Health Assessment Test III (Chapter 24)

While examining a patient's penis, the nurse finds that the patient has a narrow, red, and edematous urethral meatus with purulent discharge. What does the nurse infer from these findings? A. The patient has urethritis. B. The patient has phimosis. C. The patient has hydrocele. D. The patient has cryptorchidism.

A

A patient reports an enlarged scrotum with acute testicular pain. The nurse is not able to distinguish the epididymis from the testis during palpation. What condition should the nurse infer from the findings? A. Orchitis B. Varicocele C. Spermatocele D. Diffuse testicular tumor

A (A tender and swollen testis and acute pain in the scrotal area indicate that the patient has orchitis. In this condition the nurse cannot distinguish the epididymis from the testicles. Clinical findings of varicocele include dull pain in the inguinal area. Clinical findings of spermatocele include a painless, cystic mass on the epididymis, which feels like a third testis upon palpation. Clinical findings of diffuse testicular tumors include enlarged, swollen testes, which are soft and firm to palpate.)

Which is the most common sign in patients having acute cystitis, prostatitis, and urethritis? A. Dysuria B. Polyuria C. Nocturia D. Oliguria

A (Dysuria refers to pain, burning, and discomfort during urination. In conditions such as acute cystitis, prostatitis, and urethritis, there is an inflammation of the urinary tract that results in dysuria. Polyuria refers to an increased frequency of urination due to the excessive production of urine, which may occur in patients with diabetes mellitus. Nocturia refers to the urgency and increased frequency of urination during night hours. Oliguria refers to a diminished quantity of urine due to decreased fluid intake or renal failure.)

A patient reports an involuntary, sustained, painful erection that is not associated with sexual arousal. Which condition does the patient have? A. Priapism B. Phimosis C. Epispadias D. Paraphimosis

A (Involuntary, sustained, and painful erection without any sexual stimulation is a condition referred to as priapism. Phimosis is a condition in which the foreskin cannot be retracted due to narrowed opening of the prepuce. If the urethral meatus is located dorsally, it indicates that the patient has epispadias. Painful constriction of the glans by a retracted foreskin indicates paraphimosis. )

Which laboratory parameter indicates decreased kidney function? A. Increased serum creatinine B. Increased blood urea nitrogen C. Increased glucose levels in the urine D. Increased red blood cell count in urine

A (Kidney function is assessed by checking the levels of creatinine in the serum. The normal range of creatinine is 0.7 to 1.5 mg/dL. When glomerular filtration rate (GFR) is less, the serum creatinine levels increase. Blood urea nitrogen (BUN) measures the content of urea in the urine, which is the end product of protein metabolism in the body. This also indicates decreased kidney function, but it is less specific. Increased sugar levels in the urine are indicative of diabetes mellitus. Increased red blood cells in the urine are an indication of urinary tract infection.)

The nurse is reviewing a patient's laboratory results and finds that the prostate-specific antigen (PSA) levels are elevated. What should the nurse ask the patient in order to confirm the accuracy of the test results? A. "Did you ejaculate in the last two days?" B. "Do you take the drug finasteride?" C. "Do you currently have a urinary tract infection?" D. "Does anyone in your family have prostate cancer?"

A (Prostate-specific antigen (PSA) is a screening test that helps to detect prostate cancer. Ejaculation increases PSA levels; therefore, the patient is usually instructed to refrain from ejaculation for 2 days prior to the test. Finasteride usually causes a decrease in the PSA levels. Urinary tract infections may affect the PSA levels. Having a family member with prostate cancer may indicate an increased risk, but will not confirm the accuracy of the test results.)

