NURS 317 Unit 4 Chapter 42 Path Point Questions Flashcards
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) “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.”
Rationale: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 are altered.
Which clinical manifestations in an aging male client are due to decreased levels of testosterone? Select all that apply.
A) Decreased sexual energy
B) Testicular torsion
C) Increased muscle strength
D) Decreased testicular size
E) Infertility
A) Decreased sexual energy
D) Decreased testicular size
E) Infertility
Rationale:Decreasing levels of testosterone affect sexual energy, muscle strength, and the genital tissues. The testes become smaller and lose their firmness. The seminiferous tubules, which produce spermatozoa, thicken and begin a degenerative process that finally inhibits sperm production, resulting in a decrease in viable spermatozoa. Testicular torsion is not related to level of testosterone.
When asked if it is possible for a woman who is not using birth control to become pregnant if she has unprotected sexual intercourse 1 to 2 days before she ovulates, how should the nurse respond?
A) “Yes, sperm can live 2 to 4 days in the female genital tract.”
B) “Yes, sperm can live 1 to 2 days in the female genital tract.”
C) “No, sperm can only live 1 to 2 hours in the female genital tract.”
D) “No, sperm can live only 2 to 4 hours in the female genital tract.”
B) “Yes, sperm can live 1 to 2 days in the female genital tract.”
Rationale:Sperm can live 1 to 2 days in the female genital tract; therefore it is possible for a woman who is not using birth control to become pregnant through unprotected sexual intercourse 1 to 2 days before ovulation.
Which adverse event is an undesirable effect of supraphysiologic doses of androgens?
A) Enlarged breasts
B) Misshaped sperm
C) Erectile dysfunction
D) Enlarged testicles
A) Enlarged breasts
Rationale:The undesirable effects of increased androgens are gynecomastia, azospermia, decreased testicular size, and acne.
Which chromosome or gene results in the development of testes rather than ovaries?
A) XX
B) XY
C) SRY
D) YY
C) SRY
Rationale:In the presence of the sex-determining region of the Y chromosome (SRY) gene, embryonic gonads develop into testes, and, in its absence, the gonads develop into ovaries. The other options are not involved in the development of the testes or ovaries.
A older adult male asks the nurse about factors that affect his ability to sustain an erection. The nurse will assess for which kinds of disorders that may be responsible for secondary impotence? Select all that apply.
A) Hematologic
B) Hormonal
C) Cardiovascular
D) Digestive
E) Respiratory
A) Hematologic
B) Hormonal
C) Cardiovascular
E) Respiratory
Rationale:Aging is a major etiologic factor in this condition. Diseases that accompany aging can have a direct bearing on male reproductive function. Various cardiovascular, respiratory, hormonal, neurologic, and hematologic disorders can be responsible for secondary impotence. For example, vascular disease affects male potency because it may impair blood flow to the pudendal arteries or their tributaries, resulting in loss of blood volume with subsequent poor distention of the vascular spaces of erectile tissue.
As men age the reproductive system undergoes degenerative changes. The declining physiologic efficiency of the male reproductive function is also affected. The nurse understands that which systems are involved? Select all that apply.
A) Integumentary
B) Digestive
C) Neuromuscular
D) Endocrine
E) Circulatory
C) Neuromuscular
D) Endocrine
E) Circulatory
Rationale:Like other body systems, the male reproductive system undergoes degenerative changes as a result of the aging process; it becomes less efficient with age. The declining physiologic efficiency of the male reproductive function occurs gradually and involves the endocrine, circulatory, and neuromuscular systems.
Which male organs provide the pH environment required for successful fertilization of the ovum? Select all that apply.
A) Seminal vesicles
B) Bulbourethral glands
C) Ductus deferens
D) Scrotum
E) Prostate gland
B) Bulbourethral glands
E) Prostate gland
Rationale:Because sperm mobilization occurs at a pH of 6.0 to 6.5, the alkaline nature of the prostatic secretions is essential for successful fertilization of the ovum. The bulbourethral, or Cowper, glands lie on either side of the membranous urethra and secrete alkaline mucus, which further aids in neutralizing acids from the urine that remain in the urethra. Each of the paired seminal vesicles is lined with secretory epithelium containing an abundance of fructose, prostaglandins, and several other proteins. The fructose secreted by the seminal vesicles provides the energy for sperm motility. The spermatozoa continue their migration through the ductus deferens, also called the vas deferens. The scrotum houses the testes.
