Chapter 21 My Nursing Test Banks

DAmico/Barbarito Health & Physical Assessment in Nursing, 2/e
Chapter 21

Question 1

Type: MCSA

During the examination of an elderly male the nurse notes thin, gray pubic hairs and a scrotal sac that hangs significantly lower than the penis. The nurse would correctly choose which of the following actions?

1. Document the findings as normal.

2. Inform the client that he is no longer fertile.

3. Notify the healthcare provider of the findings.

4. Ask the client about his sexual practices.

Correct Answer: 1

Rationale 1: The older adult male begins to demonstrate thinning and graying of the pubic hair. The penis and testicles begin to diminish in size and the scrotum hangs lower.

Rationale 2: Sperm production in the middle aged and older man is reduced but there is still adequate sperm production to father children.

Rationale 3: The findings are normal and do now warrant notification of the healthcare provider.

Rationale 4: The sexual practices of the client are not impacted by the findings. Inquiry into them is not indicated at this time.

Global Rationale: According to Tanners Maturation Stages in the male, the findings in this situation are appropriate for the elderly male client. Although sperm production does decline during middle age, the presence of viable sperm in the elderly male contradicts infertility. No further subjective information is required by the nurse, and the healthcare provider does not need notification.

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 21-1: Identify the anatomy and physiology of the male reproductive system.

Question 2

Type: MCSA

During the examination of a male client who has not been circumcised, the nurse is attempts to retract the foreskin of the penis, but skin is very tight and cannot be pulled back. The nurse would correctly anticipate which of the following conditions?

1. Urethral stricture

2. Paraphimosis

3. Urethritis

4. Phimosis

Correct Answer: 4

Rationale 1: Urethral strictures would be suspected in the event of voiding problems or a pinpoint size meatus opening was noted not an inability to retract the foreskin over the glans penis.

Rationale 2: Paraphimosis is a condition in which the foreskin cannot be moved back over the glans penis once it has been retracted

Rationale 3: Urethritis manifests with symptoms including redness and edema around the glans and foreskin, eversion of the urethral mucosa, and drainage.

Rationale 4: Phimosis refers to a condition in which the foreskin cannot be moved back over the glans penis.

Global Rationale: Phimosis is a condition in which the foreskin is too tight to retract over the glans penis. Paraphimosis is a condition in which the foreskin cannot be moved back over the glans penis once retracted. Urethritis is a condition in which the urethra is infected or inflamed. Signs of urethritis include redness and edema around the glans and foreskin, eversion of urethral mucosa, and drainage. A urethral stricture is suspected if the urinary meatus is pinpoint size.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Diagnosis

Learning Outcome: 21-1: Identify the anatomy and physiology of the male reproductive system.

Question 3

Type: MCSA

The nurse is interviewing a male client who states I feel like I have a bag of worms in my scrotum. The nurse would correctly suspect which of the following conditions?

1. Orchitis

2. Varicocele

3. Epididymitis

4. Hernia

Correct Answer: 2

Rationale 1: Orchitis refers to a swelling and inflammation of the testicles.

Rationale 2: A varicocele is a distention of the spermatic cord and may be described as a bag of worms.

Rationale 3: Epididymitis is an inflammatory condition of the epididymis.

Rationale 4: An inguinal hernia feels like a bulge or mass upon palpation of the inguinal canal, which indicates a protrusion of the intestine into the groin region.

Global Rationale: Swelling or inflammation of the testicles is referred to as orchitis. A varicocele is a distention of the spermatic cord and often is described as a bag of worms. Epididymitis is an inflammatory condition of the epididymis. An inguinal hernia feels like a bulge or mass upon palpation of the inguinal canal, which indicates a protrusion of the intestine into the groin region.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Diagnosis

Learning Outcome: 21-1: Identify the anatomy and physiology of the male reproductive system.

Question 4

Type: MCMA

When caring for a male client scheduled for a prostatectomy due to cancer, the nurse would expect which of the following assessment findings to be present?

Standard Text: Select all that apply.

