CH 25 Male GU

Question 1

The mother of a 10-year-old boy asks the nurse to discuss the recognition of puberty. The nurse should reply by saying:
a.
Puberty usually begins around 15 years of age.
b.
The first sign of puberty is an enlargement of the testes.
c.
The penis size does not increase until about 16 years of age.
d.
The development of pubic hair precedes testicular or penis enlargement.

Answer 1

b.

The first sign of puberty is an enlargement of the testes.

Question 2

When performing a genital examination on a 25-year-old man, the nurse notices deeply pigmented, wrinkled scrotal skin with large sebaceous follicles. On the basis of this information, the nurse would:

a. Squeeze the glans to check for the presence of discharge.
b. Consider this finding as normal, and proceed with the examination.
c. Assess the testicles for the presence of masses or painless lumps.
d. Obtain a more detailed history, focusing on any scrotal abnormalities the patient has noticed.

Answer 2

b. Consider this finding as normal, and proceed with the examination.

Question 3

Which statement concerning the testes is true?

a. The lymphatic vessels of the testes drain into the abdominal lymph nodes.
b. The vas deferens is located along the inferior portion of each testis.
c. The right testis is lower than the left because the right spermatic cord is longer.
d. The cremaster muscle contracts in response to cold and draws the testicles closer to the body.

Answer 3

d. The cremaster muscle contracts in response to cold and draws the testicles closer to the body.

Question 4

A male patient with possible fertility problems asks the nurse where sperm is produced. The nurse knows that sperm production occurs in the:

a. Testes.
b. Prostate.
c. Epididymis.
d. V as deferens.

Answer 4

a. Testes.

Question 5

A 62-year-old man states that his physician told him that he has an inguinal hernia. He asks the nurse to explain what a hernia is. The nurse should:

a. Tell him not to worry and that most men his age develop hernias.
b. Explain that a hernia is often the result of prenatal growth abnormalities.
c. Refer him to his physician for additional consultation because the physician made the initial diagnosis.
d. Explain that a hernia is a loop of bowel protruding through a weak spot in the abdominal muscles.

Answer 5

d. Explain that a hernia is a loop of bowel protruding through a weak spot in the abdominal muscles.

Question 6

The mother of a 10-year-old boy asks the nurse to discuss the recognition of puberty. The nurse should reply by saying:

a. Puberty usually begins around 15 years of age.
b. The first sign of puberty is an enlargement of the testes.
c. The penis size does not increase until about 16 years of age.
d. The development of pubic hair precedes testicular or penis enlargement.

Answer 6

b. The first sign of puberty is an enlargement of the testes.

Question 7

During an examination of an aging man, the nurse recognizes that normal changes to expect would be:

Enlarged scrotal sac.
Increased pubic hair.
Decreased penis size.
Increased rugae over the scrotum.

Answer 7

Decreased penis size.

Question 8

An older man is concerned about his sexual performance. The nurse knows that in the absence of disease, a withdrawal from sexual activity later in life may be attributable to:

a. Side effects of medications.
b. Decreased libido with aging.
c. Decreased sperm production.
d. Decreased pleasure from sexual intercourse.

Answer 8

a. Side effects of medications.

Question 9

A 59-year-old patient has been diagnosed with prostatitis and is being seen at the clinic for complaints of burning and pain during urination. He is experiencing:

a. Dysuria.
b. Nocturia.
c. Polyuria.
d. Hematuria.

Answer 9

a. Dysuria.

Question 10

A 45-year-old mother of two children is seen at the clinic for complaints of losing my urine when I sneeze. The nurse documents that she is experiencing:

a. Urinary frequency.
b. Enuresis.
c. Stress incontinence.
d. Urge incontinence.

Answer 10

c. Stress incontinence.

Question 11

When the nurse is conducting sexual history from a male adolescent, which statement would be most appropriate to use at the beginning of the interview?

a. Do you use condoms?
b. You dont masturbate, do you?
c. Have you had sex in the last 6 months?
d. Often adolescents your age have questions about sexual activity.

Answer 11

d. Often adolescents your age have questions about sexual activity.

Question 12

Which of these statements is most appropriate when the nurse is obtaining a genitourinary history from an older man?
Do you need to get up at night to urinate?
Do you experience nocturnal emissions, or wet dreams?
Do you know how to perform a testicular self-examination?
Has anyone ever touched your genitals when you did not want them to?

Answer 12

Do you need to get up at night to urinate?

Question 13

When the nurse is performing a genital examination on a male patient, the patient has an erection. The nurses most appropriate action or response is to:

a. Ask the patient if he would like someone else to examine him.
b. Continue with the examination as though nothing has happened.
c. Stop the examination, leave the room while stating that the examination will resume at a later time.
d. Reassure the patient that this is a normal response and continue with the examination.

Answer 13

d. Reassure the patient that this is a normal response and continue with the examination.

