Deck 43: Disorders of the Male Reproductive System

Question 1

The nurse walks into a room and finds the patient forcefully expelling stomach contents into a wash basin. When documenting this occurrence, the nurse will use the term

A) nauseous.
B) retching.
C) vomiting.
D) expatriate.

Answer 1

vomiting.

Question 2

A middle-aged male walks into the emergency department complaining of chest pain radiating to the neck, shortness of breath, and nausea. His heart rate is 120 and BP is 94/60. The ED physician recognizes the patient is having an acute MI with decreased cardiac output. The nurse identifies the nausea to be in response to

A) the patient not having a very high pain tolerance.
B) hypoxia exerting a direct effect on the chemoreceptor trigger zone.
C) the patient not having digested his meal completely.
D) fear of having to make major lifestyle changes.

Answer 2

hypoxia exerting a direct effect on the chemoreceptor trigger zone.

Question 3

A female neonate has been in respiratory distress since delivery and is unresponsive to oxygen therapy. Endoscopy has confirmed a diagnosis of esophageal atresia and tracheoesophageal fistulae (EA/TEF). Which of the following explanations should the care team provide to the infant's parents?

A) "We will have to perform surgery to correct the hole in her throat to make sure that she is able to swallow and breathe normally."
B) "This problem will require respiratory therapy and supplementary feeding, but it will likely resolve itself over time."
C) "The biggest risk that your daughter will face until this is fixed is the danger of malnutrition and dehydration."
D) "The priority in our immediate treatment prior to her surgery will be pain management, as the contents of her stomach can burn her lungs."

Answer 3

"We will have to perform surgery to correct the hole in her throat to make sure that she is able to swallow and breathe normally."

Question 4

A stroke patient is having difficulty swallowing food and beverages. The patient complains that he feels like "the food is sticking to the back of his throat." Given this information, the priority nursing interventions would be to

A) make the patient "nothing per os" (NPO) and call the physician.
B) feed the patient while he is sitting in an upright position.
C) add a thickening agent to all of the patient's beverages.
D) warrant no action since this is a normal occurrence after a stroke.

Question 5

A nurse practitioner is providing care for a male client with a long-standing hiatal hernia. Which of the following statements most accurately captures an aspect of the pathophysiology of hiatal hernias?

A) Paraesophageal hiatal hernias are common and are normally not treated if the client is asymptomatic.
B) The root causes of hiatal hernias are normally treatable with medication.
C) If esophageal acid clearance is impaired, esophagitis can result.
D) An incompetent pyloric sphincter and high-fat diet are commonly implicated in the development of hiatal hernias.

Question 6

After several months of persistent heartburn, a 57-year-old female client has been diagnosed with gastroesophageal reflux disease (GERD). Which of the following treatment regimens is likely to best address the woman's health problem?

A) Surgical correction of the incompetent pylorus
B) Antacids; avoiding positions that exacerbate reflux; a soft-textured diet
C) Weight loss and administration of calcium channel blocking medications
D) Proton pump inhibitors; avoiding large meals; remaining upright after meals

Question 7

Parents of a 20-month-old infant report that he refuses food or eats poorly and that he grimaces when he swallows. He also is irritable and cries a lot. The mother is worried that he ate something inappropriate this morning, because he vomited something that looked like coffee grounds. Which of the following health problems would the care team first suspect?

A) Rotavirus infection
B) Appendicitis
C) Esophagitis from gastrointestinal reflux
D) Hirschsprung disease

Question 8

A 68-year-old African American man who has smoked for at least 50 years reports that lately he feels as though food is getting stuck in his throat. At first, this was a problem just with dry food, but now his morning oatmeal is getting "stuck." On questioning, he reports drinking at least three alcoholic beverages nearly every day. His problem is most likely

A) achalasia.
B) squamous cell carcinoma of the esophagus.
C) dysphagia secondary to scleroderma.
D) gastrointestinal reflux disease.

Question 9

A male patient has just been diagnosed with esophageal cancer. He knew that he was losing weight and fatigued most days, but he just attributed it to aging and working. The physician recommends chemotherapy and irradiation. However, the cancer has already metastasized. The patient asks the nurse what he can expect if he agrees to the treatments. The nurse responds,

A) "The therapies may shrink the cancer."
B) "The doctor is prescribing treatment measures to help you swallow better."
C) "These therapies will most likely cure your cancer."
D) "You need to talk with your physician some more. I will page him for you."

Question 10

A 43-year-old male client has presented to the emergency department with vomiting that he claims is of a sudden onset. The client also states that the emesis has often contained frank blood in the hours prior to admission. His vital signs are stable with temperature 98.3^°F, pulse 88, BP 140/87, and respiratory rate 18. Which of the following potential contributing factors would the health care team suspect first?

A) Overuse of antacids
B) Alcohol consumption
C) Staphylococcal enterotoxins
D) Effects of Helicobacter pylori

Question 11

A patient has recently been diagnosed with H. pylori gastritis. The nurse knows that this form of gastritis is usually treated with a combination of an antibiotic and

A) antianxiety medications.
B) proton pump inhibitors.
C) lactulose, to reduce the blood ammonia levels.
D) calcium carbonate, an antacid.

Question 12

Following a history of gastric pain and an endoscopy, a client has been diagnosed with a duodenal peptic ulcer. Which of the following teaching points should his caregiver provide?