1. Enlargement of the scrotal sac

2. Pyuria

3. Increase in prostatic specific antigen (PSA)

4. Dribbling of urine

5. Difficulty in initiating urine stream

Correct Answer: 3,4,5

Rationale 1: Enlargement of the scrotal sac. The scrotal sac will not be enlarged with a diagnosis for prostate cancer. Scrotal sac enlargement may be noted in the presence of inflammation of the testicles or the epididymis.

Rationale 2: Pyruia. Pyruia refers to pus in the urine. Pus in the urine is not consistent with the presence of prostate cancer.

Rationale 3: Increase in prostatic specific antigen (PSA). Low levels of prostatic specific antigen are present in normal, healthy men. Laboratory values for the PSA will be elevated in the presence of prostate cancer.

Rationale 4: Dribbling of urine. The dribbling of urine may be seen with prostate cancer. Dribbling will occur in the presence of prostate enlargement.

Rationale 5: Difficulty in initiating urine stream. Prostate enlargement as seen in malignant conditions may result in the client experiencing difficulty in initiating the urine stream.

Global Rationale: The scrotal sac of the client diagnosed with prostate cancer would not be enlarged. The prostate is located on each side of the male urethra just below the bladder. It is not anatomically near the scrotal sac. Pyruia refers to pus in the urine. Pus in the urine is not consistent with a diagnosis of prostate cancer. Low levels of prostatic specific antigen (PAS) are present in normal, healthy men. PSA levels are used to assess for the presence of prostate cancer. Laboratory values for the PSA will be elevated in the presence of prostate cancer. Conditions of the prostate gland may result in urinary changes. The dribbling of urine may be seen with prostate cancer. Dribbling or difficulty starting the urine stream may be seen in the presence of prostate enlargement.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 21-1: Identify the anatomy and physiology of the male reproductive system.

Question 5

Type: MCSA

While performing prostate palpation, the nurse notes that the client expresses severe tenderness and discomfort during the procedure. The nurse should suspect which of the following conditions in the client?

1. Prostate cancer

2. Prostatitis

3. Enlargement of the prostate

4. Urinary tract infection

Correct Answer: 2

Rationale 1: The presence of extreme hardness or nodules is characteristic of prostate cancer.

Rationale 2: The prostate should feel smooth, firm, or rubbery, and extend no larger than 1 centimeter into the rectal area. This exam should not cause tenderness, which is an indication of inflammation.

Rationale 3: Enlargement of the prostate will cause urinary tract symptoms such as difficulty in starting a stream, or dribbling of urine.

Rationale 4: Urinary tract infections will cause painful and frequent urination.

Global Rationale: Upon examination, the prostate should feel smooth, firm, or rubbery, and extend no larger than 1 centimeter into the rectal area. This exam should not cause tenderness, which is an indication of inflammation. The presence of extreme hardness or nodules is characteristic of prostate cancer. Enlargement of the prostate will cause urinary tract symptoms such as difficulty in starting a stream, or dribbling of urine. Urinary tract infections will cause painful and frequent urination.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Diagnosis

Learning Outcome: 21-1: Identify the anatomy and physiology of the male reproductive system.

Question 6

Type: HOTSPOT

The nurse is providing education to a client who has been experiencing symptoms consistent with BPH. The nurse presents a diagram the client to illustrate the location of the prostate. Mark with an X the correct location of the prostate gland.

Screen Shot 2015-09-24 at 12.37.44 PM

Standard Text: Select the correct area on the image.

Correct Answer:

Rationale : The lobes of the prostate gland are located on each side of the male urethra.

Global Rationale:

Cognitive Level: Understanding

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 21-1: Identify the anatomy and physiology of the male reproductive system.

Question 7

Type: HOTSPOT

The nurse is caring for a client who has hypospadias . Mark the figure provided to illustrate the location of the phenomena.

Standard Text: Select the correct area on the image.

Correct Answer:

Rationale : Hypospadias is a condition in which the urinary meatus opens on the underside of the penis.

Global Rationale:

Cognitive Level: Understanding

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 21-1: Identify the anatomy and physiology of the male reproductive system.

Question 8

Type: MCSA

A couple seeking infertility treatments has just received the results of a semen analysis, which shows a diminished sperm count. The nurse would ask which of the following questions to the male in this scenario?

1. How often do you masturbate?

2. Do you smoke?

3. How old is your present house?

4. Do you still want to have children?

Correct Answer: 3

Rationale 1: Masturbation does not influence sperm count and the ability to father children.