Which assessment technique reveals the presence of a nontender nodule during the physical assessment of a patient with a syphilitic chancre? A. Palpation B. Inspection C. Percussion D. Auscultation

A (Syphilis begins as a small, solitary, silvery papule that erodes and changes into a red round papule with yellowish serous discharge called a chancre. Palpation of the nodule reveals the presence of a nontender indurated base, which can be lifted up by a grasping action of the thumb and finger. Inspection refers to the visual observation of a body part that helps to elicit specific information. It cannot help to assess the tenderness of a papule. Percussion is useful in determining the size and shape of the internal organs; it is not helpful in assessing tenderness. Auscultation is the technique used to listen to body sounds; it cannot be used to assess tenderness.)

The nurse is reviewing the urinalysis reports of a patient. Which assessment findings does the nurse consider abnormal? A. Urine of pH 4 B. Absence of protein C. Absence of glucose D. Specific gravity of urine 1.028

A (The normal pH of urine is 4.5 to 8.0; therefore, a urine pH of 4.0 is abnormal. Normally, urine does not contain protein or glucose. Hence, the absence of protein and glucose is considered normal. The specific gravity of urine normally ranges from 1.003 to 1.030; therefore, a specific gravity of 1.028 is a normal finding.)

Which statement, if made by the nurse while instructing the patient about testicular self-examination, is appropriate? A. "You should perform self-examination monthly." B. "Perform testicular self-examination under cold water." C. "Report immediately if the testicle feels rubbery or smooth." D. "Use a thumb and first two fingers to hold the scrotum tightly."

A (The nurse instructs the patient to perform a testicular self-examination monthly to detect any abnormal lumps or lesions. The use of cold water will stimulate a muscle reflex and retract the scrotal contents. Therefore, the nurse should ask the patient to perform the testicular self-examination in the shower with warm water. The nurse should ask the patient to hold the scrotum gently, because too much pressure will cause pain. Normal testicles feel rubbery and have a smooth surface. Therefore, it is not necessary to report this finding to the primary health care provider.)

When should the nurse obtain a patient's sexual history? A. Before a genital examination B. During a genital examination C. After a genital examination D. Per the patient's inclination

A (The nurse obtains a sexual history before the genital examination. Information regarding sexual health practices will help in understanding the potential risks and help guide the nurse during the examination of the genitalia. The patient may not be comfortable during the examination and may perceive any discussion regarding personal sexual practices as judgmental. Performing the examination prior to the interview will not help in understanding which areas need a detailed examination. The patient may be unwilling or embarrassed to share information with the nurse. However, instead of depending on the patient's inclination, the nurse should inform the patient that sexual history is necessary to understand the patient's condition.)

On reviewing the laboratory reports of a patient, the nurse sees that the blood urea nitrogen level is 40 mg/dL. Which conditions does the nurse expect to find in the patient? Select all that apply. A. Decrease in fluid volume B. Increase in protein intake C. Red blood cells in the urine D. Increase in the glucose level E. Fever and burning urination

A, B (Blood urea nitrogen (BUN) measures urea, which is the end product of protein metabolism in the body. The normal range of BUN is 10 to 20 mg/dL. The BUN level may rise due to a decrease in fluid volume, which may occur as a result of diuresis or dehydration. High protein intake results in increased protein metabolism, which may also contribute to increased BUN levels. The presence of red blood cells in the urine indicates hematuria, which is a common sign of urinary tract infection. The increase in blood or urine glucose level indicates hyperglycemia associated with diabetes. Signs such as fever and burning micturition indicate urinary tract infection.)

Which interventions should the nurse perform to prevent eliciting the cremasteric reflex in an infant during the palpation of the inguinal region? Select all that apply. A. Palpate down from the external inguinal ring. B. Block the inguinal canals with the thumb and forefinger. C. Warm the hands before starting the palpation technique. D. Compress the glans anteroposteriorly between the thumb and forefinger. E. Palpate the shaft of the penis between the thumb and the first two fingers.