Question 14

The nurse is examining the glans and knows which finding is normal for this area?

a. The meatus may have a slight discharge when the glans is compressed.
b. Hair is without pest inhabitants.
c. The skin is wrinkled and without lesions.
d. Smegma may be present under the foreskin of an uncircumcised male.

Answer 14

d. Smegma may be present under the foreskin of an uncircumcised male.

Question 15

When performing a genitourinary assessment, the nurse notices that the urethral meatus is ventrally positioned. This finding is:

a. Called hypospadias.
b. A result of phimosis.
c. Probably due to a stricture.
d. Often associated with aging.

Answer 15

a. Called hypospadias.

Question 16

The nurse is performing a genital examination on a male patient and notices urethral drainage. When collecting urethral discharge for microscopic examination and culture, the nurse should:

a. Ask the patient to urinate into a sterile cup.
b. Ask the patient to obtain a specimen of semen.
c. Insert a cotton-tipped applicator into the urethra.
d. Compress the glans between the examiners thumb and forefinger, and collect any discharge.

Answer 16

d. Compress the glans between the examiners thumb and forefinger, and collect any discharge.

Question 17

When assessing the scrotum of a male patient, the nurse notices the presence of multiple firm, nontender, yellow 1-cm nodules. The nurse knows that these nodules are most likely:

a. From urethritis.
b. Sebaceous cysts.
c. Subcutaneous plaques.
d. From an inflammation of the epididymis.

Answer 17

b. Sebaceous cysts.

Question 18

When performing a scrotal assessment, the nurse notices that the scrotal contents show a red glow with transillumination. On the basis of this finding the nurse would:

a. Assess the patient for the presence of a hernia.
b. Suspect the presence of serous fluid in the scrotum.
c. Consider this finding normal, and proceed with the examination.
d. Refer the patient for evaluation of a mass in the scrotum.

Answer 18

b. Suspect the presence of serous fluid in the scrotum.

Question 19

When the nurse is performing a genital examination on a male patient, which action is correct?

a. Auscultating for the presence of a bruit over the scrotum
b. Palpating for the vertical chain of lymph nodes along the groin, inferior to the inguinal ligament
c. Palpating the inguinal canal only if a bulge is present in the inguinal region during inspection
d. Having the patient shift his weight onto the left (unexamined) leg when palpating for a hernia on the right side

Answer 19

d. Having the patient shift his weight onto the left (unexamined) leg when palpating for a hernia on the right side

Question 20

The nurse is aware of which statement to be true regarding the incidence of testicular cancer?

a. Testicular cancer is the most common cancer in men aged 30 to 50 years.
b. The early symptoms of testicular cancer are pain and induration.
c. Men with a history of cryptorchidism are at the greatest risk for the development of testicular cancer.
d. The cure rate for testicular cancer is low.

Answer 20

c. Men with a history of cryptorchidism are at the greatest risk for the development of testicular cancer.

Question 21

The nurse is describing how to perform a testicular self-examination to a patient. Which statement is most appropriate?

a. A good time to examine your testicles is just before you take a shower.
b. If you notice an enlarged testicle or a painless lump, call your health care provider.
c. The testicle is egg shaped and movable. It feels firm and has a lumpy consistency.
d. Perform a testicular examination at least once a week to detect the early stages of testicular cancer.

Answer 21

b. If you notice an enlarged testicle or a painless lump, call your health care provider.

Question 22

A 2-month-old uncircumcised infant has been brought to the clinic for a well-baby checkup. How would the nurse proceed with the genital examination?

a. Eliciting the cremasteric reflex is recommended.
b. The glans is assessed for redness or lesions.
c. Retracting the foreskin should be avoided until the infant is 3 months old.
d. Any dirt or smegma that has collected under the foreskin should be noted.

Answer 22

c. Retracting the foreskin should be avoided until the infant is 3 months old.

Question 23

A 2-year-old boy has been diagnosed with physiologic cryptorchidism. Considering this diagnosis, during assessment the nurse will most likely observe:

a. Testes that are hard and painful to palpation.
b. Atrophic scrotum and a bilateral absence of the testis.
c. Absence of the testis in the scrotum, but the testis can be milked down.
d. Testes that migrate into the abdomen when the child squats or sits cross-legged.

Answer 23

c. Absence of the testis in the scrotum, but the testis can be milked down.

Question 24

The nurse knows that a common assessment finding in a boy younger than 2 years old is:

a. Inflamed and tender spermatic cord.
b. Presence of a hernia in the scrotum.
c. Penis that looks large in relation to the scrotum.
d. Presence of a hydrocele, or fluid in the scrotum.

Answer 24

d. Presence of a hydrocele, or fluid in the scrotum.

Question 25

When performing a genital assessment on a middle-aged man, the nurse notices multiple soft, moist, painless papules in the shape of cauliflower-like patches scattered across the shaft of the penis. These lesions are characteristic of:

a. Carcinoma.
b. Syphilitic chancres.
c. Genital herpes.
d. Genital warts.