Rationale 2: Tobacco use does not impact sperm count and the ability to father children.

Rationale 3: The age of the home may be influencing the sperm count. Lead paint may be present in older homes built before 1979. Lead exposure may result in reduced libido, diminished sperm count and abnormal sperm motility.

Rationale 4: The responsibility of the nurse is to assess for related causes, not to assess the desire to father children.

Global Rationale: Males exposed to lead may experience decreased libido, diminished sperm count, and abnormal sperm motility. Lead may be present is homes built before 1979. Masturbation and tobacco use do not influence sperm count and motility. The responsibility of the nurse is to assess for related causes, not to assess the desire to father children.

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 21.2: Develop questions to be used when completing the focused interview.

Question 9

Type: MCSA

During the focused interview, a male client describes his erection and ejaculate in terms that are less than professional. The nurse would correctly do which of the following?

1. Ask the client to refrain from using the terms.

2. Ask the client to define the terms.

3. Document the clients responses in the terms used.

4. Find another nurse to complete the assessment.

Correct Answer: 3

Rationale 1: Men may be embarrassed to discuss health problems or concerns involving their reproductive organs. During the interview use words that the man can understand, and do not be embarrassed or offended by the words he uses.

Rationale 2: Asking the client to define terms may promote a sense of inferiority. Men may be embarrassed to discuss health problems or concerns involving their reproductive organs; it is important for the nurse to ask questions in a non-threatening, matter-of-fact manner.

Rationale 3: The words and responses of the client will need to be documented. They provide the framework of the subjective data from the assessment.

Rationale 4: Asking another nurse to complete the interview reduces the quality and continuity of care and is inappropriate.

Global Rationale: During the interview use words that the man can understand, and do not be embarrassed or offended by the words he uses. Asking the client to define terms may promote a sense of inferiority. Men may be embarrassed to discuss health problems or concerns involving their reproductive organs; it is important for the nurse to ask questions in a nonthreatening, matter-of-fact manner. Consider the psychologic, social, and cultural factors that affect sexuality and sexual activity. The words and responses of the client will need to be documented. Asking another nurse to complete the interview reduces the quality and continuity of care and is inappropriate.

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 21.2: Develop questions to be used when completing the focused interview.

Question 10

Type: MCSA

The nurse has completed testicular self-exam teaching for a male client. Which of the following statements if made by the client would indicate the need for further instruction?

1. I will feel hardened areas where the testicles and epididymis are located.

2. I should perform this exam monthly.

3. I should be in a warm room or the shower to perform this exam.

4. I should apply gentle pressure to each testicle to feel the area.

Correct Answer: 1

Rationale 1: The contour of the testicles should be firm and smooth.

Rationale 2: The testicular self-examination should be performed monthly beginning in adolescence.

Rationale 3: The most opportune time to perform the testicular self-examination is in the shower or bath. Heat and steam will warm the hands and will help their movement over the skin surface.

Rationale 4: The correct technique utilizes a gentle pressure over the surface of the skin.

Global Rationale: Testicular self-exam should be performed monthly beginning in adolescence. The scrotum will descend in a warm environment such as the bath or shower, allowing adequate palpation. Gentle pressure should be applied to locate the testicle and epididymis, but these areas are normally soft, without lumps or hardness.

Cognitive Level: Understanding

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 21.3: Describe techniques required for assessment of the male reproductive system.

Question 11

Type: MCMA

The student nurse is preparing to examine the male reproductive system of a client. Prior To starting the examination the student nurse explains to the supervising nurse the techniques that will be used. Plans to use which of the following indicates the need for further instruction?

Standard Text: Select all that apply.

1. Inspection

2. Palpation

3. Percussion

4. Auscultation

5. Aspiration

Correct Answer: 3,4,5

Rationale 1: Inspection. The physical assessment techniques of inspection and palpation are used in the examination of the male reproductive system.

Rationale 2: Palpation. The physical assessment techniques of inspection and palpation are used in the examination of the male reproductive system.

Rationale 3: Percussion. The physical assessment techniques of inspection and palpation are used in the examination of the male reproductive system. Percussion is used to assess the chest and abdomen.

