the urethra C. Teaching the client how to perform a straight catheterization every time they feel the need to empty their bladder D. Brachytherapy inserted into the penis and instilled into the prostate tissue

B The surgical removal of an enlarged prostate can be accomplished by the transurethral, suprapubic, or perineal approach. Currently, transurethral prostatectomy (TURP) is the most commonly used technique. For men who have heart or lung disease or a condition that precludes major surgery, a stent may be used to widen and maintain the patency of the urethra. A stent is a device made of tubular mesh that is inserted under local or regional anesthesia. Within several months, the lining of the urethra grows to cover the inside of the stent. It would be highly unlikely for the client to be asked to straight cath for urination. Brachytherapy would not be a treatment of choice since it would block the passage of urine from the bladder.

The physiological reasoning behind giving acyclovir, an antiviral medication, to a client diagnosed with genital herpes would include the fact that these drugs: A. Attack the cell wall and totally destroy the virus, thus curing the client B. Interfere with viral DNA replication, which can decrease the frequency of recurrences C. Will prevent the organism from developing a resistance to the treatment protocols D. Can be obtained without a prescription and usually applied topically

B There is no known cure for genital herpes, and the methods of treatment are largely symptomatic. The oral antiviral drugs acyclovir, valacyclovir, and famciclovir have become the cornerstone for management of genital herpes. By interfering with viral DNA replication, these drugs decrease the frequency of recurrences, shorten the duration of active lesions, reduce the number of new lesions formed, and decrease viral shedding. There are no FDA-approved PCR tests for chancroids. The chancroid organism has shown resistance to treatment with sulfamethoxazole alone and to tetracycline. Uncomplicated cases of candidiasis (not herpes) are treated with antifungal medications (e.g., clotrimazole, miconazole) that are available as topical preparations (creams or suppositories) that can be obtained without a prescription.

A client presents to the GYN clinic complaining of large amounts of frothy yellow-green discharge that smells very foul. Immediately, the health care provider is thinking this client most likely has: A. Candidiasis B. Trichomoniasis C. Bacterial vaginosis D. Chlamydial infection

B Trichomoniasis causes a copious, frothy, malodorous, green or yellow discharge. The characteristic vaginal discharge of candidiasis, when present, is usually odorless, thick, and cheesy. The predominant symptom of bacterial vaginosis is a thin, grayish white discharge that has a foul, fishy odor. Chlamydial STD may be asymptomatic, but most women have mucopurulent drainage or hypertrophic cervical changes on examination.

Which of the following assessment questions is most likely to address the causation of a woman's new case of candidiasis? A) "Have you recently begun a new sexual relationship?" B) "Have you been on antibiotics recently?" C) "Have you noticed any new growths on your vagina in recent months?" D) "Do you use condoms during sexual activity?"

B) "Have you been on antibiotics recently?"

A 21-year-old college student has sought care because of the vaginal burning, itching, and redness that have become worse in recent weeks. Which of the clinician's assessment questions is most likely to apply to a diagnosis of vaginitis? A) "Have your periods been regular in the last few months?" B) "Have you ever had a sexually transmitted infection?" C) "Are you using oral contraceptives?" D) "Have you ever been pregnant?"

B) "Have you ever had a sexually transmitted infection?"

Common risk factors associated with erectile dysfunction due to generalized penile arterial insufficiency include: A) Cryptorchidism B) Cigarette smoking C) Testicular torsion D) Benign prostate hypertrophy

B) Cigarette smoking

A 17-year-old male has developed phimosis to the point that he is having difficulty voiding. The nurse should prepare this teenager for: A) Radiation therapy to loosen the foreskin B) Circumcision C) Injection of lidocaine into the head of the penis D) Traumatic retraction of the foreskin

B) Circumcision

During infertility workup, the client is diagnosed with chlamydial infection. The health care provider will especially be looking for which complication of chlamydial infections that can interfere with egg transportation? A) Uterine cancer B) Fallopian tube damage C) Amenorrhea D) Vaginal adhesions

B) Fallopian tube damage

When educating a teenager diagnosed with genital herpes (herpes simplex virus type 2, HSV-2), the health care provider needs to inform her of the importance of careful follow-up since she may be at greater risk for future development of: A) Cervical cancer B) HIV transmission C) Localized necrosis D) Urinary tract infection

B) HIV transmission

Progesterone maintains pregnancy but also has which of the following local effects on the body? Select all that apply. A) Decrease in absorption of sodium B) Increase in basal body temperature C) Increase in secretion of aldosterone by the adrenal cortex D) Relaxation of smooth muscle

B) Increase in basal body temperature C) Increase in secretion of aldosterone by the adrenal cortex D) Relaxation of smooth muscle

The physiological reasoning behind giving acyclovir, an antiviral medication, to a client diagnosed with genital herpes would include the fact that these drugs: A) Attack the cell wall and totally destroy the virus, thus curing the client B) Interfere with viral DNA replication, which can decrease the frequency of recurrences C) Will prevent the organism from developing a resistance to the treatment protocols D) Can be obtained without a prescription and usually applied topically

B) Interfere with viral DNA replication, which can decrease the frequency of recurrences

A client visited her health care provider and was diagnosed with acute cervicitis. A clinical manifestation that accompanies acute cervicitis may include: A) Abscess formation B) Mucopurulent drainage C) Thick gray-white plaques D) Persistent pruritic vulvitis

B) Mucopurulent drainage

Which of the following physiologic processes results from the synthesis and release of testosterone? A) Protein catabolism B) Musculoskeletal growth C) Release of luteinizing hormone (LH) D) Prostatic hyperplasia

B) Musculoskeletal growth

A client with herpes simplex virus (HSV) presents to the clinic stating, "I can stop taking my drugs because I'm cured. My lesions are gone." The health care provider bases his or her response knowing the pathophysiology behind the disappearance of HSV symptoms infection relates to: A) Replication of the squamous epithelium B) Periods of latency in the nervous system C) Inhibition of cell-mediated immunity D) Production of exotoxins

B) Periods of latency in the nervous system

Which of the following statements are accurate when it comes to changes in the male reproductive system as one ages? Select all that apply. A) Androgen hormone levels increase with age. B) Sexual energy levels decrease as one ages with decreasing testosterone levels. C) The testes become smaller and lose their firmness. D) The prostate gland enlarges with age. E) The force of ejaculation increases with age.

B) Sexual energy levels decrease as one ages with decreasing testosterone levels. C) The testes become smaller and lose their firmness. D) The prostate gland enlarges with age.

An elderly male client has been diagnosed with prostate cancer. However, because he has a history of heart failure with an ejection fraction of 20% and chronic obstructive pulmonary disease due to many years of smoking, the client is not a candidate for major surgery. Which of the following treatments should the nurse anticipate being utilized for this client? A) Transurethral prostatectomy (TURP) that only utilizes epidural blocks and small amounts of Versed and Fentanyl B) Stent placed to widen and maintain the patency of the urethra C) Teaching the client how to perform a straight catheterization every time they feel the need to empty their bladder D) Brachytherapy inserted into the penis and instilled into the prostate tissue

B) Stent placed to widen and maintain the patency of the urethra

A client presents to the GYN clinic complaining of large amounts of frothy yellow-green discharge that smells very foul. Immediately, the health care provider is thinking this client most likely has: A) Candidiasis B) Trichomoniasis C) Bacterial vaginosis D) Chlamydial infection

B) Trichomoniasis

Which of the following statements are accurate when it comes to changes in the male reproductive system as one ages? Select all that apply. A. Androgen hormone levels increase with age. B. Sexual energy levels decrease as one ages with decreasing testosterone levels. C. The testes become smaller and lose their firmness. D. The prostate gland enlarges with age. E. The force of ejaculation increases with age.

B, C, D Male sex hormone levels, particularly testosterone, decrease with age. The sex hormones play a part in the structure and function of the reproductive system and other body systems from conception to old age; they affect protein synthesis, salt and water balance, bone growth, and cardiovascular function. Decreasing levels of testosterone affect sexual energy, muscle strength, and the genital tissues. The testes become smaller and lose their firmness. The prostate gland enlarges, and its contractions become weaker. The force of ejaculation also decreases because of a reduction in the volume and viscosity of the seminal fluid.

During infertility workup, the client is diagnosed with chlamydial infection. The health care provider will especially be looking for which complication of chlamydial infections that can interfere with egg transportation? A- Uterine cancer B- Fallopian tube damage C- Amenorrhea D- Vaginal adhesions

B- Fallopian tube damage

When educating a teenager diagnosed with genital herpes (herpes simplex virus type 2, HSV-2), the health care provider needs to inform her of the importance of careful follow-up since she may be at greater risk for future development of: A- Cervical cancer B- HIV transmission C- Localized necrosis D- Urinary tract infection

B- HIV transmission (they are already immunocompromised due to herpes making you more at risk for HIV)

A client visited her health care provider and was diagnosed with acute cervicitis. A clinical manifestation that accompanies acute cervicitis may include: A- Abscess formation B- Muco-purulent discharge C- Thick gray-white plaques D- Persistent pruritic vulva

B- Muco-purulent discharge

Study Question- Which of the following statements are accurate when it comes to changes in the male reproductive system as one ages? (select all that apply): A- Androgen hormone levels increase with age. B- Sexual energy level decrease as one ages with decreasing testosterone levels. C- The testes become smaller and lose their firmness. D- The prostate gland enlarges with age. E- The force of ejaculation decreases with age.

B- Sexual energy level decrease as one ages with decreasing testosterone levels. C- The testes become smaller and lose their firmness. E- The force of ejaculation decreases with age.