A, B, C (The cremasteric reflex is a superficial reflex in which the testis of a male is retracted in response to cold, touch, exercise, or emotion. This reflex is strong in infants. The nurse should palpate from the external inguinal ring down in order to prevent eliciting the reflex. The nurse should block the inguinal canals with the thumb and the forefinger of other hand to prevent the testes from retracting. The cremasteric reflex is initiated by cold; therefore, the nurse should warm the hands before palpation. Compressing the glans anteroposteriorly between the thumb and the forefinger helps to detect the presence of any urinary problems like stricture, which is a narrowed opening. The nurse should palpate the shaft of the penis between the thumb and the first two fingers in order to check for the presence of nodules or induration and tenderness of the penis. )

Which developmental changes would the nurse be able to observe in a male adolescent during physical examination? Select all that apply. A. Enlargement of the testis B. Increase in the penis size C. Appearance of pubic hair D. Pendulous appearance of the scrotum E. Descent of the testis along the inguinal canal

A, B, C (The nurse can observe the signs of puberty during physical examination in adolescents. Enlargement of the testis is the first sign of puberty, which starts around 10 years of age. Then the nurse should look for an increase in the penis size, followed by the appearance of pubic hair; the rate at which these changes occur can vary due to hormonal regulation, diet, and physical activity. The appearance of a pendulous scrotum occurs due to decreased muscle mass and rugae. It is seen in elderly males. Descent of the testis along the inguinal canal occurs before birth.)

Which conditions are examples of scrotal abnormalities? Select all that apply. A. Varicocele B. Epididymitis C. Hypospadias D. Paraphimosis E. Spermatocele

A, B, E (Varicocele, epididymitis, and spermatocele are abnormalities of the scrotum. Varicocele refers to the dilated, tortuous varicose veins in the spermatic cord caused by incompetent valves within the vein that permit the reflux of blood. Acute infection to the epididymis is known as epididymitis. Spermatocele is a cyst in the epididymis that is filled with a thin, milky fluid that contains sperm. Hypospadias and paraphimosis are abnormalities of the penis.)

What are the objective assessment findings recorded by the nurse after examining a male patient's genitourinary system? Select all that apply. A. Asymmetrical testis B. Pain while passing urine C. Voiding of urine 5 times/day D. Inflammation of the glans penis E. Presence of white discharge from the penis

A, D, E (After an assessment of the genitourinary system, the nurse documents the findings as subjective and objective. Objective findings are collected by the nurse through the skills of physical examination such as inspection and palpation. Objective findings include unevenness of the left and right testis; swollen, erythematous, tender glans penis; and the presence of white discharge from the penis. Subjective data include the data that is obtained from the history given by the patient. The frequency of urination (4 or 5 times/day) and pain while passing urine are subjective findings.)

A male patient expresses discomfort with a female nurse performing a genitalia examination. What action should the nurse take? A. Continue with the assessment and engage in friendly talk. B. Arrange to have a male nurse perform the physical assessment. C. Defer the physical assessment and record that the patient has refused it. D. Tell the patient that it is a professional matter and she has no personal interest in him.

B

The nurse finds an ulcer with watery discharge on the penis. The patient denies pain. Which condition does the nurse suspect? A. Dermatitis B. Carcinoma C. Cryptorchidism D. Syphilitic chancre

B (A painless ulcer with a watery discharge on the penis is a carcinoma. The ulcer grows and may necrose and slough. Cryptorchidism refers to an absence of testes. Syphilitic chancre is an ulcer with a yellowish, serous discharge. Dermatitis is an inflammation of the skin in which the skin becomes red and itchy.)

Before assessment, the health care provider instructs the nurse to perform a careful examination of the inguinal area of a 6-month-old child. What is the most likely reason for this instruction? A. It is a potential site for a tumor. B. It is a potential site for a hernia. C. It is a potential site for a chancre. D. It is a potential site for an infection.

