Deck 24: Male Genitourinary System

Question 1

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 due to:
1)side effects of medications.
2)decreased libido with aging.
3)decreased sperm production.
4)decreased pleasure from sexual intercourse.

Answer 1

1
In the absence of disease,a withdrawal from sexual activity may be due to side effects of medications such as antihypertensives,antidepressants,or sedatives.

Question 2

The nurse is examining the glans and knows that which of the following is a normal finding for this area?
1)The dorsal vein may be visible.
2)Hair is without pest inhabitants.
3)The skin is wrinkled and without lesions.
4)Smegma may be present under the foreskin of an uncircumcised male.

Answer 2

4
The glans looks smooth and without lesions and does not have hair.Some cheesy smegma may have collected under the foreskin of an uncircumcised male.

Question 3

When assessing the scrotum of a male patient,the nurse notes the presence of multiple firm,nontender,yellow 1-cm nodules.The nurse knows that these nodules are most likely:
1)from urethritis.
2)sebaceous cysts.
3)subcutaneous plaques.
4)from inflammation of the epididymis.

Answer 3

2
Sebaceous cysts are commonly found on the scrotum.These are yellowish,1-cm nodules and are firm,nontender,and often multiple.

Question 4

When performing a scrotal assessment,the nurse notes that the scrotal contents transilluminate and show a red glow.On the basis of this finding the nurse would:
1)assess the patient for the presence of a hernia.
2)suspect the presence of serous fluid in the scrotum.
3)consider this normal and proceed with the examination.
4)refer the patient for evaluation of a mass in the scrotum.

Question 5

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

Question 6

When the nurse is performing a genital examination on a male patient,which of the following actions is correct?
1)Auscultate for the presence of bowel sounds over the scrotum.
2)Palpate for the vertical chain of lymph nodes along the groin inferior to the inguinal ligament.
3)Palpate the inguinal canal only if there is a bulge present in the inguinal region during inspection.
4)Have the patient shift his weight onto the left (unexamined)leg when palpating for a hernia on the right side.

Question 7

During an examination of an aging male,the nurse recognizes that normal changes to expect would be:
1)premature ejaculation.
2)declining testosterone production.
3)difficulty in maintaining an erection.
4)a decreased refractory state after ejaculation.

Question 8

Which of the following statements is true regarding the penis?
1)The urethral meatus is located on the ventral side of the penis.
2)The prepuce is the fold of foreskin covering the shaft of the penis.
3)The penis is composed of two cylindrical columns of erectile tissue.
4)The corpus spongiosum expands into a cone of erectile tissue called the glans.

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:
1)dysuria.
2)nocturia.
3)polyuria.
4)hematuria.

Question 10

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?
1)"Do you use condoms?"
2)"You don't masturbate,do you?"
3)"Have you had sex in the last 6 months?"
4)"Often boys your age have questions about sexual activity."

Question 11

The mother of a 10-year-old boy asks the nurse to discuss the recognition of puberty.The nurse should reply:
1)"Puberty usually begins about age 15."
2)"The first sign of puberty is enlargement of the testes."
3)"Penis size does not increase until about the age of 16."
4)"The development of pubic hair precedes testicular or penis enlargement."

Question 12

A 62-year-old man states that his doctor told him that he has an "inguinal hernia." He asks the nurse to explain what a hernia is.The nurse should:
1)tell him not to worry and that most men his age develop hernias.
2)explain that a hernia is often the result of prenatal growth abnormalities.
3)refer him to his physician for additional consultation because the physician made the initial diagnosis.
4)explain that a hernia is a loop of bowel protruding through a weak spot in the abdominal muscles.

Question 13

A newborn baby boy is about to have a circumcision.The nurse knows that indications for circumcision include:
1)cultural beliefs.
2)prevention of testicular cancer.
3)improving the sperm count later in life.
4)preventing the transmission of human immunodeficiency virus during sexual intercourse.

Question 14

An accessory glandular structure for the male genital organs is the:
1)testis.
2)penis.
3)prostate.
4)vas deferens.

Question 15

The nurse is performing a genital examination on a male patient and notes urethral drainage.When collecting urethral discharge for microscopic examination and culture,the nurse should:
1)ask the patient to urinate into a sterile cup.
2)ask the patient to obtain a specimen of semen.
3)insert a cotton-tipped applicator into the urethra.
4)compress the glans between the examiner's thumb and forefinger and collect any discharge.

Question 16

Which of the following statements about the testes is true?
1)The lymphatics of the testes drain into the abdominal lymph nodes.
2)The vas deferens is located along the inferior portion of each testis.
3)The right testis is lower than the left because the right spermatic cord is longer.
4)The cremaster muscle contracts in response to cold and draws the testicles closer to the body.

Question 17

The external male genital structures include the:
1)testis.
2)scrotum.
3)epididymis.
4)vas deferens.

Question 18

A 45-year-old carpenter is seen at the clinic for complaints of "losing my urine when I lift heavy objects." He is experiencing:
1)frequency.
2)urinary hesitancy.
3)stress incontinence.
4)urgency incontinence.

Question 19

When performing a genitourinary assessment,the nurse notes that the urethral meatus is positioned ventrally.This finding is:
1)called hypospadius.
2)the result of phimosis.
3)probably due to a stricture.
4)often associated with aging.