Rationale 4: Auscultation. The physical assessment techniques of inspection and palpation are used in the examination of the male reproductive system. Auscultation is used to assess the gastrointestinal, cardiovascular, and respiratory systems.

Rationale 5: Aspiration. The physical assessment techniques of inspection and palpation are used in the examination of the male reproductive system. Aspiration may be used to obtain a specimen.

Global Rationale: Examination of the male reproductive system will utilize the techniques of inspection and palpation. The external genitalia will be inspected as the onset of the examination. Palpation will be used to assess the organs. Percussion is utilized in the assessment of the gastrointestinal system. Auscultation is used to assess the gastrointestinal, cardiac, and respiratory systems. Aspiration is a technique used to obtain a specimen.

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 21.3: Describe techniques required for assessment of the male reproductive system.

Question 12

Type: MCMA

The nurse is preparing to examine a male clients reproductive organs. Which of the following steps should the nurse do in preparation for this examination?

Standard Text: Select all that apply.

1. Secure a private examination room.

2. Use clean hands for the examination.

3. Ask the client to lie down on the exam table.

4. Ask the client to empty his bladder.

5. Make sure the rooms temperature is cool and comfortable.

Correct Answer: 1,2,4,5

Rationale 1: Secure a private examination room. A private room is indicated to perform a physical examination.

Rationale 2: Use clean hands for the examination. The examiner must have clean hands to perform the exam. This will reduce the transmission of infections.

Rationale 3: Ask the client to lie down flat on the exam table. The examination may be performed with the client sitting or standing. The client does not need to lie flat.

Rationale 4: Ask the client to empty his bladder. Emptying the bladder will reduce discomfort during palpation portions of the exam. In addition, a full bladder may impede the examination.

Rationale 5: Make sure the rooms temperature is cool and comfortable. The examination room must be comfortable for the client.

Global Rationale: Ensure that the examining room is warm and private. The examiner will need to wash hands and put on gloves before beginning the examination. The gloves will need to be worn during the examination. Ask the client to empty his bladder, remove his clothing, and put on a gown or drape. The assessment may be done with the client sitting or standing. There is no need for the client to lie flat. Expose only those body parts being examined to preserve modesty. It is necessary for the client to be comfortable. The temperature should be regulated accordingly.

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 21.3: Describe techniques required for assessment of the male reproductive system.

Question 13

Type: MCSA

During the examination of a male clients scrotum the nurse detects a hardened area in the right side of the scrotal sac. The nurse would correctly choose which of the following actions to complete first?

1. Ask the client about voiding patterns.

2. Notify the healthcare provider of this finding.

3. Use a light to perform transillumination.

4. Ask the client about sexual practices.

Correct Answer: 3

Rationale 1: Voiding patterns are not related to the findings of the examination.

Rationale 2: Abnormalities noted on the assessment will need to be reported to the healthcare provider but first, the nurse must obtain additional supporting information to include in the report.

Rationale 3: Transillumination is indicated to obtain further information.

Rationale 4: The clients sexual practices do not have direct bearing on the findings.

Global Rationale: The scrotum contains the testes and the epididymis, which should not feel hard upon palpation. Areas suggesting abnormalities may be detected using transillumination, or the use of light to examine the scrotum. Upon transillumination, light should shine through the scrotum with a red glow, with the testes showing up as oval structures. Abnormal areas, such as masses, will not show penetration of the light. The clients voiding patterns or sexual practices are not relevant to this situation, and the nurse requires additional information prior to notification of the healthcare provider.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 21.3: Describe techniques required for assessment of the male reproductive system.

Question 14

Type: HOTSPOT

A client has presented for a physical examination. During the examination the nurse palpates to assess the right inguinal region.

Screen Shot 2015-09-24 at 12.39.12 PM

Standard Text: Select the correct area on the image.

Correct Answer:

Rationale : The X should be placed on the right side at the diagram just below the hair line where the thigh and the scrotum meet.

Global Rationale:

Cognitive Level: Understanding

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 21.3: Describe techniques required for assessment of the male reproductive system.

Question 15

Type: MCSA

The nurse is examining a male client and notes small clusters of vesicular lesions on the glans penis. The client states the areas are painful and that often are reddened. The nurse would suspect which of the following?