B (Hernia is the protrusion of the abdominal contents through a canal. While examining an infant, the nurse should assess for inguinal hernia, because it is the most common type of hernia that occurs in infants. It is not required to assess for the presence of tumors in a 6-month-old infant, because most testicular or diffused tumors occur in patients between 18 and 35 years of age. A chancre is a painless ulcer formed during the primary stage of syphilis. It is a sexually transmitted infection; therefore, the presence of a chancre need not be assessed in a 6-month-old infant. Urinary tract infections occur due to poor hygiene, whereas sexually transmitted infections occur due to direct or indirect sexual contact. Therefore, infection need not be assessed for in a 6-month-old child. )

How would the nurse describe the inguinal lymph nodes? A. "The nodes receive drainage from the testes." B. "The nodes lie horizontally along the inguinal ligament." C. "The nodes receive drainage from the superficial regions of the leg and foot." D. "The nodes lie vertically below the junction of the saphenous and femoral veins."

B (The inguinal lymph nodes lie horizontally in a chain along the groin or the inguinal ligament. The inguinal lymph nodes lie vertically along the upper inner thigh. The nodes receive drainage from the lymphatics of the penis and the scrotal surface. The lymphatics of the testes drain into the abdomen.)

A patient's medical record shows the patient's urinary output is 200 mL per day. What does the nurse infer from this finding? A. The patient has dysuria. B. The patient has oliguria. C. The patient has polyuria. D. The patient has hematuria.

B (The normal range of urinary output per day is 400 to 2000 mL. If it is less than 400 mL per day, it indicates that the patient has oliguria, or diminished urine output. Because the patient's urinary output is 300 mL per day, the nurse infers that the patient has oliguria. Any pain or burning sensation with urination indicates dysuria. Excessive production of urine indicates polyuria. The presence of blood in the urine indicates hematuria.)

The nurse is instructing an 18-year-old patient how to perform a testicular self-exam as a part of self-care. Which statements by the patient indicate effective learning? Select all that apply. A. "I should perform testicular self-examination once in a year." B. "I should perform testicular self-examination while bathing." C. "I should report if the scrotum feels rubbery, tender, and enlarged." D. "I should use the thumb and the first two fingers to assess the testicles." E. "I should ensure that my hands are cold and soapy during the testicular examination."

B, C, D (Testicular self-examination (TSE) is a recommended self-examination practice for detecting any abnormalities of the testicles. During the examination, if the patient finds any changes in the testis such as tenderness, swelling, or a hard mass, it should be reported immediately to the health care provider. This helps to diagnose testicular abnormalities at an early stage. A good time to perform TSE is at the time of taking a bath, when the testicles are properly exposed. The patient should hold the scrotum in the palm of the hand, and gently assess each testicle using the thumb and two forefingers to detect abnormalities. The patient should perform TSE frequently. Performing TSE once a year is not beneficial, because this frequency may miss abnormal findings in the early stages. TSE should not be performed when the patient's hands are cold, because cold hands stimulate the cremasteric reflex and may cause the retraction of scrotum.)

What medical benefits does a female receive when her male sexual partner undergoes circumcision? Select all that apply. A. Reduced risk of genital warts B. Reduced risk of genital herpes C. Reduced risk of trichomoniasis D. Reduced risk of bacterial vaginosis E. Reduced risk of human papilloma virus infections

B, C, D (The area under the foreskin serves as a good breeding ground for bacteria and infection, but circumcision helps in preventing the growth and transmission of sexually transmitted infection. The medical benefits of male circumcision to female partners include a reduced risk of trichomoniasis, bacterial vaginosis, and human papillomavirus infection. Trichomoniasis is a sexually transmitted disease caused by the single-celled protozoan parasite Trichomonas vaginalis. Bacterial vaginosis is a vaginal disease caused by an imbalance of the vaginal flora. Human papillomavirus infections are transmitted by genital contact. Circumcised males receive medical benefits such as a reduced risk of acquiring genital warts and genital herpes.)

What is a characteristic of a direct inguinal hernia? A. It is acquired by loss of muscle substance. B. It is more common in infants younger than 1 year of age. C. It is a congenital weakness exacerbated by coughing or obesity. D. It is a painful swelling over the internal inguinal ring during straining.