Which of the following statements are accurate when it comes to changes in the male reproductive system as one ages? (Select all that apply) A- Androgen hormone levels ^ with age B- Sexual energy levels decrease as one ages with decreasing testosterone levels C- The testes become smaller and lose their firmness D- The prostate gland enlarges with age E- The force of ejaculation decreases with age

B- Sexual energy levels decrease as one ages with decreasing testosterone levels C- The testes become smaller and lose their firmness E- The force of ejaculation decreases with age

Which of the following phenomena is thought to underlie the decreased reported incidence of some sexually transmitted infections (STIs)? A. Decreased numbers of sexual partners among young adults B. Decreased reporting of cases of certain STIs C. Increased public funding for health promotion activites D. Increased knowledge of the correct use of condoms

B. Decreased reporting of cases of certain STIs

A client comes to the college campus nurse complaining of unilateral pain, swelling, and redness on his scrotal area. The nurse known these clinical manifestations are likely caused by: A. Tick bites B. Epididymis C. Syphilis D. Testicular torsion

B. Epididymis

Of the following STIs, for which STI should the nurse anticipate a prescription for antibiotics such as tetracycline or doxycycline since this infection will respond to antibiotic treatment? A. Human papillomavirus infection (HPV) B. Lymphgranuloma venereum (LGV) C. Herpes simplex virus type 2 infection (HSV-2) D. Candidiasis

B. Lymphgranuloma venereum (LGV)

Which of the following physiologic process results from the synthesis and release of testosterone? A. Protein catabolism B. Musculoskeletal growth C. Prostatic hyperplasia D. Release of luteinizing horomone

B. Musculoskeletal growth

Which of the following statements about screening for prostate cancer is most accurate? A. Digital rectal examination detects the majority of new cases of prostate cancer. B. A positive prostate-specific antigen (PSA) test is definitive for prostate cancer. C. BPH and prostatitis can confound prostate screening results. D. Digital rectal examination and PSA testing have been proven ineffective.

C PSA is a glycoprotein secreted into the cytoplasm of benign and malignant prostatic cells that is not found in other normal tissues or tumors. However, a positive PSA test indicates only the possible presence of prostate cancer. It also can be positive in cases of BPH and prostatitis. Detection using digital rectal examination varies from 1.5% to 7%. Screening remains somewhat controversial, but it has not been proven wholly ineffective.

While discussing the physiological process behind penile erection, the anatomy and physiology instructor mentions that what substance is released to facilitate smooth muscle relaxation and shunting of blood into the sinusoids? A. Norepinephrine B. Nitroglycerine C. Nitric oxide D. Nicotinic acid

C Parasympathetic innervation must be intact and nitric oxide synthesis must be active for erection to occur. Parasympathetic stimulation results in release of nitric oxide, a nonadrenergic-noncholinergic neurotransmitter, which causes relaxation of the trabecular smooth muscle of the corpora cavernosa. This relaxation permits inflow of blood into the sinuses of the cavernosa at pressures approaching those of the arterial system. The nicotinic acid in cigarette smoke can induce vasoconstriction and penile venous leakage because of its effects on cavernous smooth muscle. Nitroglycerine is a vasodilator that has no effect on trabecular smooth muscle. A norepinephrine action is vasoconstriction, rather than relaxation, as part of sympathetic nervous system response.

Which of the following phenomena is thought to underlie the decreased reported incidence of some sexually transmitted infections (STIs)? A. Increased knowledge of the correct use of condoms B. Increased public funding for health promotion activities C. Decreased reporting of cases of certain STIs D. Decreased numbers of sexual partners among young adults

C The actual incidence and prevalence of some STIs are thought to exceed reported rates. Consequently, apparent decreases are not thought to reflect reality. This trend in reported incidence is not attributed to changes in condom use, health promotion, or decreased numbers of sexual partners.

Which of the following signs and symptoms is most clearly suggestive of primary genital herpes in a male client? A. Presence of purulent, whitish discharge from the penis B. Emergence of hard, painless nodules on the shaft of the penis C. Itching, pain, and the emergence of pustules on the penis D. Production of cloudy, foul-smelling urine

C The initial symptoms of primary genital herpes infection include tingling, itching, and pain in the genital area, followed by eruption of small pustules and vesicles. In men, the infection can cause urethritis and lesions of the penis and scrotum. Rectal and perianal infections are possible with anal contact. Firm, subcutaneous nodules are not associated with herpes simplex virus (HSV), and the production of penile discharge and cloudy urine is not suggestive of the disease.

Squamous cell cancer of the penis is characterized by which of the following clinical manifestations? A. Erectile dysfunction with prolonged erection B. Herpes ulcerations on the penile shaft C. Painless lump on the inner surface of the prepuce D. Smegma accumulation in uncircumcised male requiring regular reminders about hygiene

C The cause of penile cancer is unknown. Invasive squamous cell carcinoma of the penis usually begins as a small lump or ulcer on the glans or inner surface of the prepuce. Several risk factors have been suggested, including poor hygiene, human papillomavirus infections (rather than herpes simplex virus infections), ultraviolet radiation exposure, and immunodeficiency states. There is an association between penile cancer and poor genital hygiene and phimosis. Circumcision confers protection, and hence cancer of the penis is extremely rare in men circumcised at birth. It is thought that circumcision is associated with better genital hygiene, which, in turn, reduces exposure to carcinogens that may accumulate in smegma and decreases the likelihood of potentially oncogenic strains of HPV. Erectile dysfunction can be the result of depression, androgen level imbalance, systemic medications, or arterial insufficiency that are unrelated to squamous cell tissue changes.

Which of the following assessments is most likely to reveal a potential exacerbation in a 70-year-old client's diagnosis of benign prostatic hyperplasia (BPH)? A. Urine testing for microalbuminuria B. Blood test for white blood cells and differential C. Digital rectal examination D. Sperm morphology testing

C The diagnosis of BPH is based on history, physical examination, digital rectal examination, urinalysis, blood tests for serum creatinine and prostate-specific antigen (PSA), and urine flow rate. The digital rectal examination is used to examine the external surface and size of the prostate. An enlarged prostate found during a digital rectal examination does not always correlate with the degree of urinary obstruction. Some men can have greatly enlarged prostate glands with no urinary obstruction, but others may have severe symptoms without a palpable enlargement of the prostate. Proteinuria, increased WBCs, and changes in sperm morphology are not associated with BPH.

A client presents to the out-client clinic complaining of gray discharge that has a fishy odor. The health care provider sees "clue cells" on wet-mount microscopic exam. This would most likely lead to the diagnosis of: A. Trichomonas vaginalis B. Chlamydial C. Bacterial vaginosis D. Syphilis

C The diagnosis of bacterial vaginosis is made when at least three of the following signs or symptoms are present: abnormal gray discharge, vaginal pH above 4.5 (usually 5.0-6.0), positive fishy odor of vaginal discharge on addition of 10% potassium hydroxide, and appearance of characteristic "clue cells" on wet-mount microscopic studies. T. vaginalis is an anaerobic protozoan that is shaped like a turnip and has three or four anterior flagella. Chlamydia exists in two morphologically distinct forms during its unique life—a small infectious elementary body and a large noninfectious reticulate body. The diagnosis of syphilis can be made rapidly by dark-field microscopic examination of the exudate from skin lesions. However, the test is reliable only when a specimen with actively motile T. pallidum is examined immediately by a trained microscopist. It does, however, evoke a humoral immune response and production of antibodies that provide the basis for serologic tests.

Which of the following clients is at high risk for developing acute bacterial prostatitis? A. A middle-aged male with prostate hyperplasia B. A fifth grade male diagnosed with acute pyelonephritis C. An elderly male diagnosed with frequent UTIs testing positive for gram-negative rods D. A sickle cell anemia client complaining of prolonged erection lasting less than 4 hours

C The most likely etiology of acute bacterial prostatitis is an ascending urethral infection or reflux of infected urine into the prostatic ducts. E. coli, other gram-negative rods, and enterococci, organisms known to cause urethritis are the most common infectious agents, rather than a descending bacterial infection from the kidneys (as in pyelonephritis). Benign prostatic hyperplasia (BPH) is an age-related, nonmalignant enlargement of the prostate gland caused by overgrowth of the prostate mucosal glands. Prolonged erection does not increase the probability of developing acute bacteria prostatitis.

A 30-year-old man has been diagnosed with mumps orchitis. The nurse should educate the client that which of the following complications may occur? A. Erectile dysfunction B. Hematocele formation C. Sterility D. Penile atrophy

C The residual effects seen after the acute phase of mumps orchitis include hyalinization of the seminiferous tubules and atrophy of the testes, along with impaired spermatogenesis that has the potential to result in sterility. Spermatogenesis is irreversibly impaired in approximately 30% of testes damaged by mumps orchitis. Penile atrophy, hematuria, and hematocele are not among the signs, symptoms, and sequelae of mumps orchitis.

A client with a family history of breast cancer has just learned that she carries the BRCA1 and BRCA2 mutation. When educating this client about follow-up care, which of the following statements would be most appropriate? A) "You do not have to worry about passing this on to your adult female children." B) "You should schedule a bilateral mastectomy today." C) "You should have more frequent breast evaluations using an MRI rather than standard mammography." D) "You should ask your doctor to order a PET scan to see if you have any cancer lesions anywhere else in your body."

C) "You should have more frequent breast evaluations using an MRI rather than standard mammography."