1. Carcinoma

2. Genital warts

3. Syphilis

4. Genital herpes

Correct Answer: 4

Rationale 1: Carcinoma lesions are nodular or ulcerative.

Rationale 2: Genital warts present as soft fleshy growths.

Rationale 3: Syphilis presents as nonpainful ulcers called chancres.

Rationale 4: Genital herpes presents as painful ulcerations.

Global Rationale: Genital herpes lesions present as painful ulcerations. Carcinoma lesions are nodular or ulcerative. Genital warts are soft, painless, fleshy growths. Syphilis produces nonpainful ulcers called chancres.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Diagnosis

Learning Outcome: 21.4: Differentiate normal from abnormal findings in physical assessment.

Question 16

Type: MCSA

The nurse is assessing a male infant and notes only one testis. The mother asks what effect this will have on the child. Which of the following would be a correct response by the nurse?

1. There will be a need for your child to have hormone replacement therapy.

2. He will be unable to father children.

3. He will do fine and have no problems.

4. There will be a normal level of sperm production.

Correct Answer: 1

Rationale 1: The testes produce sperm and testosterone. With one testis, there will be a reduction in produced testosterone requiring hormone replacement therapy.

Rationale 2: The exiting testis will produce sperm, which will allow for him to reproduce.

Rationale 3: There are implications of the condition. This is a broad and potentially misleading statement.

Rationale 4: The testes produce sperm and testosterone. With one testis, there will be a reduction in produced testosterone

Global Rationale: The testes produce sperm and testosterone. With one testis, there will be a reduction in produced testosterone and sperm. The client will need to have hormone replacement therapy. Sterility should not be a problem. Expressing that the client will be fine is a broad and potentially misleading statement.

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 21.4: Differentiate normal from abnormal findings in physical assessment.

Question 17

Type: MCSA

During the examination of a male client, the nurse detects a bulge in the right inguinal area as the client is bearing down. The nurse would correctly interpret this finding as which of the following conditions?

1. Varicocele

2. Prostatitis

3. Orchitis

4. Hernia

Correct Answer: 4

Rationale 1: The varicocele is a distention of the spermatic cord. It feels most like a bag of worms rather than a mass.

Rationale 2: Examination of the prostate gland is performed via the rectum, rather than the inguinal area.

Rationale 3: Orchitis refers to an inflammation in the testicular region. This would present as a pain and swelling in the scrotal region.

Rationale 4: An inguinal hernia feels like a bulge or mass upon palpation of the inguinal canal, which indicates a protrusion of the intestine into the groin region.

Global Rationale: An inguinal hernia feels like a bulge or mass upon palpation of the inguinal canal, which indicates a protrusion of the intestine into the groin region. A varicocele is a distention of the spermatic cord and feels like a bag of worms rather than a mass. Examination of the prostate gland is performed via the rectum, rather than the inguinal area. Orchitis refers to an inflammation of the testicles.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Diagnosis

Learning Outcome: 21.4: Differentiate normal from abnormal findings in physical assessment.

Question 18

Type: MCSA

The nurse is examining a male clients genitalia and notices the scrotum is asymmetric. The left side hangs lower than the right side. The nurse would correctly choose which of the following actions?

1. Reassess after increasing the temperature in the room.

2. Report the finding to the healthcare provider.

3. Consider this a normal finding and proceed with palpation of the scrotum.

4. Ask if the client if has noticed this before.

Correct Answer: 3

Rationale 1: Elevation in temperatures will facilitate the scrotums dropping away from the body. It will not correct symmetry issues.

Rationale 2: The complete assessment findings will need to be shared with the healthcare provider but the nurse will need to have completed the assessment first to be able to provide adequate information.

Rationale 3: Palpation of the scrotum is indicated to aid in determining other related abnormalities.

Rationale 4: Asking the client for additional subjective information is not the priority action at this time.

Global Rationale: The male scrotum is normally asymmetric due to the longer length of the left spermatic cord. This finding does not need further subjective data from the client or need to be reported to the healthcare provider. Although the scrotum does drop away from the body in elevated temperatures, this will not change its asymmetrical appearance.

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 21.4: Differentiate normal from abnormal findings in physical assessment.