Answer 25

d. Genital warts.

Question 26

A 15-year-old boy is seen in the clinic for complaints of dull pain and pulling in the scrotal area. On examination, the nurse palpates a soft, irregular mass posterior to and above the testis on the left. This mass collapses when the patient is supine and refills when he is upright. This description is consistent with:

a. Epididymitis.
b. Spermatocele.
c. Testicular torsion.
d. V aricocele.

Answer 26

d. V aricocele.

Question 27

When performing a genitourinary assessment on a 16-year-old male adolescent, the nurse notices a swelling in the scrotum that increases with increased intra-abdominal pressure and decreases when he is lying down. The patient complains of pain when straining. The nurse knows that this description is most consistent with a(n) ______ hernia.

a. Femoral
b. Incisional
c. Direct inguinal
d. Indirect inguinal

Answer 27

d. Indirect inguinal

Question 28

When the nurse is performing a testicular examination on a 25-year-old man, which finding is considered normal?

a. Nontender subcutaneous plaques
b. Scrotal area that is dry, scaly, and nodular
c. Testes that feel oval and movable and are slightly sensitive to compression
d. Single, hard, circumscribed, movable mass, less than 1 cm under the surface of the testes

Answer 28

c. Testes that feel oval and movable and are slightly sensitive to compression

Question 29

The nurse is inspecting the scrotum and testes of a 43-year-old man. Which finding would require additional follow-up and evaluation?

a. Skin on the scrotum is taut.
b. Left testicle hangs lower than the right testicle.
c. Scrotal skin has yellowish 1-cm nodules that are firm and nontender.
d. Testes move closer to the body in response to cold temperatures.

Answer 29

a. Skin on the scrotum is taut.

Question 30

A 55-year-old man is experiencing severe pain of sudden onset in the scrotal area. It is somewhat relieved by elevation. On examination the nurse notices an enlarged, red scrotum that is very tender to palpation. Distinguishing the epididymis from the testis is difficult, and the scrotal skin is thick and edematous. This description is consistent with which of these?

a. V aricocele
b. Epididymitis
c. Spermatocele
d. Testicular torsion

Answer 30

b. Epididymitis

Question 31

The nurse is performing a genitourinary assessment on a 50-year-old obese male laborer. On examination, the nurse notices a painless round swelling close to the pubis in the area of the internal inguinal ring that is easily reduced when the individual is supine. These findings are most consistent with a(n) ______ hernia.

a. Scrotal
b. Femoral
c. Direct inguinal
d. Indirect inguinal

Answer 31

c. Direct inguinal

Question 32

The nurse is providing patient teaching about an erectile dysfunction drug. One of the drugs potential side effects is prolonged, painful erection of the penis without sexual stimulation, which is known as:

a. Orchitis.
b. Stricture.
c. Phimosis.
d. Priapism.

Answer 32

d. Priapism.

Question 33

During an examination, the nurse notices that a male patient has a red, round, superficial ulcer with a yellowish serous discharge on his penis. On palpation, the nurse finds a nontender base that feels like a small button between the thumb and fingers. At this point the nurse suspects that this patient has:

a. Genital warts.
b. Herpes infection.
c. Syphilitic chancre.
d. Carcinoma lesion.

Answer 33

c. Syphilitic chancre.

Question 34

During a health history, a patient tells the nurse that he has trouble in starting his urine stream. This problem is known as:

a. Urgency.
b. Dribbling.
c. Frequency.
d. Hesitancy.

Answer 34

d. Hesitancy.

Question 35

During a genital examination, the nurse notices that a male patient has clusters of small vesicles on the glans, surrounded by erythema. The nurse recognizes that these lesions are:

a. Peyronie disease.
b. Genital warts.
c. Genital herpes.
d. Syphilitic cancer.

Answer 35

c. Genital herpes.

Question 36

During a genital examination, the nurse notices that a male patient has clusters of small vesicles on the glans, surrounded by erythema. The nurse recognizes that these lesions are:

a. Peyronie disease.
b. Genital warts.
c. Genital herpes.
d. Syphilitic cancer.

Answer 36

c. Genital herpes.

Question 37

During a genital examination, the nurse notices that a male patient has clusters of small vesicles on the glans, surrounded by erythema. The nurse recognizes that these lesions are:

a. Peyronie disease.
b. Genital warts.
c. Genital herpes.
d. Syphilitic cancer.

Answer 37

d. Syphilitic cancer.

Question 38

During a physical examination, the nurse finds that a male patients foreskin is fixed and tight and will not retract over the glans. The nurse recognizes that this condition is:

a. Phimosis.
b. Epispadias.
c. Urethral stricture.
d. Peyronie disease.

Answer 38

a. Phimosis.