Which of the following clients is at greatest risk for developing balanitis xerotica obliterans? A) A homosexual male with a monogamous partner B) A client who has had their pituitary gland removed due to cancer C) A male who has an uncircumcised penis D) A middle-aged male with history of chronic prostatitis

C) A male who has an uncircumcised penis

From the following list of clients, which ones are at high risk for developing priapism? Select all that apply. A) A teenage cocaine abuser who has been "high" for the past 72 hours B) An uncircumcised male with poor hygiene habits C) A sixth grade male returning to school following sickle cell crisis D) A college student with complete spinal cord injury at T12 level following auto accident E) A middle-aged adult male with recent history of myocardial infarction

C) A sixth grade male returning to school following sickle cell crisis D) A college student with complete spinal cord injury at T12 level following auto accident

Which of the following statements about screening for prostate cancer is most accurate? A) Digital rectal examination detects the majority of new cases of prostate cancer. B) A positive prostate-specific antigen (PSA) test is definitive for prostate cancer. C) BPH and prostatitis can confound prostate screening results. D) Digital rectal examination and PSA testing have been proven ineffective.

C) BPH and prostatitis can confound prostate screening results.

A client presents to the out-client clinic complaining of gray discharge that has a fishy odor. The health care provider sees "clue cells" on wet-mount microscopic exam. This would most likely lead to the diagnosis of: A) Trichomonas vaginalis B) Chlamydial C) Bacterial vaginosis D) Syphilis

C) Bacterial vaginosis

Which of the following physiologic changes results in menopause? A) Changes in anterior pituitary function that alter ovarian hormone production B) Gradual resistance of ovarian target cells to LH and FSH stimulation C) Cessation of ovarian function and decreased estrogen levels D) Decreased levels of gonadotropin-releasing hormone (GnRH)

C) Cessation of ovarian function and decreased estrogen levels

Which of the following phenomena is thought to underlie the decreased reported incidence of some sexually transmitted infections (STIs)? A) Increased knowledge of the correct use of condoms B) Increased public funding for health promotion activities C) Decreased reporting of cases of certain STIs D) Decreased numbers of sexual partners among young adults

C) Decreased reporting of cases of certain STIs

Which of the following assessments is most likely to reveal a potential exacerbation in a 70-year-old client's diagnosis of benign prostatic hyperplasia (BPH)? A) Urine testing for microalbuminuria B) Blood test for white blood cells and differential C) Digital rectal examination D) Sperm morphology testing

C) Digital rectal examination

When explaining polycystic ovary syndrome (PCOS) to a newly diagnosed client, the health care worker states, "This ovarian dysfunction is caused by: A) Absent FSH." B) Insulin deficit." C) Elevated LH." D) Low androgen."

C) Elevated LH."

A client comes to the college campus nurse complaining of unilateral pain, swelling, and redness on his scrotal area. The nurse knows these clinical manifestations are likely caused by: A) Syphilis B) Testicular torsion C) Epididymitis D) Ticks bites

C) Epididymitis

When educating a group of teenagers about sexually transmitted infections (STIs), the school nurse also mentions that cervical cancer has been associated with which of the following viral infections? A) Chlamydia trachomatis B) Herpes simplex C) Human papilloma D) Varicella zoster

C) Human papilloma

Which of the following disorders of the male genitourinary system creates the most urgent need for prompt and aggressive surgical treatment? A) Spermatocele B) Benign prostatic hyperplasia (BPH) C) Intravaginal testicular torsion D) Erectile dysfunction

C) Intravaginal testicular torsion

While discussing the physiological process behind penile erection, the anatomy and physiology instructor mentions that what substance is released to facilitate smooth muscle relaxation and shunting of blood into the sinusoids? A) Norepinephrine B) Nitroglycerine C) Nitric oxide D) Nicotinic acid

C) Nitric oxide

During a visit to the health care provider, a client complains of swelling in the scrotum. The health care worker suspects a hydrocele and performs an exam by shining a light through the scrotum. If the hydrocele is dense, the health care worker should: A) Continue to monitor the client every 6 months to see if there is a change in size. B) Prescribe diuretics like Lasix to help remove excess fluid. C) Order an ultrasound or biopsy to rule out testicular cancer. D) Gently try to express the fluid out of the scrotal sac

C) Order an ultrasound or biopsy to rule out testicular cancer.

A client is complaining to the health care provider about several vague signs/symptoms. Which of the following raises a "red flag" indicating the client may have developed endometrial cancer? A) Lumps palpated in her breasts B) Small, atrophied ovaries C) Painless abnormal bleeding D) Difficulty emptying the bladder

C) Painless abnormal bleeding

Squamous cell cancer of the penis is characterized by which of the following clinical manifestations? A) Erectile dysfunction with prolonged erection B) Herpes ulcerations on the penile shaft C) Painless lump on the inner surface of the prepuce D) Smegma accumulation in uncircumcised male requiring regular reminders about hygiene

C) Painless lump on the inner surface of the prepuce

Which of the following physiologic processes is caused by estrogens? A) Increased release of gonadotropin-releasing hormone (GnRH) B) Stimulation of lactation in the postpartum period C) Promotion of ovarian follicle growth D) Progesterone synthesis

C) Promotion of ovarian follicle growth

C) STI polymicrobial infection

. A 30-year-old man has been diagnosed with mumps orchitis. The nurse should educate the client that which of the following complications may occur? A) Erectile dysfunction B) Hematocele formation C) Sterility D) Penile atrophy

C) Sterility

When evaluating a client with suspected benign prostatic hypertrophy (BPH), the health care worker should collect data related to which of the following signs/symptoms? Select all that apply. A) Frequency of erectile dysfunction B) Enlarged inguinal lymph nodes C) Urinary frequency issues D) Weak urine stream E) Straining to empty the bladder

C) Urinary frequency issues D) Weak urine stream E) Straining to empty the bladder

Men older than age 50 are at high risk for prostatic hypertrophy with complications that include: A) Hypospadias B) Scrotal edema C) Urine retention D) Testicular cancer

C) Urine retention

From the following list of clients, which ones are at high risk for developing priapism? Select all that apply. A. A teenage cocaine abuser who has been "high" for the past 72 hours B. An uncircumcised male with poor hygiene habits C. A sixth grade male returning to school following sickle cell crisis D. A college student with complete spinal cord injury at T12 level following auto accident E. A middle-aged adult male with recent history of myocardial infarction

C, D Priapism is due to impaired blood flow in the corpora cavernosa of the penis. Priapism is classified as primary (idiopathic) or secondary to a disease or drug effect. Secondary causes include hematologic conditions (e.g., leukemia, sickle cell disease, polycythemia), neurologic conditions (e.g., stroke, spinal cord injury), and renal failure. Two mechanisms for priapism have been proposed: low-flow (ischemic) priapism, in which there is stasis of blood flow in the corpora cavernosa with a resultant failure of detumescence (diminution of swelling or erection), and Peyronie disease, which involves a localized and progressive fibrosis of unknown origin that affects the tunica albuginea (i.e., the tough, fibrous sheath that surrounds the corpora cavernosa) of the penis. Circumcision trauma to the penis and abnormal tightening of foreskin are external penile problems associated with phimosis rather than the internal vascular problem of priapism.

When evaluating a client with suspected benign prostatic hypertrophy (BPH), the health care worker should collect data related to which of the following signs/symptoms? Select all that apply. A. Frequency of erectile dysfunction B. Enlarged inguinal lymph nodes C. Urinary frequency issues D. Weak urine stream E. Straining to empty the bladder

C, D, E It is now thought that the single most important factor in the evaluation and treatment of BPH is the man's own personal experiences related to the disorder. The American Urological Association Symptom Index consists of seven questions about symptoms regarding incomplete emptying, frequency, intermittency, urgency, weak stream, straining, and nocturia. Erectile dysfunction may develop secondary to the androgen hormone imbalances associated with BPH. Enlarged lymph nodes usually relates to a regional infection.

From the following list of clients, which ones are at high risk for developing priapism? (select all that apply): A- A teenage concaine abuser who has been "high" for the past 72 hours B- An uncircumcised male with poor hygiene habits C- A sixth grade male returning to school following sickle cell crisis. D- A middle aged adult male with recent history of myocardial infarction.

C- A sixth grade male returning to school following sickle cell crisis

Which of the following statements about screening for prostate cancer is most accurate? A- Digital rectal examination detects the majority of new cases of prostate cancer. B- A positive prostate-specific antigen (PSA) test is definitive for prostate cancer (anything that goes wrong w/prostate). C- BPH and prostatitis can confound prostate screening results. D- Digital rectal examination and PSA testing have been proven ineffective.

C- BPH and prostatitis can confound prostate screening results.

When explaining polycystic ovary syndrome (PCOS) to a newly diagnosed client, the health care worker states, "this ovarian dysfunction is caused by": A- Absent FSH B- Insulin deficit C- Elevated LH D- Low androgen

C- Elevated LH (All the other options are symptoms, not causes).

Which of the following disorders of the male genitourinary system creates the most urgent need for prompt and aggressive surgical treatment? A- Epididymitis B- Benign prostatic hyperplasia (BPH) C- Testicular torsion D- Erectile dysfunction

C- Testicular torsion

Men older than age 50 are at high risk for benign prostatic hypertrophy (BPH), with complications that include: A- Hypospadias and other congenital abnormalities B- Scrotal edema and palpable painless mass C- Urinary frequency and retention with weak urine stream D- Testicular cancer

C- Urinary frequency and retention with weak urine stream

A 21 yr old college student has sought care because of the vaginal burning, itching, and redness that have become worse in recent weeks. Which of the clinician's assessment questions is most likely to apply to a diagnosis of vaginitis? A. "Have you ever been pregnant?" B. "Have your periods been regular in the last few months" C. "Have you ever had a sexually transmitted infection?" D. "Are you using oral contraceptives?"

C. "Have you ever had a sexually transmitted infection?"

A 41 yr old male client is planning on having a vasectomy. While explaining the surgery to the client, the health care worker will include which physiologic principle as the basis for this contraception technique? A. "The rete testis becomes inhospitable to sperm." B. "Spermatozoa can no longer reach the epididymis and do not survive." C. "Sperm can no longer pass through the ductus deferens." D. "Spermatogenesis is inhibited because sex hormones no longer stimulate the Sertoli cells."