Question 19

Type: MCSA

The mother of a toddler expresses concern over her son constantly playing with his penis and scrotum. The nurse would correctly use which of the following responses to address the mothers concern in this situation?

1. These practices are normal for a child of this age.

2. Does she see his father doing the same actions?

3. Does he know what it means to be a boy or a girl?

4. These behaviors will go away as he gets older.

Correct Answer: 1

Rationale 1: Children often display curiosity with their genitals throughout all age spans. Parents should be reassured that this is normal behavior and part of the childs growth and development.

Rationale 2: The behaviors being displayed are normal for the age and are not a reflection of practices noticed by male role models.

Rationale 3: The behaviors being displayed are normal for this age and do not reflect any sense of confusion concerning sexual identity.

Rationale 4: Children often display curiosity with their genitals throughout all age spans. Parents should be reassured that this is normal behavior and part of the childs growth and development.

Global Rationale: Children often display curiosity with their genitals throughout all age spans. Parents should be reassured that this is normal behavior and part of the childs growth and development. Observing that male role models have an interest in their genitals is not associated with the behaviors noted. The behaviors noted are not reflective of confusion relating to sexual identity.

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 21.5: Describe developmental, psychosocial, cultural, and environmental variations in assessment techniques and findings.

Question 20

Type: MCSA

During the examination of an adult male the nurse notes thick, curly hair over the pubis area, a pear-shaped scrotum, and slightly darkened skin on the penis. The nurse would correctly choose which of the following actions?

1. Ask the client about recent illnesses.

2. Ask the client about sexual practices.

3. Notify the healthcare provider the findings.

4. Document the findings as normal.

Correct Answer: 4

Rationale 1: There is no need to explore medical health history relating to this normal physical appearance.

Rationale 2: The sexual practices of the client have no bearing on the normal findings.

Rationale 3: The assessment findings are normal and do not warrant notification of the healthcare provider.

Rationale 4: The findings are normal for a healthy adult male.

Global Rationale: According to Tanners Maturation Stages in the male, the findings in this situation are appropriate for the adult male client. No further subjective information is required by the nurse. There is no need to explore medical health history relating to this normal physical appearance. The sexual practices of the client have no bearing on the normal findings. The healthcare provider does not need notification.

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 21.5: Describe developmental, psychosocial, cultural, and environmental variations in assessment techniques and findings.

Question 21

Type: MCSA

A 65-year-old client reports to the ambulatory care clinic for a routine physical examination. During the assessment the client reports plans to marry a much younger woman in the coming weeks. The client voices concerns about his ability to father children. What information may be provided by the nurse?

1. The client is facing infertility in the next few years as the majority of older men become infertile by age 70 years.

2. Although the production of sperm may be reduced in the older male, fathering a child is still possible with advancing age.

3. There are no changes to fertility of a man associated with aging.

4. Limited studies concerning the fertility of men are available and there is no definitive information available.

Correct Answer: 2

Rationale 1: Sperm production begins to decline with middle age but the male is still able to produce adequate quantities of viable sperm to father children. A man of age 70 is able to father children.

Rationale 2: Sperm production begins to decline with middle age but the male is still able to produce adequate quantities of viable sperm to father children.

Rationale 3: Sperm production begins to decline with middle age but the male is still able to produce adequate quantities of viable sperm to father children.

Rationale 4: There is adequate research available to prove the ability of older men to father children.

Global Rationale: Sperm production begins to decline with middle age but the male is still able to produce adequate quantities of viable sperm to father children. A man of age 70 is able to father children. There is adequate research available to prove the ability of older men to father children.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 21.5: Describe developmental, psychosocial, cultural, and environmental variations in assessment techniques and findings.

Question 22

Type: MCMA

The nurse is preparing a presentation on testicular cancer and wishes to target the age group most frequently affected. Which of the following settings would be considered appropriate to provide audiences considered to be at an increased risk for the disease?

Standard Text: Select all that apply.

1. Elementary schools

2. Colleges

3. Cub Scout groups

4. High schools

5. Senior assisted living facilities

Correct Answer: 2,4

Rationale 1: Elementary schools. Testicular cancer is the most common type of cancer in males between the ages of 20 and 35. It is recommended that testicular self-examinations be performed monthly beginning in adolescence and continue on through adulthood. Children in elementary schools are too young to initiate the examination.