Question 20

When performing a genital examination on a 25-year-old man,the nurse notes deeply pigmented,wrinkled scrotal skin with large sebaceous follicles.On the basis of this information the nurse would:
1)squeeze the glans checking for the presence of discharge.
2)consider this a normal finding and proceed with the examination.
3)assess the testicles for the presence of masses or painless lumps.
4)obtain a more detailed history focusing on any scrotal abnormalities the patient has noticed.

Question 21

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 notes an enlarged,red scrotum that is very tender to palpation.It is difficult to distinguish the epididymis from the testis and the scrotal skin is thick and edematous.This description is consistent with which of the following?
1)Varicocele
2)Epididymitis
3)Spermatocele
4)Testicular torsion

Question 22

During an examination of an aging male,the nurse recognizes that normal changes to expect would be:
1)a change in scrotal color.
2)a decrease in the size of the penis.
3)enlargement of the testes and scrotum.
4)an increase in the number of rugae over the scrotal sac.

Question 23

The nurse is aware that which of the following statements is true regarding the incidence of testicular cancer?
1)Testicular cancer is the most common cancer in men aged 30-50 years.
2)The early symptoms of testicular cancer are pain and induration.
3)Men with a history of cryptorchidism are at greatest risk for development of testicular cancer.
4)Nonwhite men are four times more likely to develop testicular cancer than white men are.

Question 24

During an examination,the nurse notes 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:
1)genital warts.
2)a herpes infection.
3)a syphilitic chancre.
4)a carcinoma lesion.

Question 25

The nurse is describing how to perform a testicular self-examination to a patient.Which of the following statements is most appropriate?
1)"A good time to examine your testicles is just before you take a shower."
2)"If you notice an enlarged testicle or a painless lump,call your health care provider."
3)"The testicle is egg shaped and movable.It feels firm and has a lumpy consistency."
4)"Perform a testicular exam at least once a week to detect the early stages of testicular cancer."

Question 26

During a health history,a patient tells the nurse that he has trouble in starting his urine stream.This problem is known as:
1)urgency.
2)dribbling.
3)frequency.
4)hesitancy.

Question 27

During a genital exam,the nurse notes that a male patient has clusters of small vesicles on the glans,surrounded by erythema.The nurse recognizes that these lesions are:
1)Peyronie's disease.
2)genital warts.
3)genital herpes.
4)syphilitic cancer.

Question 28

When performing a genitourinary assessment on a 16-year-old boy,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/an:
1)femoral hernia.
2)incisional hernia.
3)direct inguinal hernia.
4)indirect inguinal hernia.

Question 29

A 55-year-old man is in the clinic for a yearly check-up.He is worried because his father died of prostate cancer.The nurse knows that which tests should be done at this time? Select all that apply.
1)Blood test for prostate-specific antigen
2)Urinalysis
3)Transrectal ultrasound
4)Digital rectal examination
5)Prostate biopsy

Question 30

A 2-year-old boy has been diagnosed with "physiologic cryptorchidism." Given this diagnosis,during assessment,the nurse will most likely observe:
1)testes that are hard and painful to palpation.
2)an atrophic scrotum and absence of the testis bilaterally.
3)an absence of the testis in the scrotum,but the testis can be milked down.
4)testes that migrate into the abdomen when the child squats or sits cross-legged.

Question 31

Prolonged,painful erection of the penis without sexual desire is known as:
1)orchitis.
2)stricture.
3)phimosis.
4)priapism.

Question 32

When the nurse is performing a testicular examination on a 25-year-old man,which of the following findings is considered normal?
1)Nontender subcutaneous plaques
2)A scrotal area that is dry,scaly and nodular
3)Testes that feel oval and movable and are slightly sensitive to compression
4)A single,hard,circumscribed,movable mass,less than 1 cm under the surface of the testes

Question 33

During a physical examination,the nurse finds that a male patient's foreskin is fixed and tight and will not retract over the glans.The nurse recognizes that this condition is:
1)phimosis.
2)epispadias.
3)urethral stricture.
4)Peyronie's disease.

Question 34

The nurse is inspecting the scrotum and testes of a 43-year-old man.Which finding would require additional follow-up and evaluation?
1)The skin on the scrotum is shiny and smooth.
2)The left testicle hangs lower than the right testicle.
3)The scrotum is a darker color than the general skin color.
4)The testes move closer to the body in response to cold temperatures.

Question 35

When performing a genital assessment on a 34-year-old man,the nurse notes the following: multiple soft,moist,painless papules in the shape of cauliflower-like patches scattered across the shaft of the penis.These lesions are characteristic of:
1)carcinoma.
2)syphilitic chancres.
3)herpes progenitalis.
4)genital warts

Question 36

The nurse is performing a genitourinary assessment on a 50-year-old obese male laborer.On examination the nurse notes 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 which of the following conditions?
1)A scrotal hernia
2)A femoral hernia
3)A direct inguinal hernia
4)An indirect inguinal hernia

Question 37

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:
1)epididymitis.
2)spermatocele.
3)testicular torsion.
4)spermatic cord varicocele.