C (A direct inguinal hernia is exacerbated by coughing or obesity because it may bulge due to strain. A direct inguinal hernia does not occur due to a loss of muscle substance but due to muscle atrophy. The disease occurs more often in men older than 40. The patient with a direct inguinal hernia has swelling close to the pubis inside the internal inguinal ring; however, it is painless.)

A 20-year-old white male has a history of undescended testes. Which condition is this patient at high risk of developing? A. Varicocele B. Prostate cancer C. Testicular cancer D. Sexually transmitted infections

C (A history of undescended testes is the most important risk factor for cause testicular cancer. Testicular cancer is also more common in white males between the ages of 18 and 35. Sexually transmitted infections can occur in a sexually active patient who practices unsafe sex. Undescended testes are not a risk factor for prostate cancer; advanced age, African-American race, and having a first-degree relative with prostate cancer are risk factors for prostate cancer. Varicocele refers to the dilation of varicose veins in the spermatic cord.)

A patient presents with a genital infection. During the assessment, the nurse finds a small, round, silvery papule with a yellowish serous discharge. On palpation, the nurse finds a nontender button-like structure and enlarged lymph nodes in the inguinal region. Which medication may help treat this patient? A. HPV4 (Gardasil) B. Acyclovir (Zovirax) C. Penicillin G (Pfizerpen) D. Lidocaine-prilocaine cream (Oraqix)

C (A small, round, solitary, silvery papule with yellowish discharge and nontender lymph nodes indicate that the patient may have a syphilitic chancre. Syphilis is a sexually transmitted infection and can be easily treated using broad-spectrum antibiotics such as penicillin G (Pfizerpen). HPV4 (Gardasil) is a HPV vaccine used in the treatment of genital warts. Acyclovir (Zovirax) is used in the treatment of genital herpes. Lidocaine-prilocaine cream (Oraqix) is used to prevent pain during the circumcision procedure. )

A patient presents with clusters of painful vesicles and eruptions on the glans and foreskin of the penis. Which drug could be prescribed to treat this condition? A. HPV4 (Gardasil) B. Penicillin G (Pfizerpen) C. Oral acyclovir (Zovirax) D. Lidocaine-prilocaine cream (EMLS)

C (Clusters of painful vesicles and eruptions on the glans and foreskin indicate that the patient has genital herpes. Genital herpes is a sexually transmitted infection, the acute stage of which lasts for 7 to 10 days. Oral acyclovir (Zovirax) is the most commonly used antiviral drug used in the treatment of herpes simplex and varicella zoster viral infections. HPV4 (Gardasil) is a vaccine recommended for use in the prevention of genital warts. Penicillin G (Pfizerpen) is derived from a group of antibiotics and is effective against some sexually transmitted infections, such as syphilis. Lidocaine-prilocaine cream (EMLA) is a local anesthetic used during minor and treatable invasive procedures. )

What condition does the nurse suspect in the patient whose creatinine level is 3.0 mg/dL? A. Urinary tract infection B. Renal calculi formation C. Decreased kidney function D. Hyperglycemia associated with diabetes mellitus

C (Creatinine is an indicator of kidney function, and the normal range is 0.7 to 1.5 mg/dL. A creatinine level of 3.0 mg/dL indicates decreased kidney function. Urinary tract infections may result when there is a high count of white blood cells in the urine. Renal calculi may be suspected if there are red blood cells in the urine. Hyperglycemia associated with diabetes mellitus results in the presence of glucose in the urine. )

While reviewing the assessment reports of a patient, the nurse finds that the patient has lower abdominal pain, nausea, vomiting, and a sudden onset of unilateral pain in the testicles. Upon performing palpation, the nurse finds that the spermatic cord is thick, swollen, and tender. Which condition does the nurse expect to find in the patient? A. Varicocele B. Epididymitis C. Testicular torsion D. Early testicular tumor