C. "Sperm can no longer pass through the ductus deferens."

Which of the following physiologic changes results in menopause? A. Changes in anterior pituitary function that alter ovarian hormone production B. Gradual resistance of ovarian target cells to LH and FSH stimulation C. Cessation of ovarian function and decrease estrogen levels D. Decreased levels of gonadotropin-releasing hormone (GnRH)

C. Cessation of ovarian function and decrease estrogen levels

While in its dormant state, herpes simplex virus resides and replicates in the A. local lymph nodes B. Subcutaneous tissues C. Dorsal root ganglia D. Mucous membrane

C. Dorsal root ganglia

When educating a group of teenagers about sexually transmitted infections, the school nurse also mentions that cervical cancer has been associated with which of the following viral infections? A. Chlamydia trachomatis B. Herpes simplex C. Human papilloma D. Varicella zoster

C. Human papilloma

During a visit to the health care provider, a client complains of swelling in the scrotum. The health care worker suspects a hydrocele and performs an exam by shining a light through the scrotum. If the hydrocele is dense, the health care worker should: A. Prescribe diuretics like Lasix to help remove excess fluids B. Continue to monitor the client every six months to see if there is a change in size C. Order an ultrasound or biopsy to rule out testicular cancer D. Gently try to express the fluid out of the scrotal sac

C. Order an ultrasound or biopsy to rule out testicular cancer

A client visits the OB/GYN clinic complaining of low abdominal pain, purulent cervical discharge, and painful intercourse. The health care worker diagnoses pelvic inflammatory disease. The health care worker educated the client about the fact that this disease may be associated with: A. Chronic endometriosis B. Serous luteal ovarian cysts C. Sexually transmitted infection- polymicrobial infection D. Ruptured tubal pregnancy

C. Sexually transmitted infection- polymicrobial infection

A client arrives in the emergency department complaining of severe testicular pain associated with nausea and vomiting. Their pulse rate is 120 beats per min. Physical exam reveals an enlarged testis that is painful to palpation. The nurse suspects: A. Cancer of the scrotum B. Inguinal hernia C. Testicular torsion D. Testicular aneurysm

C. Testicular torsion

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

There are many cancers of the female reproductive system. The nursing student knows that the most readily detected and most easily cured cancer—if detected early—is:

Cervical

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

The pediatric nurse is caring for a newborn with hypospadias. The mother requests that a circumcision be performed prior to discharge. 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. Surgery is the treatment of choice for hypospadias (termination of the urethra is on the ventral surface of the penis). Circumcision is avoided because the foreskin is used for surgical repair, usually performed between the ages of 6 and 12 months.

Which woman will the nurse encourage to have annual Papanicolaou (Pap) smears? Select all that apply.

Client age 63, postmenopausal for 10 years Client age 44, has multiple sexual partners Client age 27, history of human papillomavirus (HPV)

When caring for a group of clients, the nurse recognizes which of these individuals has increased risk for balanitis?

Client with a sexually transmitted infection

A sexually transmitted infection that is caused by a microorganism with two morphologically distinct forms is: A. Chancroid B. Candidiasis C. Trichomonas vaginalis D. Chlamydia

D Chlamydia exists in two morphologically distinct forms during its unique life—a small infectious elementary body and a large noninfectious reticulate body. T. vaginalis is a large anaerobic, pear-shaped, flagellated protozoan. Chancroid is a disease of the external genitalia and lymph nodes caused by the gram-negative bacterium Haemophilus ducreyi. Candida albicans is the most commonly identified organism in vaginal candidiasis (yeast infection), but other candidal species, such as Candida glabrata and Candida tropicalis may also be present.

While in its dormant state, herpes simplex virus resides and replicates in the: A) Local lymph nodes B) Subcutaneous tissue C) Mucous membrane D) Dorsal root ganglia

D) Dorsal root ganglia

D 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. The dartos muscle separates the two testes and responds to changes in temperature by contracting when cold and relaxing when warm. Most squamous cell cancers of the scrotum occur after 60 years of age and are linked to poor hygiene, chronic inflammation, exposure to ultraviolet A radiation, or human papilloma virus (HPV). 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.

Which of the following complaints by middle-aged women should prompt a care provider to assess for the possibility of ovarian cancer? A) "I'm having a lot of vaginal discharge lately and it's quite foul." B) "My periods have become quite irregular since last winter." C) "I have a sharp, stabbing pain on my side for the last few days." D) "I'm having a lot of indigestion and bloating, which I've never had before."

D) "I'm having a lot of indigestion and bloating, which I've never had before."

A 41-year-old male client is planning on having a vasectomy. While explaining this surgery to the client, the health care worker will include which physiologic principle as the basis for this contraception technique? A) "Spermatogenesis is inhibited because sex hormones no longer stimulate the Sertoli cells." B) "Spermatozoa can no longer reach the epididymis and do not survive." C) "The rete testis becomes inhospitable to sperm." D) "Sperm can no longer pass through the ductus deferens."

D) "Sperm can no longer pass through the ductus deferens."

While breast-feeding her 3-month-old infant, the mother notices the breast area is hard, inflamed, and tender to touch. The clinic nurse explains that this is likely caused by: A) Intraductal papillomas B) Secretory cell hyperplasia C) Fibrocystic tissue changes D) Ascending bacterial infection

D) Ascending bacterial infection

A 59-year-old woman with a recent diagnosis of breast cancer has begun a course of hormone therapy. What is the goal of this pharmacologic treatment? A) Blocking the effects of progesterone on tumor growth B) Increasing serum hormone levels to promote tumor cell lysis C) Blocking the entry of malignant cells into the axillary lymph nodes D) Blocking effects of estrogen on the growth of malignant cells

D) Blocking effects of estrogen on the growth of malignant cells

A sexually transmitted infection that is caused by a microorganism with two morphologically distinct forms is: A) Chancroid B) Candidiasis C) Trichomonas vaginalis D) Chlamydia

D) Chlamydia

Of the following STIs, for which STI should the nurse anticipate a prescription for antibiotics such as tetracycline or doxycycline since this infection will respond to antibiotic treatment? A) Human papillomavirus (HPV) infection B) Herpes simplex virus type 2 (HSV-2) infection C) Candidiasis D) Lymphogranuloma venereum (LGV)

D) Lymphogranuloma venereum (LGV)

D) Testicular torsion

Which of the following signs and symptoms are most clearly suggestive of primary genital herpes in a male client? A- Presence of purulent, whitish discharge from the penis B- Emergence of hard, painless nodules on the shaft of the penis C- Production of cloudy, foul smelling urine D- Itching, pain, and the emergence of pustules on the penis

D- Itching, pain, and the emergence of pustules on the penis

A client presents to the GYN clinic complaining of large amounts of frothy yellow-green discharge that smells very foul. Immediately, the heath care provider is thinking this client most likely has: A- Candidiasis B- Chlamydial infection C- Human papillomavirus D- Tricomoniasis

D- Tricomoniasis

Which of the following complaints by middle aged women should prompt a health care provider to assess for the possibility of ovarian cancer? A. " My periods have become quite irregular since last winter" B. " I'm having a lot of vaginal discharge lately and it's quite foul" C. " I have a sharp, stabbing pain on my side for the last few days." D. " I'm having a long of indigestion and bloating, which I've never had before"

D. " I'm having a long of indigestion and bloating, which I've never had before"

Which of the following assessment questions is most likely to address the causation of a woman's new case of candiasis? A. "Do you use condoms during sexual activity?" B. "Have you recently begun a new sexual relationship?" C. Have you noticed any new growths on your vagina in recent months?" D. "Have you been on antibiotics recently?"

D. "Have you been on antibiotics recently?"

A 59 yr old women with a recent diagnoses of breast cancer has begun a course of hormone therapy. What is the goal of this pharmacologic treatment? A. Blocking the effects of progesterone on tumor growth B. Increase serum hormone levels to promote tumor cell lysis C. Blocking the entry of malignant cells into the axillary lymph nodes D. Blocking effects of estrogen on the growth of malignant cells.

D. Blocking effects of estrogen on the growth of malignant cells.

Common risk associated with erectile dysfunction is due to generalized penile arterial insufficiency include: A. Testicular torsion B. Cryptorchidism C. Benign prostate hypertrophy D. Cigarette smoking

D. Cigarette smoking

When explaining polycystic ovary syndrome (PCOS) to a newly diagnosed client, the health care worker states. " The ovarian dysfunction is caused by: " A. Absent FSH B. Insulin deficit C. Low androgen D. Elevated LH

D. Elevated LH

Which of the following events is associated with the primary stage of syphilis? A. Development of gummas B. Palmar rash C. Development of central nervous system lesions D. Genital chancres

D. Genital chancres

A 22 yr old client has presented to her primary care provider for her scheduled Pap smear. Abnormal results of this diagnostic test may imply infection with: A. Candida albicans B. Chlamydia trachomatis C. Trichomonas vaginalis D. Human papillomavirus (HPV)

D. Human papillomavirus (HPV)

Men whose sexual partners have been diagnosed with Trichomonas vaginalis will likely exhibit: A. Numerous pustules on the penal shaft B. Copious amounts of frothy discharge from the penis C. Redness and pain at the urethral meatus D. No symptoms of infection

D. No symptoms of infection

Squamous cell cancer of the penis is characterized by which of the following clinical manifestations? A. Erectile dysfunction with prolonged erection B. Smegma accumulation in uncircumcised male requiring regular reminders about hygiene C. Herpes ulcerations on the penile shaft D. Painless lump on the inner surface of the prepuce

D. Painless lump on the inner surface of the prepuce

A 30 yr old man has been diagnosed with mumps orchitis. The nurse should educate the client that which of the following complications may occur? A.Erectile dysfunction B. Hematocele formation C. Penile atrophy D. Sterility

D. Sterility

Which of the following clinical manifestations is most likely to accompany a diagnosis of vulvodynia? A. Purulent discharge B. Open lesions on the surface of the vulva C. Urinary incontinence D. Vulvar Pain

D. Vulvar Pain

When explaining polycystic ovary syndrome (PCOS) to a newly diagnosed client, the health care worker states, "This ovarian dysfunction is caused by:

Elevated LH.