Where is the final site for sperm maturation?
A) Urethra
B) Bulbourethral gland
C) Bladder
D) Epididymis
D) Epididymis
Rationale:The final site of sperm maturation is in the epididymis. The bladder, urethra, and bulbourethral gland do not store sperm.
Select the structure responsible for secreting fructose that will provide energy for spermatic motility.
A) Seminal vesicles
B) Bulbourethral gland
C) Hypothalamus
D) Prostate gland
A) Seminal vesicles
Rationale:The seminal vesicles are the only structure that secretes fructose to provide energy for sperm motility.
Screening for which disease process should be done prior to beginning testosterone replacement therapy?
A) Any current sexually transmitted disease
B) Any scrotal malformations
C) Prostate cancer
D) Erectile dysfunction
C) Prostate cancer
Rationale:Before testosterone replacement therapy is initiated, all males should be screened for prostate cancer, as it is a testosterone-dependent disease. None of the other options are relevant to testosterone replacement therapy.
A nurse in a fertility clinic is taking a history from the couple. When asked what type of underwear the male wears, he responds by asking, “Why do you need to know this? It seems a little too personal.” Which response by the nurse is most appropriate for the nurse to reply?
A) “Tight fitting undergarments are best so sperm cannot move around too much to become deformed.”
B) “Since you live in your clothing the better part of the day, tight-fitting underwear is a must to prevent scrotal movement.”
C) “For sperm production, it is best if underwear is loose to keep scrotal temperatures 3.5 to 5°F (2 to 3°C) below body temps.”
D) “Only plain white undergarments are best. Chemicals from colored briefs may damage the sperm.”
C) “For sperm production, it is best if underwear is loose to keep scrotal temperatures 3.5 to 5°F (2 to 3°C) below body temps.”
Rationale:The location of the testes in the scrotum is important for sperm production, which is optimal at 3.5 to 5°F (2 to 3°C) below body termperature. Tight fitting undergarments that hold the testes against the body are thought to contribute to a decrease in sperm counts and to increase infertility by interfering with the thermoregulatory function of the scrotum. Once undergarments are washed, there are no excess chemicals remaining in the cloth. Prolonged exposure to elevated termperatures may impair the process of spermatogenesis, which can occur with tight-fitting undergarments that hold the testes against the body.
Temperature regulation of the testes is maintained by which structure?
A) Epididymis and urethra
B) Pampiniform plexus and cremaster muscles
C) Corpora cavernosa and prostate
D) Vas deferens and bulbourethral gland
B) Pampiniform plexus and cremaster muscles
Rationale:The venous network known as the pampiniform plexus absorbs heat from the arterial blood, cooling it before it enters the testes. The cremaster muscles respond to decreases in testicular temperature by moving the testes closer to the body. The other options are not involved in temperature regulation.
What would be the expected laboratory finding that supports a diagnosis of hypergonadotropic hypogonadism?
A) High levels of testosterone and a low level of luteinizing hormone (LH)
B) High levels of LH and low levels of FSH
C) Low levels of testosterone and a high level of follicle-stimulating hormone (FSH)
D) Low levels of testosterone and low levels of LH
C) Low levels of testosterone and a high level of follicle-stimulating hormone (FSH)
Rationale:If testosterone levels are low, the diagnosis for hypogonadism can be established. LH and FSH are then measured. Increased LH and FSH indicates primary hypogonadism (hypergonadotropic hypogonadism) and decreased or normal LH and FSH a secondary or tertiary hypogonadism (hypogonadotropic hypogonadism).
Which hormone is responsible for the development of male facial hair and change in voice to a deeper level?
A) Testosterone
B) Androstenedione
C) Dihydrotestosterone
D) Estrogen
A) Testosterone
Rationale:Testosterone is the most abundant hormone and contributes to the development of pubic, chest, and facial hair, as well as changes in the larynx that result in the male bass voice. The other hormones are not involved in causing these changes.