C (Sudden twisting of the spermatic cord results in the sudden onset of unilateral pain in the testicle during sleep or trauma. This indicates testicular torsion, which usually occurs on the left side. Symptoms of testicular torsion include abdominal pain, nausea, and vomiting. The spermatic cord feels thick, swollen, and tender to palpate due to the obstruction of blood supply. Varicocele refers to the dilated, tortuous, varicose veins in the spermatic cord; it is caused by the incompetent valves within the vein. Clinical findings of varicocele include dull pain. The acute infection of the epididymis is known as epididymitis. It is characterized by the sudden onset of pain in the scrotum, rapid swelling, and fever. Early testicular tumors can occur due to an undescended testis. They are characterized by swelling of the testis, which is hard and firm to palpate. )

When does sperm production start decreasing in an adult? A. Around 30 years of age B. Around 60 years of age C. Around 40 years of age D. Around 80 years of age

C (The aging adult male may experience age-related changes but does not experience a definite end to fertility. Around the age of 40 years, there is a drastic reduction in testosterone levels, which directly affects the production of sperm. Testosterone production starts decreasing after 30 years of age. However, a reduction in testosterone levels is not sufficient to cause a decrease in sperm production until the age of 40. Rapid detumescence may occur after 60 years of age due to less forceful and shorter sperm ejaculation. The adult may experience all aging-related changes at around 80 years of age.)

When do the testes enlarge and pubic hair appears in males? A. Between 7 and 8 years of age B. Between 8 and 9 years of age C. Between 12 and 16 years of age D. Between 18 and 20 years of age

C (The appearance of pubic hair and enlargement of the testes occur during adolescent years between the ages of 12 and 16 years. Penis size is smaller in young boys until puberty. Therefore, the enlargement of the testes will not be seen in a child between the ages of 7 and 9 years. Pubic hair also appears with puberty. The age of 18 to 20 years is past puberty. Therefore, pubic hair and enlargement of the testes will have already occurred by this time.)

The nurse teaches a patient about testicular self-examination. Which statement would be appropriate for the nurse to include? A "Testicular cancer usually affects men after 50 years of age." B. "Avoid self-examination because lesions are difficult to detect." C. "The cure rate of testicular cancer is almost 100% when detected early." D. "There is no need to worry if any hard lumps on the testicles are painless."

C (The cure rate of testicular cancer is almost 100% if the treatment begins before metastasis. The nurse should instruct the patient to report any painless hard lumps on the testicles, because some tumors are painless. The nurse should teach testicular self-examination to the patient, because the patient can detect any lumps and report immediately. Testicular cancer usually occurs in males between 15 and 35 years of age.)

Where is the erectile tissue located in males? A. Epididymis B. Scrotum C. Corpora cavernosa D. Cremaster muscle

C (The erectile tissue of the penis is located in the corpora cavernosa. The epididymis is a coiled duct system and stores the sperm. The scrotum is a loose, protective sac that contains the testicles. The cremaster muscle does not contain the erectile tissue; it covers the testes.)

Which condition is caused by hyperactivity of the detrusor muscle? A. Nocturia B. Urinary retention C. Urge incontinence D. Stress incontinence

C (The overactive detrusor muscle causes an urge to urinate, which may in turn result in the leakage of urine. This condition is referred to as urge incontinence. Nocturia is a condition in which the patient frequently wakes up during the nighttime to urinate. Any obstruction to the passage of urine causes urinary retention. Involuntary urine loss during coughing and sneezing is caused by weakness of the pelvis floor and indicates stress incontinence.)

A middle-aged patient reports painful bending of his penis during erection. Upon palpation, the nurse finds nontender and subcutaneous plaques on the dorsal surface of the penis. What condition will the nurse infer from the findings? A. Priapism B. Paraphimosis C. Peyronie disease D. Syphilitic chancre

C (The presence of hard, nontender, and subcutaneous plaques on the dorsal or lateral surface of the penis indicates Peyronie disease. These plaques cause painful bending of the penis during erection. It usually occurs after 45 years of age. Prolonged painful erection of the penis without sexual stimulation that is unrelieved by intercourse indicates priapism. It occurs in patients who are 30 to 40 years old. Painful constriction of the glans due to a retracted foreskin indicates paraphimosis. Superficial ulcers with yellowish serous discharge indicate syphilitic chancre.)