When explaining polycystic ovary syndrome (PCOS) to a newly diagnosed client, the health care worker states, "This ovarian dysfunction is caused by

Elevated LH."

When explaining polycystic ovary syndrome (PCOS) to a newly diagnosed client, the health care worker states, "This ovarian dysfunction is caused by:

Elevated LH."

The stages of the sexual act that constitute the culmination of the male sexual act include which of the following? You selected:

Emission Emission and ejaculation, which constitute the culmination of the male sexual act, are a function of the sympathetic nervous system.

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 Androgens have been abused to enhance athletic performance. By testosterone being aromatized to estradiol in the peripheral tissues, gynecomastia (breast enlargement) can occur.

Which of the following is the final site for sperm maturation?

Epididymis The final site of sperm maturation is in the epididymis. The bladder, urethra, and bulbourethral gland do not store sperm.

A client comes to the college campus nurse complaining of urethral pain, swelling, and redness on his scrotal area. The nurse knows these clinical manifestations are likely caused by:

Epididymitis

Pre Menstrual Syndrome:

Etiology: A group of physical, emotional and behavior S/S associated with the menstrual cycle. Incidence: 5-10% disabling symptoms Pathophys: S/S begin with the luteal phase of the menstrual cycle S/S: Over 150 reported symptoms. Most common are: painful, swollen breasts, abdominal bloating, pelvic pain, mood changes. Rx: Relief of s/s through medication, application of heat; hormone meds, and antidepressants.

Cancers of Male Reproductive System: A. Penile CA <1% of male CA in US; 40% < 60 yrs old B. Testicular CA 1% of male CA; 15-35 yrs old- self exam to check for painless mass. *Highest risk among men who have a history of undescended testicle as an infant. HIGH CURE RATE w/orchiectomy of testicle & chemo.* C. Prostate CA 28% of male CA; 80% >65 yrs old- no initial s/s so usually has metastasized before discovered. Dx: via *prostate specific antigen (PSA) test! (NOTE- PSA can also be high in BPH & Prostatitis) *Most common in American Men.

Etiology: Men with affected 1st degree relative (father, brother) and 2nd degree relative (grandfather or uncle) are at highest risk. Possibly increased dietary fats may alter hormone production and increase the risk of *Prostate CA. Pathophys: as for all cancers. Sites of metastasis: Lungs (via lymph system) and Spinal column/pelvis (bone pain is often the 1st presenting symptom). S/S: *Early stages are asymptomatic. May be similar to s/s of BPH (urgency, frequency, nocturia, hematuria, or blood in ejaculate).* Digital exam (gloved finger is inserted into rectum) used to check the size of prostate and to palpate for abnormal bumps. Rx: sugery, radiation, chemotherapy.

Benign Prostatic Hypertrophy (BPH):

Etiology: Nonmalignant enlargement of the prostate gland. Age-related but otherwise unknown etiology. Incidence: 70% in 60-70 year old age range and 80% of 70+ year old males. S/S: frequency, urgency, straining to void, decreased urine stream, incontinence, impotence, palpable prostate, nocturia (waking up at night to void). Can give a false-positive PSA test (test for prostate CA) Rx: Catheter, surgical resection, an instrument is inserted up the urethra to remove the section of the prostate that is blocking urine flow.

Trichomoniasis:

Etiology: PROTOZOA (Trichomonas vaginalis) Incidence: Anyone, but greater with multiple partners. Pathophys: Parasitic infection 3rd most commonly reported STD. Can also be transmitted via fomites (swimming pools and hot tubs) infection with "Trich" males it easier to get infected with other STD pathogens. S/S: Frequently asymptomatic in men. In women there is a thick, foamy or frothy, foul-smelling green discharged; burning pain with urination and/or itching. Rx: Antiprotozoal medication

Cervicitis: (infection of the cervix)

Etiology: Sexually transmitted diseases (STDs), trauma Pathophys: trigger > cervix becomes red > edematous, muco-purulent discharge (if infectious) > infectious > may ascend to PID (pelvic inflammatory if untreated) S/S: dysuria, spotting/bleeding, vague pain, dyspareunia (painful sexual intercourse) Rx: antibiotics- treat partner, avoid reinjury

Human Papillomavirus (HPV):

Etiology: VIRUS (over 150 types), in most cases it goes away on its own and does not cause any health problems. Other strains of HPV can cause health problems like Genital Warts and Cancer. Incidence: the most common STD in the US nearly all sexually active men and women get it at some point in their lives. Pathophys: Virus is spread by having vaginal, anal, or oral sex with someone who has the virus. S/S: Possibly genital warts, or avidence of cervical cancer (positive Pap smear), or cancer of the throat, penis, or anas. Rx: HPV vaccination for males and females (series of 3 injections/6months)

Which of the following events is associated with the primary stage of syphilis?

Genital chancres

Sexually Transmitted Diseases: Herpes Simplex:

Etiology: Viral infection with Herpes Simplex 1&2 (1= cold sores 2= genital) Incidence: anyone, but greater with multiple partners Pathophys: viral infection which may be transmitted wwhen there are no visible lesions; recurrence is common. Herpes can be passed on to babies during childbirth causing a potential fatal disease in the baby. Herpes attacks can be triggered by stress to the body. S/S: *Painful blisters (pustules) break open & cause ulcerations*, flu-like symptoms w/the initial outbreak; recurrent outbreaks proceeded by *burning or itching*, less painful than initial outbreak. *(NOTE: There are either painful genital sores or no s/s at all... NO IN-BETWEEN!) Rx: Antiviral med's for treatment of active outbreaks & suppression therapy (NO CURE).

Scrotal Disorders (Male reproductive system)- Inguinal Hernia:

Etiology: Weakness or opening in the inguinal (inner groin) canal. Incidence: accounts for about 70-80% of all hernia cases an is surprisingly common in men, not so much in women. Kids and teens receive inguinal surgeries. Pathophys: soft tissue, lower intestines starts to come through the lower abdominal wall through a small hole or tear in the inguinal canal (which is supposed to close completely after testes descend in utero). S/S: Asymptomatic if a small herniation or a feeling of fullness or lump in the groin area w/pain and burning; N/V if the bowel is significantly involved.

Chlamydia:

Etiology: bacteria (Chlamydia trachomatis) Incidence: anyone, but greater with multiple partners. One of the most common STDs (reported twice as often as gonorrhea). Can be transmitted to baby during vaginal birth. Pathophys: bacterial infection S/S: frequently asymptomatic! If S/S are present: painful urination, genital pain, dyspareunia, CAN CAUSE PID/INFERTILITY.

Sexually Transmitted Diseases: Gonorrhea:

Etiology: bacteria (Neisseria gonorrhea) Incidence: anyone, but greater with multiple sexual partners. Common STD that can either have no s/s (especially for men) or can develop systemic problems in joints, meninges, heart valves, etc. Passed to baby during birth from infected mother- causing BLINDNESS to baby. S/S:* frequently asypmtomatic*, but if s/s are present: Genital sores, painful urination, abnormal discharge (creamy/yellow), menstural irregularities, urinary symptoms, *Can cause PID & Infertility* Rx: antibiotic therapy

Sexually Transmitted Diseases: Syphilis:

Etiology: bacteria (Treponema pallidum) spread through kissing and sexual contact; Incidence: anyone, but greater with multiple partners Pathophys: bacterial infection. Transfers through placenta to fetus causing premature birth, stillborn babies. congential defects & active infection in the infant. Divided into 3 stages (NOTE: all stages have a PHYSICAL sign). S/S: Depending on the stage of the disease: See Stages. Initially a hard, painless sore (chancre) appears on the genital area. Secondly a rash develops on the palms of the hands; if untreated, syphilis may progress to *heart disease, blindness, paralysis, brain damage, and death* Rx: antibiotic therapy (penicillin ususally).

Genital warts

Genital warts are a common sexually transmitted infection caused by the human papillomavirus (HPV). The characteristic symptom is a small bump on the genitals.

Bartholinitis (infection of bartholin glands):

Etiology: bacterial infections, STDs Pathophys: contamination of opening of Bartholin's gland> infection/trauma obstructs flow of secretions>swelling, pain, arythema S/S: erythema, edema, pain, purulent drainage, fever, malaise. Can form into a pustule (cyst). Rx: warm compresses, antibiotics, incision and drainage.

Candidiasis Yeast Infection:

Etiology: fungal (yeast) infection with Candida albicans. Vaginal yeast infections are one of the most frequent reasons that women visit a doctor. Incidence: anyone; greater with the following risk factors: antibiotic use (antibiotics destroy the normal bacteria that keeps yeast under control), pregnancy (2ndary to high hormone levels), Uncontrolled diabetes (yeast loves glucose!), or compromised immune systems (HIV pt's- chronically ill), not transmitted sexually-unless oral sex. Pathophys: Candida

Prostate Disorders (Male reproductive system): read text on this! only 4 pgs. Prostatitis:

Etiology: idiopathic, bacteria Incidence: 4-36% in general population Pathopys: inflammation/infection S/S: *Pain (Rectal of low abdominal & back which may be worse with BM's), urinary frequency/urgency, pain with erection, painful ejaculation, fever (infection), enlarged/tender prostate. *Can give a FASE-POSITIVE PSA test! (Test for prostate CA). Rx: antibiotics, anti-inflammatories, bed rest.