A) "While your diet most certainly contributed to this problem, the good news is that changing your diet can help solve it."
B) "Ulcers like yours do not penetrate all layers of the stomach or duodenum, so you don't have to worry about losing too much blood."
C) "Your family history, your smoking history, and NSAID use may all have contributed to this problem."
D) "While there aren't really any effective medications for these ulcers, changes in lifestyle can keep them well controlled."

Question 13

Which of the following clients is most clearly displaying the signs and symptoms of irritable bowel disease (IBD)?

A) A 32-year-old mother who complains of intermittent abdominal pain that is worse during her menstrual period
B) A 51-year-old male who states that his stomach pain is in his lower abdomen, "comes and goes," and "feels more like a cramp than a dull ache"
C) A 44-year-old man who works the evening shift at a factory and who states that his lower abdominal pain is much worse at night than during the day
D) A 24-year-old man who has a stressful job but whose diarrhea and cramping do not worsen during periods of high stress

Question 14

A 28-year-old man presents with complaints of diarrhea, fecal urgency, and weight loss. His stool is light colored and malodorous, and it tends to float and be difficult to flush. He has also noted tender, red bumps on his shins and complains of pain and stiffness in his elbows and knees. Sigmoidoscopy reveals discontinuous, granulomatous lesions; no blood is detected in his stool. Which of the following diagnoses would his care team first suspect?

A) Crohn disease
B) Ulcerative colitis
C) Diverticulitis
D) Colon cancer

Question 15

A 20-year-old woman has visited her family physician due to occasional bouts of bloody diarrhea over the past several weeks, a phenomenon that she experienced 2 years prior as well. Her physician has diagnosed her with ulcerative colitis based on her history and visualization of the affected region by colonoscopy and sigmoidoscopy. Which of the following pathophysiological phenomena is most likely to underlie the client's health problem?

A) Fissures and crevices developing in the mucosa that are seen as a characteristic "cobblestone" appearance
B) Erosion of the endothelial lining of the distal small intestine by a combination of genetic, autoimmune, and environmental factors
C) Compromise of the mucosal layer of the large intestinal surface by the effects of H. pylori
D) Mucosal hemorrhages that have developed into crypt abscesses, which have in turn necrotized and ulcerated

Question 16

A number of clients on a geriatric subacute medical floor of a hospital have developed foul-smelling diarrhea over the last several days, and subsequent culture of stool samples has confirmed the presence of Clostridium difficile in each case. The care team in the unit would recognize that which of the following factors likely contributed to the health problem and would anticipate which of the following treatments?

A) The use of broad-spectrum antibiotics likely played a role in the development of infections, and most clients would likely receive metronidazole as a treatment.
B) Genetic predisposition and the presence of the bacterium in clients' normal flora likely contributed, and treatment would consist of broad-spectrum antibiotics.
C) Poor hand washing practice on the part of care providers led to the outbreak, and treatment will consist of hydration and nutritional support.
D) Ingestion of contaminated food probably contributed to the infections, and corticosteroids will be needed to treat them.

Question 17

Parents have brought their 7-year-old child into the emergency room with abdominal pain. Which of the following clinical manifestations would lead the health care team to suspect the child has appendicitis? Select all that apply.

A) Tenderness in right lower quadrant with palpation
B) Rebound tenderness in inguinal areas with palpation
C) Redness and warmth over right lower quadrant
D) Bloating and flatulence noticeable
E) Urine has the smell of stool with brown coloring

Question 18

A 22-year-old student has developed a fever and diarrhea while on a backpacking trip in Southeast Asia. His oral temperature is 101.4^°F. The diarrhea is bloody, frequent, and small in volume. These clinical manifestations are sufficiently distressing that he is visiting a local medical clinic in the area. Which of the following diagnoses best characterizes this health problem?

A) Noninflammatory diarrhea
B) Inflammatory diarrhea
C) Factitious diarrhea
D) Secretory diarrhea

Question 19

The mother of a 19-week-old infant has brought her baby in for assessment to a pediatrician because of the baby's persistent weight loss and diarrhea. An intestinal biopsy has confirmed a diagnosis of celiac disease, and the child's mother is anxious to know what caused the disease. Which of the following aspects of the etiology of celiac disease would underlie the explanation that the physician provides?

A) Bacterial or chemical invasion of the peritoneum leads to decreased nutrient absorption and transport.
B) An inappropriate T-cell-mediated response results in increased levels of antibodies and an inflammatory response.
C) Neurogenic or muscular inhibition of peristalsis results in inappropriate motility of ingested food in the lower small intestine and the colon.
D) Inability to process or absorb the fat content of breast milk results in malnutrition and deficiency of fat-soluble vitamins.

Question 20

A 71-year-old male has been recently diagnosed with a stage III tumor of colorectal cancer and is attempting to increase his knowledge base of his diagnosis. Which of the following statements about colorectal cancer demonstrates a sound understanding of the disease?

A) "If accurate screening test for this type of cancer existed, it could likely have been caught earlier."
B) "The NSAIDs and aspirin that I've been taking for many years probably contributing to me getting cancer."
C) "While diet is thought to play a role in the development of colorectal cancer, the ultimate causes are largely unknown."
D) "A large majority of patients who have my type of colon cancer survive to live many more years."