While performing a genital examination of a male infant, the nurse sees that the infant's urethral meatus is located ventrally. Which condition does the infant have? A. Phimosis B. Epispadias C. Hypospadias D. Paraphimosis

C (The urethral meatus is generally positioned at the center of the penis. Hypospadias is a congenital birth defect in which the urinary meatus is located ventrally in the infant. Phimosis is a condition in which the foreskin cannot be retracted due to a narrowed opening of the prepuce. If the urethral meatus is located dorsally, it indicates that the infant has epispadias. Painful constriction of the glans by a retracted foreskin is referred to as paraphimosis. )

A patient approaches the nurse saying, "I involuntarily pass a small amount of urine and my underwear is always wet." What does the nurse infer from the patient report? A. The patient may have polyuria. B. The patient may have oliguria. C. The patient may have urinary incontinence. D. The patient may have a urinary tract infection.

C (Urinary incontinence refers to the involuntary leakage of urine. It may be due to physical stress, aging, or weakness of the pelvic floor muscles. The signs and symptoms of urinary incontinence include leakage of urine when a patient sneezes, laughs, and coughs. Polyuria is the elimination of an excessive quantity of urine, characterized by frequent urination and frequent intake. Oliguria is the reduced production of urine, characterized by decreased water intake and urine output less than 100 mL/day. Urinary tract infection refers to the invasion of a pathogen into the urinary tract, and is characterized by frequent, burning urination.)

How would a normal epididymis feel in a male patient? A. Rough B. Tender C. Firm and rubbery D. Softer than the testes

D (A normal epididymis is softer than the testis and feels discrete. The epididymis is not rough but feels smooth on palpation. The testes will feel firm and rubbery, but the epididymis will not.)

While performing a routine physical assessment, the nurse asks a patient about any difficulty in urination, any dribbling, incomplete emptying, and straining during urination. What is the reason for these questions? A. To determine if the patient has nocturia B. To distinguish phimosis from paraphimosis C. To find out if the patient has urinary incontinence D. To identify the early symptoms of an enlarging prostate

D (An increase in prostate size may block the passage of urine and cause incomplete emptying of the bladder, dribbling, and difficulty in urination. The nurse may ask about these findings during history collection to determine whether the patient has prostate enlargement. Nocturia refers to excessive urination during the night and is characterized by the urgency to urinate. Urinary incontinence is the involuntary leaking of urine, which occurs due to weakness of the pelvic floor muscles or overactivity of the detrusor muscle. Phimosis and paraphimosis are abnormal findings of the penis in which the foreskin on the glans cannot be retracted or reduced, respectively.)

While caring for a patient with benign prostatic hyperplasia (BPH), the nurse finds that the patient is unable to urinate and has abdominal pain. Which condition does the nurse suspect in the patient? A. Oliguria B. Urethritis C. Urethral stricture D. Acute urinary retention

D (Benign prostatic hyperplasia causes obstruction to the bladder and bladder distention, which cause the inability to pass urine. The sudden inability to pass urine and abdominal pain indicate acute urinary retention. A diminished quantity of urine production indicates oliguria. Painful burning sensations during urination indicate that the patient may have urethritis. A pinpointed and constricted opening of the meatus or constriction along the internal part of the urethra indicates urethral stricture.)

What is hypospadias? a. A foreskin that cannot be retracted b. A painful penile bending during erection c. A urethral meatus on the dorsal side of the penis d. A urethral meatus at a proximal, ventral site on the penis

D (Hypospadias is a congenital defect in which the urethral meatus opens on the ventral side of the penis. Phimosis is a defect in which the foreskin cannot retract because of a narrow opening of the prepuce. Peyronie disease is painful penile bending during erection. Epispadias is a defect in which the urethral meatus is on the dorsal side of the penis.)