Penile Disorders (Male reproductive system)- Priapism:

Etiology: idiopathic, or due to neurological injury* Involuntary prolonged (>4 hrs) abnormal and PAINFUL ERECTION that either continues beyond or is unrelated to sexual stimulation. Incidence: 60% idiopathic; 40% neurologic. Can occur at any age from newborn and older. *MOST COMMON IN SICKLE CELL DISEASE, cancers, or neurologic disorders. Can be caused by stoke or spinal cord injury; leukemia or polycythemia; renal disease. RN's working in Neuro or Orthopedic rehab units in particular will need to assess their pt's.

Priapism:

Etiology: idiopathic, or due to neurological injury. Incidence: most common in sickle cell disease, cancers, or neurologic disorder. Can be caused by stroke or spinal cord injury. Pathophys: Urologic emergency because of tissue death that will lead to impotence. S/S: PAINFUL ERECTION

Scrotal Disorders (Male reproductive system)- Cryptorchidism (undescended testicle):

Etiology: in utero development of baby. Incidence: 20% premature boys have undescended testicle(s); 75-90% descended by 1yr of age. Pathophys: failure of testes to descend into scrotal sac. *Risk of testicular cancer* in the undescended testicle is 4-10x higher than in the general population! *Reduced fertility possible due to length of time the testes were in the abdomen (rather then outside scrotal sac where it is cooler). S/S: no testes palpable in scrotum. May do laparoscopy to confirm dx since no imaging is available. Rx: None- (wait to see if testicle descends by age 1 to max. fertility), or orchiopexy*

Epididymitis:

Etiology: inflammation of the epididymitis (secondary to UTI or STD) Incidence: < 35yo = STD, >35= UTI Pathophys: pathogen ascension from urethra or bladder> inflammation. Risk factors include sexual activity heavy physical exertion, and bicycle/motorcycle riding. S/S: acute scrotal/inguinal pain, urethral discharge, dysuria Rx: antibiotics, scrotal support (NOTE: elevation of scrotum RELIEVES pain)

Testicular Torsion: (potential urologic EMERGENCY)

Etiology: twisting of spermatic cord that suspends the testies (singular- testes is plural), Incidence: occurs in neonates and adolescents. Pathophys: spermatic cord twists > ischemia and loss of the testis S/S: extreme testicular pain (sudden onset), scrotal edema, N/V, Cremasteric reflex is absent (natural reflex that makes testicles retract when the skin of the inner thigh is stroked). Rx: surgical reduction w/in 6 hours to save the testis. (NOTE: elevation of the scrotum INCREASES PAIN).

Penile Disorders (Male reproductive system)- Peyronie's Disease:

Etiology: unknown. Begins with an inflammatory process that results in dense fibrous plaque (build-up; hard mass formation) on the tunica albuginea of the penis. Incidence: ^ with diabetes, keloid formation; 50% spontaneous remission. Pathophys: inflammation> plaque fibrosis> abnormal penile curvature with erection S/S: PAINFUL ERECTION, dyspareunia (painful sexual intercourse) unable to penetrate partner. Rx: none, surgical implant. (PAINFUL ERECTION lasting >4 hrs).

Leiomyoma (uterine fibrosis) aka fibrosis

Etiology: unknown. Benign growths in the muscular lining of the uterus Incidence: 30% caucasians/ 50% blacks by age 50- decrease w/menopause S/S: can be asymptomatic or cause heavy menses & dysmenorrhea (large clots) Rx: menopause, hysterectomy..

A teenager has been diagnosed with failure to thrive. The health care providers expect a malabsorption syndrome. In addition to having diarrhea and bloating, the client more than likely has what hallmark manifestation of malabsorption?

Fatty, yellow-gray, foul-smelling stools

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? a) Imdur (isosorbide mononitrate), a vasodilator b) Leuprolide (Lupron), a gonadotropin-releasing hormone analog c) Finasteride (Proscar), a 5a-reductase inhibitor d) Birth control pills containing both estrogen and progestin

Finasteride (Proscar), a 5a-reductase inhibitor Finasteride (Proscar), a 5a-reductase inhibitor reduces prostate size by blocking the effect of androgens on the prostate. Vasodilators, BCPs, and GnRH analogs do not decrease prostate size.

In assessing a client with a fibroadenoma of the breast, what will the nurse find?

Firm, rubbery masses

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? a) Glans penis b) Scrotum c) Prostate d) Testes

Glans penis The most important source of impulse stimulation for initiating the male sexual act is the glans penis, which contains a highly organized sensory system. Afferent impulses from sensory receptors in the glans penis pass through the pudendal nerve to ascending fibers in the spinal cord by way of the sacral plexus.

A diabetic client is controlled in Avandia (rosiglitazone), a thiazolidinedione medication that acts at the level of nuclear peroxisome proliferator-activate receptors (PPARs) to promote:

Glucose uptake

The nurse is caring for a client with lichen simplex chronicus. What assessment finding does the nurse expect?

Gray-white plaques with an irregular surface

Which of the processes is a component of the pathogenesis of proliferative breast lesions without atypia?

Growth of ductile or lobular epithelia cells

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? a) Chronic inflammation of the glans penis b) Poor hygiene c) Cardiovascular disease d) Impaired blood flow in the corpora cavernosa of the penis

Impaired blood flow in the corpora cavernosa of the penis Priapism is an involuntary, prolonged (>4 hours), abnormal, and painful erection that continues beyond, or is unrelated to, sexual stimulation. Priapism is a true urologic emergency because the prolonged erection can result in ischemia and fibrosis of the erectile tissue with significant risk of subsequent impotence. Priapism is caused by impaired blood flow in the corpora cavernosa of the penis

A male client has developed priapism. The nurse is aware that the client is at risk for:

Impotence Priapism is an involuntary, prolonged (>4 hours), abnormal, and painful erection that continues beyond, or is unrelated to, sexual stimulation. The prolonged erection can result in ischemia and fibrosis of the erectile tissue with significant risk of subsequent impotence. The other results will not occur.

Which disorder of the male genitourinary system creates the most urgent need for prompt and aggressive surgical treatment?

Intravaginal testicular torsion

Which of the disorders of the male genitourinary system creates the most urgent need for prompt and aggressive surgical treatment?

Intravaginal testicular torsion

Leiomyoma

Noncancerous growths in the uterus that can develop during a woman's childbearing years. Symptoms include heavy menstrual bleeding, prolonged periods, and pelvic pain. In some cases, there are no symptoms.

A 27-year-old male developed mumps and was ill for several days. The client suddenly developed a fever and painful enlargement of the testes approximately 4 days after recovering. The nurse should suspect that the client has developed:

Orchitis

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

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 rising PSA (prostate-specific antigen) after treatment is consistent with progressive disease and is used to detect recurrence after total prostatectomy. Because the prostate is the source of PSA, levels should drop to zero after surgery.

Menses at intervals of 21 days or fewer

Polymenorrhea

A nurse is evaluating diagnostic tests for a client suspected of having prostate cancer. Which of the following results requires further evaluation? a) Uroflow examination 12 mL/second b) BUN 20 ng/mL c) Creatinine 1.0 ng/mL d) Prostate-specific antigen (PSA) of 12 ng/mL

Prostate-specific antigen (PSA) of 12 ng/mL A prostate-specific antigen (PSA) level of 12 ng/mL is high (<4.0 ng/mL is considered normal); all other tests are within normal limits. Uroflow examination shows obstruction with a flow of less than 7 mL/second (average normal flow is 12 mL/second). The findings are positive for prostate cancer. PSA testing may be recommended annually for men, starting at age 50.

A child born premature does not have descended testes. The pediatrician has made a note to watch in the coming visits for testicular descension. Which consequence is the most significant concern if the testes do not descend?

Testicular torsion

A client who had been utilizing pharmacologic management for BPH is now experiencing severe signs of obstruction. The client would most likely require: a) Radiation treatment of the prostate b) Transurethral prostatectomy c) Insertion of a urinary catheter d) Injecting the prostate with a chemotherapy drug

A client reports heaviness in the scrotum and pain in the lower back. The client is diagnosed with a hydrocele. In which anatomical structure does the excess fluid collect?

Tunica vaginalis

In a hydrocele, excess fluid is present in the...

Tunica vaginalis

While playing outside in the snow, a young child complained of painful fingertips since he would not keep his gloves on. In the emergency department, the nurse knows this painful sensation is a result of which transmission of proprioceptive somatosensory information?

Type C dorsal root ganglion neurons

When explaining why some children have albinism, the science teacher explains that which enzyme is needed for synthesis of melanin?

Tyrosinase

A client asks, "What caused my acute prostatitis?" Which response by the nurse explains the most common cause of acute prostatitis?

Urethral infection with Escherichia coli

Mumps

When symptoms occur, they include swollen, painful salivary glands, fever, headache, fatigue, and appetite loss.

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: a) "Why do you want children at your age?" b) "Have you ever fathered a child before?" c) "Yes; some 80- and 90-year-old men have been known to father children." d) "No, fertility ends at 50 years of age."

Yes; some 80- and 90-year-old men have been known to father children." Gonadal and reproductive failures usually are not related directly to age because a man remains fertile into advanced age; 80- and 90-year-old men have been known to father children. -Past history may not identify fertility. -Asking "why" is considered a confrontational response.

A client is brought to the emergency department semi-comatose and a blood glucose reading of 673. The nurse should anticipate that which of the following orders may correct this diabetic ketosis? A- The administration of potassium chloride B- Initiating an insulin IV infusion along with fluid replacement C- Administering supplemental oxygen and rebreathing from a paper bag D- Instituting a cough and deep breathing schedule for every hour while awake to improve ventilation

B- Initiating an insulin IV infusion along with fluid replacement

A client comes to the OB/GYN clinic complaining of difficulty in emptying the bladder and frequency and urgency of urination. After examination, the health care provider will likely diagnose: A) Rectocele B) Cystocele C) Endometritis D) Prolapsed uterus

B) Cystocele

Which of the following signs and symptoms is most clearly suggestive of primary genital herpes in a male client? A) Presence of purulent, whitish discharge from the penis B) Emergence of hard, painless nodules on the shaft of the penis C) Itching, pain, and the emergence of pustules on the penis D) Production of cloudy, foul-smelling urine

C) Itching, pain, and the emergence of pustules on the penis

A female client presents an STD clinic. She is in the first trimester of pregnancy and has tested positive for gonorrhea. Because strains of N. gonorrhoeae have become resistant to penicillin, the current treatment recommendation includes: A. High-dose cefixime given in a single dose B. Ten-day supply of Flagyl C. Doxycycline over the course of 1 week D. No treatment until after the baby is born

A The current treatment recommendation to combat penicillin- and tetracycline-resistant strains of gonorrhea is ceftriaxone or cefixime in a single injection. While a single injection of cefixime is still the standard treatment, some strains of N. gonorrhoeae have begun to show resistance to this dose. Metronidazole (Flagyl) is one treatment of choice against anaerobic protozoans, which can cure Trichomonas vaginalis. The treatment of choice for syphilis is penicillin. Tetracycline or doxycycline is used for treatment in persons who are sensitive to penicillin, but these medications cannot be used in pregnancy. Obviously, the client will receive treatment. However, at time of delivery, the infant will be tested and treated as necessary.

A male diagnosed with gonorrhea will likely complain of which of the following clinical manifestations? Select all that apply. A) Creamy, yellow discharge B) Pain in the urethra with urination C) Difficulty starting a stream of urine D) "Fish"-smelling discharge from the penis E) Diffuse pelvic pain

A) Creamy, yellow discharge B) Pain in the urethra with urination

The anatomy of the prostate gland is made up of three concentric areas surrounding the prostatic uretha, into which they open. The nurse understands that an overgrowth of the mucosal glands can cause which disorder in older men? a) Benign prostatic hypertrophy b) Testicular cancer c) Prostate cancer d) Neoplasm cells of the prostate

Benign prostatic hypertrophy The prostate gland is made up of many secretory glands arranged in three concentric areas surrounding the prostatic urethra, into which they open. The component glands of the prostate include the small mucosal glands associated with the urethral mucosa, the intermediate submucosal glands that lie peripheral to the mucosal glands, and the large main prostatic glands that are situated toward the outside of the gland. It is the overgrowth of the mucosal glands that causes benign prostatic hypertrophy (BPH) in older men.

A 41-year-old male client is planning on having a vasectomy. While explaining this surgery to the client, the health care worker will include which physiologic principle as the basis for this contraception technique? A."Spermatogenesis is inhibited because sex hormones no longer stimulate the Sertoli cells." B. "Spermatozoa can no longer reach the epididymis and do not survive." C. "The rete testis becomes inhospitable to sperm." D. "Sperm can no longer pass through the ductus deferens."

D When the male ejaculates, the smooth muscle in the wall of the epididymis contracts vigorously, moving sperm into the next segment of the ductal system, the ductus deferens, also called the vas deferens. A vasectomy severs this conduit, rendering the male effectively infertile within a few weeks of the procedure. The procedure has no hormonal effect and neither the epididymis nor the rete testis is altered.

A nurse is conducting a healthy living workshop for a group of women in their 20s. Which of the following screening recommendations should the nurse provide to the participants? A) Monthly breast self-examination (BSE) B) BSE or mammography each year starting at age 40 C) Annual clinical breast examination until age 65 D) Clinical breast examination every 3 years until age 40

D) Clinical breast examination every 3 years until age 40

Which of the physiologic processes is caused by estrogens?

Promotion of ovarian follicle growth

From the following list of clients, which ones are at high risk for developing priapism? Select all that apply. a) A middle-aged adult male with recent history of myocardial infarction b) An uncircumcised male with poor hygiene habits c) A college student with complete spinal cord injury at T12 level following auto accident d) A sixth grade male returning to school following sickle cell crisis e) A teenage cocaine abuser who has been "high" for the past 72 hours

• A sixth grade male returning to school following sickle cell crisis • A college student with complete spinal cord injury at T12 level following auto accident Priapism is due to impaired blood flow in the corpora cavernosa of the penis. Priapism is classified as primary (idiopathic) or secondary to a disease or drug effect. -Secondary causes include hematologic conditions (e.g., leukemia, sickle cell disease, polycythemia), neurologic conditions (e.g., stroke, spinal cord injury), and renal failure. Two mechanisms for priapism have been proposed: low-flow (ischemic) priapism, in which there is stasis of blood flow in the corpora cavernosa with a resultant failure of detumescence (diminution of swelling or erection), and Peyronie disease, which involves a localized and progressive fibrosis of unknown origin that affects the tunica albuginea (i.e., the tough, fibrous sheath that surrounds the corpora cavernosa) of the penis. -Circumcision trauma to the penis and abnormal tightening of foreskin are external penile problems associated with phimosis rather than the internal vascular problem of priapism.

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? a) Back pain b) Coughing bloody sputum c) Enlargement of the testicle d) One testicle lower than the other in the scrotal sac

Enlargement of the testicle Often the first sign of testicular cancer is a slight enlargement of the testicle that may be accompanied by some degree of discomfort. - Back pain and hemoptysis are last signs leading to a metastatic lesion. -It is normal for one testicle to hang lower than the other.

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 In the male, the stages of the sexual act involve erection, emission, ejaculation, and detumescence. Erection involves the shunting of blood into the corpus cavernosum.

Polycystic Ovary Syndrome:

Etiology: Endocrine disorder (excess LH compared to FSH) Pathophys: unbalanced hormones lead to ovulation and menstrual irregularities. S/S: Male pattern baldness (due to higher levels of male hormones), Metabolic syndrome w/insulin resistance (& subsequent obesity), Irregular menstrual cycles. Rx: relief of symptoms, hormone replacement, anti-diabetic medication (to treat insulin resistance)- Don't confuse with functional cysts, PCOS has multiple cysts & hormone imbalance.

The primary reason genital herpes has reached epidemic proportions throughout the world relates to the fact that: A. A large percentage (70%) of those infected experience no symptoms of the disease. B. The lesions (LSILs) occur on the cervix and can only be detected by a Pap test. C. Lesions take a long time to incubate and the small papules are usually located inside the vagina. D. The organism spreads upward to the prostate gland in males and fallopian tubes in females.

A Persons infected with HSV-1 remain at risk for acquiring HSV-2. Most cases of HSV-2 infection are subclinical, manifesting as asymptomatic or symptomatic but unrecognized infections. These subclinical infections can occur in people who have never had a symptomatic outbreak or they can occur between recognized clinical recurrences. Up to 70% of genital herpes is spread through asymptomatic shedding by people who do not realize they have the infection. Transient HPV infections can develop low-grade squamous intraepithelial lesions (LSILs) of the cervix as detected on a Pap test, colposcopy, or biopsy. Lesions of LGV can incubate for a few days to several weeks and thereafter cause small, painless papules or vesicles that may go undetected. If untreated, gonorrhea spreads from its initial sites upward into the genital tract. In males, it spreads to the prostate and epididymis; in females, it commonly moves to the fallopian tubes.

An elderly female has slowly developed dementia and loss of vision. She is being evaluated for nursing home placement. Routine admission blood work reveals that the client tested positive for which STI associated with her current symptoms? A. Tertiary syphilis B. Chlamydial C. Gonorrhea D. Human papillomavirus infection

A Tertiary syphilis is a delayed response of the untreated disease. The symptomatic tertiary stage frequently affects the cardiovascular system, central nervous system, liver, bones, and testes. In women, chlamydial infections may cause urinary frequency, dysuria, and vaginal discharge. In women, gonorrhea has recognizable symptoms, which include unusual genital or urinary discharge, dysuria, dyspareunia, pelvic pain or tenderness, unusual vaginal bleeding (including bleeding after intercourse), and fever. HPV infection is associated with genital warts that typically present as soft, raised, fleshy lesions on the external genitalia, including the penis, vulva, scrotum, perineum, and perianal skin. External warts may appear as small bumps, or they may be flat, rough surfaced, or pedunculated.

If a male has a history of impaired blood flow in his vascular system, he may be prone to developing: a) Premature ejaculation. b) Penile engorgement. c) Vascular clots in pudendal arteries. d) Erectile dysfunction.

Erectile dysfunction. 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. -Premature ejaculation is not caused by a vascular problem. - Penile engorgement is expected as part of an erection. -Vascular clots may relate to a trauma or surgery to the penis.

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 of the client's following statements indicates the need for further teaching? A. "I can't shake this feeling like I've received a death sentence." B. "I have to admit that the prospect of losing a testicle is a bit overwhelming." C. "I really hope the cancer hasn't spread anywhere, because I've read that it's a possibility." D. "I guess there's some solace in the fact that this cancer wasn't a result of an unhealthy lifestyle."

A Testicular cancer has the potential for metastasis, but outcomes are positive for most clients and survival rates are high. With appropriate treatment, the prognosis for men with testicular cancer is excellent. Orchiectomy remains the standard treatment, and the pathogenesis of testicular cancer is not thought to be related to lifestyle factors.

During physical exam of a newborn, the nurse palpates the scrotal sac and only locates one testicle. Which statement about undescended testicles is most accurate? A) "The child can become infertile later in life as a result of decreased sperm count." B) "This is more common in full-term infants when compared to premature births." C) "This may be a precursor to the development of prostate cancer later in life." D) "The child will need surgery to move the testes back into the scrotal sac since they rarely descend spontaneously."