What would transillumination of a normal adult scrotal sac reveal? A. The presence of hydrocele B. The presence of a faint pink glow C. The presence of blood in the scrotum D. Scrotal contents as dark masses with regular borders

D (Normal scrotal contents will not transilluminate and will appear as dark masses with regular borders. Hydrocele may transilluminate as a faint pink glow and may be associated with orchitis in adults. Blood does not transilluminate and should not be present in the scrotum.)

What is a characteristic of spermatogenesis? A. Spermatogenesis occurs in the epididymis. B. Spermatogenesis requires a temperature less than 42° C. C. Spermatogenesis occurs at a temperature greater than 38° C. D. Spermatogenesis is protected by movement of the scrotum.

D (Spermatogenesis refers to the process of sperm cell development that is protected by movement of the scrotum. The cremaster muscle of the scrotum contracts when it is cold and relaxes when it is warmer. This keeps the testes at 3° C below the abdominal temperature, which is the best temperature for sperm production. Therefore, spermatogenesis does not occur at a temperature greater than 38° C or less than 42° C. It occurs in response to the change in abdominal temperature. Spermatogenesis does not occur in the epididymis. The epididymis is a coiled duct system and stores the sperm.)

Which structure controls the size of the scrotum? A. Frenulum B. Epididymis C. Inguinal canal D. Cremaster muscle

D (The cremaster muscle is located in the wall of the scrotal sac. It controls the size of the scrotum by responding to the surrounding temperature. The frenulum is a fold of the foreskin extending from the urethral meatus ventrally. The epididymis is a comma-shaped structure, curved over the top and the posterior surface of the testis, which stores sperm. The inguinal canal is a narrow tunnel passing obliquely between the layers of the abdominal muscle. These structures are not associated with the shape and size of the scrotum.)

Chart/Exhibit The nurse is reviewing the data obtained on the examination of a male genitourinary system. Which assessment finding does the nurse consider normal? A. Tender scrotal sac B. Narrow prepuce opening C. Hard and enlarged lymph nodes D. Left scrotal sac is lower than right

D (The left scrotal sac appears low because the left testis has a longer spermatic cord when compared to the right testis. The scrotal sac is not usually tender. Tenderness of the scrotal sac may be indicative of inflammation of the scrotal contents. A narrowed opening of the prepuce indicates phimosis, which is an abnormal finding. Hard and enlarged nodes in the inguinal area may be indicative of tumor and hernia. )

The nurse is performing a physical examination of a male patient's genitourinary system. Which position would be best to assess the presence of hernia? A. Prone position B. Sitting position C. Supine position D. Standing position

D (The presence of hernia can be checked by instructing the patient to stand. In this position, gravity assists the downward movement of the herniated content, which may help the nurse to palpate the hernia with ease. The nurse cannot examine the male genitalia in the prone position, because it is not well exposed in the prone position. The genital region is not adequately exposed in the sitting position. The examiner should be in the sitting position while the patient is in the standing position. This position helps the nurse to identify abnormal findings at eye level. In the supine position, gravity assists the retraction of the herniated contents. Therefore, the nurse should not assess for hernia in the supine position.)

The nurse teaches a student about the functions of the male genital structures. Which statement, if made by the student, indicates a need for further instruction? A. "The testis produces sperm." B. "The epididymis stores the sperm." C. "The prostate produces ejaculatory fluid." D. "The seminal vesicles form the spermatic cord."

D (The vas deferens, a muscular duct, joins the duct of the seminal vesicle and forms the ejaculatory duct, not the spermatic cord. The testes that lie in each scrotal half produce sperm. The epididymis is a coiled duct system and stores the sperm. The prostate produces the ejaculatory fluid that helps sperm viability.)