A) "The child can become infertile later in life as a result of decreased sperm count."

A female college student is distressed at the recent appearance of genital warts, an assessment finding that her care provider has confirmed as attributable to human papillomavirus (HPV) infection. Which of the following information should the care provider give the client? A) "There is a chance that these will clear up on their own without any treatment." B) "It's important to start treatment soon, so I will prescribe you pills today." C) "Unfortunately, this is going to greatly increase your chance of developing pelvic inflammatory disease." D) "I'd like to give you an HPV vaccination if that's okay with you."

A) "There is a chance that these will clear up on their own without any treatment."

A client asks the health care provider to, "Explain this brachytherapy they want to do for my cervical cancer again." The response should include which of the following statements? A) "They will insert a radioactive device into your vagina, position it next to the cervix, so that curative levels of radiation are directly on the cancer site." B) "The physician will take you to surgery, place your legs in the stirrups, and irrigate your entire vaginal cavity with radioactive water. Then they will pack your vaginal with sterile packing." C) "You will go to the x-ray department where they will insert a device in your vagina until it touches the cervix and then turn on a laser." D) "You will come to the radiation department daily for at least 4 weeks where they will insert a device and shine a beam on your cervical cancer area, hoping for it to burn the cancer off."

A) "They will insert a radioactive device into your vagina, position it next to the cervix, so that curative levels of radiation are directly on the cancer site."

The primary reason genital herpes has reached epidemic proportions throughout the world relates to the fact that: A) A large percentage (70%) of those infected experience no symptoms of the disease. B) The lesions (LSILs) occur on the cervix and can only be detected by a Pap test. C) Lesions take a long time to incubate and the small papules are usually located inside the vagina. D) The organism spreads upward to the prostate gland in males and fallopian tubes in females.

A) A large percentage (70%) of those infected experience no symptoms of the disease.

A client has been diagnosed with an anterior pituitary tumor, and synthesis and release of follicle-stimulating hormone has become deranged. What are the potential consequences of this alteration in endocrine function? A) Dysfunction of spermatogenesis B) Overproduction of luteinizing hormone C) Inhibition of testosterone synthesis D) Impaired detumescence

A) Dysfunction of spermatogenesis

Which of the following would be considered a structural abnormality or disease process that could cause menstrual pain known as secondary dysmenorrhea? Select all that apply. A) Endometriosis B) Uterine fibroids C) Cervicitis D) Cystocele E) Rectocele

A) Endometriosis B) Uterine fibroids

A client presents to a STI clinic. Her primary complaint is related to purulent exudate and bleeding after intercourse. The health care worker will primarily focus on the diagnosis of which STI? A) Gonorrhea B) Chlamydial infection C) Human papillomavirus infection D) Genital herpes simplex virus infection

A) Gonorrhea

Which of the following processes is a component of the pathogenesis of proliferative breast lesions without atypia? A) Growth of ductile or lobular epithelial cells B) Cystic dilation of terminal ducts C) Increase in fibrous breast tissue D) Fat necrosis leading to lesion formation

A) Growth of ductile or lobular epithelial cells

A female client presents an STD clinic. She is in the first trimester of pregnancy and has tested positive for gonorrhea. Because strains of N. gonorrhoeae have become resistant to penicillin, the current treatment recommendation includes: A) High-dose cefixime given in a single dose B) Ten-day supply of Flagyl C) Doxycycline over the course of 1 week D) No treatment until after the baby is born

A) High-dose cefixime given in a single dose

A male diagnosed with gonorrhea will likely complain of which of the following clinical manifestations? Select all that apply. A. Creamy, yellow discharge B. Pain in the urethra with urination C. Difficulty starting a stream of urine D. "Fish"-smelling discharge from the penis E. Diffuse pelvic pain

A, B In men, the initial symptoms of gonorrhea include urethral pain and a creamy, yellow, sometimes bloody, discharge. Candidiasis, trichomoniasis, and bacterial vaginosis are vaginal infections that can be sexually transmitted, and the male partner usually is asymptomatic. Chancroid causes genital ulcers; the lesions begin as macules, progress to pustules, and then rupture.

Which of the following clinical manifestations are characteristic for clients with Peyronie disease? Select all that apply. A. Painful erection B. Thick, yellow discharge from the penis C. Presence of a hard mass on the tunica albuginea of the penis D. Papillary lesions on penis filled with serous-colored fluid E. Thick, nonretractable foreskin of uncircumcised male

A, C Peyronie disease involves a localized and progressive fibrosis of unknown origin that affects the tunica albuginea (i.e., the tough, fibrous sheath that surrounds the corpora cavernosa) of the penis. The manifestations of Peyronie disease include painful erection, bent erection, and the presence of a hard mass at the site of fibrosis. Approximately two thirds of men complain of pain as a symptom. Discharge and lesions from the penis is usually caused from infections or STDs. Thick, nonretractable foreskin of uncircumcised male is associated with balanitis xerotica obliterans.

During a physical exam of a newborn, the nurse palpates the scrotal sac and only locates one testicle. Which statement about undescended testicles is most accurate? A- "The child can become infertile later in life as a result of decreased sperm count." B- This is more common in full-term infant when compared to premature births." C- "This may be a precursor to the development of prostate cancer later in life." D- "The child will need surgery to move the testes back into the scrotal sac since they rarely descend spontaneously."

A- "The child can become infertile in life as a result of decreased sperm count."

A client is complaining to the health care provider about several vague signs/symptoms. Which of the following raises a "red flag" indicating the client may have developed endometrial cancer? A. Painless abnormal bleeding B. Difficulty emptying the bladder C. Small, atrophied ovaries D. Lumps palpated in her breasts

A. Painless abnormal bleeding

An 18-month-old boy is diagnosed with cryptorchidism. Based on this diagnosis, which of the following does the nurse expect to observe during the physical assessment? a) Testes that are hard and difficult to palpate b) Enlargement of the scrotum c) Absence of the testis in the scrotum bilaterally d) Testes that migrate into the abdomen when the child squats

Absence of the testis in the scrotum bilaterally Cryptorchidism is the failure of the testes to descend into the scrotum.

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? a) Acute bacterial prostatitis requiring antimicrobial therapy b) Testicular cancer requiring appointment with an urologist c) Inflammation of the epididymis requiring scrotal elevation d) Urinary tract infection requiring a prescription of sulfur drugs

Acute bacterial prostatitis requiring antimicrobial therapy Manifestations of acute bacterial prostatitis include fever and chills, malaise, frequent and urgent urination, and dysuria. The urine may be cloudy and malodorous because of urinary tract infection. Rectal examination reveals a swollen, tender prostate. During exam, prostatic massage produces a thick discharge with WBCs that grows a large numbers of pathogens on culture.

Which of the following clients is at high risk for developing acute bacterial prostatitis? A) A middle-aged male with prostate hyperplasia B) A fifth grade male diagnosed with acute pyelonephritis C) An elderly male diagnosed with frequent UTIs testing positive for gram-negative rods D) A sickle cell anemia client complaining of prolonged erection lasting less than 4 hours

C) An elderly male diagnosed with frequent UTIs testing positive for gram-negative rods

While in its dormant state, herpes simplex virus resides and replicates in the: A. Local lymph nodes B. Subcutaneous tissue C. Mucous membrane D. Dorsal root ganglia

D In genital herpes, the virus ascends through the peripheral nerves to the sacral dorsal root ganglia. The virus can remain dormant in the dorsal root ganglia, or it can reactivate, in which case the viral particles are transported back down the nerve root to the skin, where they multiply and cause a lesion to develop. During the dormant or latent period, the virus replicates in a different manner so that the immune system or available treatments have no effect on it. Local lymph nodes respond to the inflammation of reactivation; the mucous membrane becomes erythematous and painful when lesions form; subcutaneous tissue is not damaged by the vesicles and shallow ulcerations.

Which of the following events is associated with the primary stage of syphilis? A. Development of gummas B. Development of central nervous system lesions C. Palmar rash D. Genital chancres

D Primary syphilis is characterized by the appearance of a chancre at the site of exposure. A rash on the palms is associated with secondary syphilis, whereas gummas and central nervous system (CNS) lesions are indicative of tertiary syphilis.

A 17 yr old male has developed phimosis to the point that he is having difficulty voiding. The nurse should prepare the teenager for A. Injection of lidocaine into the head of the penis B. Radiation therapy to loosen the foreskin C. Traumatic retraction of the foreskin D. Circumcision

D. Circumcision

An elderly female has slowly developed dementia and loss of vision. She is being evaluated for nursing home placement. Routine admission blood work reveals that the client tested positive for which STI associated with her current symptoms? A. Human papillomavirus symptoms B. Chlamydia C. Gonorrhea D. Tertiary syphilis

D. Tertiary syphilis

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 hematocele is an accumulation of blood in the tunica vaginalis, which causes the scrotal skin to become dark red or purple. It may develop as a result of an abdominal surgical procedure, scrotal trauma, a bleeding disorder, or a testicular tumor. This client sustained an injury to the scrotal area that created the hematocele. A spermatocele is a painless, sperm-containing cyst that forms at the end of the epidydmis. Spermatoceles are freely movable and transilluminate. A varicocele is characterized by varicosities of the pampiniform plexus, a network of veins supplying the testes. The left side of the scrotum is more commonly affected. A hydrocele forms when excess fluid collecting between the layers of the tunica vaginalis.

Chapter 45: Disorders of the Female Reproductive System, Quiz Thirteen, Chapter 39: Disorders of the Male Genitourinary System-Patho Level 3, Ch. 40 Pathophysiology, Ch. 39 Pathophysiology, Patho Ch 39 Disorders of Male GU, Patho Quiz 1, Patho Final...

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