Rationale 2: Colleges. Testicular cancer is the most common type of cancer in males between the ages of 20 and 35. It is recommended that testicular self-examinations be performed monthly beginning in adolescence and continue on through adulthood. College-age males are in the target group and should be included.

Rationale 3: Cub Scout groups. Testicular cancer is the most common type of cancer in males between the ages of 20 and 35. It is recommended that testicular self-examinations be performed monthly beginning in adolescence and continue on through adulthood. Cub scouts is a service group consisting primarily of elementary schoolaged children. This group is too young to be considered in the target group.

Rationale 4: High schools. Testicular cancer is the most common type of cancer in males between the ages of 20 and 35. It is recommended that testicular self-examinations be performed monthly beginning in adolescence and continue on through adulthood. Testicular cancer is the most common type of cancer in males between the ages of 20 and 35. It is recommended that testicular self-examinations be performed monthly beginning in adolescence and continue on through adulthood.

Rationale 5: Senior Assisted Living Facilities. Testicular cancer is the most common type of cancer in males between the ages of 20 and 35. It is recommended that testicular self-examinations be performed monthly beginning in adolescence and continue on through adulthood.

Global Rationale: Testicular cancer is the most common type of cancer in males between the ages of 20 and 35. Self-examinations should begin in adolescence and continue throughout adulthood. Populations of the target subjects would be available in colleges and high schools. Elementary school students are too young for this level of education. The educational process should begin before a male reaches advanced age.

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 21.6: Discuss the objectives for the male reproductive system as presented in Healthy People 2020.

Question 23

Type: MCMA

The nurse is interviewing a male client with an elevated prostate specific antigen level (PSA). The nurse would correlate potential risk factors for this client by asking which of the following questions?

Standard Text: Select all that apply.

1. Do you have a positive family history for prostate cancer?

2. Do you masturbate?

3. How frequently do you have sexual intercourse?

4. Do you smoke?

5. Do you have a history of urinary tract infections?

Correct Answer: 1,4

Rationale 1: Do you have a positive family history for prostate cancer? Family history is a significant risk factor for the development of prostate cancer.

Rationale 2: Do you masturbate? Masturbation is not considered a risk factor for the development of prostate cancer.

Rationale 3: How frequently do you have sexual intercourse? The frequency of sexual intercourse does not have a bearing on the occurrence of prostate cancer.

Rationale 4: Do you smoke? Smoking has been linked to the development of prostate cancer.

Rationale 5: Do you have a history of urinary tract infections? Urinary tract infections are not linked to the incidence of prostate cancer.

Global Rationale: Familial links are noted for the development of prostate cancer. Smoking is also identified as a risk for the development of prostate cancer. Masturbation, the frequency of sexual intercourse and the incidence of urinary tract infections is not associated with the development of prostate cancer.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 21.6: Discuss the objectives for the male reproductive system as presented in Healthy People 2020.

Question 24

Type: MCSA

The nurse is conducting a health interview for a 55-year-old client who has presented to the clinic for an annual physical examination. The client questions the need to begin screening for prostate cancer at this examination. What response by the nurse is indicated?

1. Unless you are at an increased risk for the development of prostate cancer no additional screening indicated.

2. PSA screening tests should be performed once you reach age 75.

3. You need to begin having an annual prostate examination.

4. A cystoscopy should be performed annually to assess for prostate changes at age 55.

Correct Answer: 3

Rationale 1: Annual prostate screening is recommended to begin at age 50 years.

Rationale 2: PSA screening tests are not recommended for men over age 75 years.

Rationale 3: Annual prostate screening is recommended to begin at age 50 years.

Rationale 4: The cystoscopy is a diagnostic test that is used to assess the inside of the bladder. It is not used to assess for the presence of prostate cancer.

Global Rationale: Annual prostate examination is recommended for males after the age of 50. The United States Preventive Task Force (USPSTF) (2008) has issued recommendations regarding the use of the prostate specific antigen (PSA) screening. The USPSTF recommends against PSA screening in males 75 years of age and older. In men younger than 75 the recommendations are to review individual risk factors to determine the use of the test. Cystoscopy is a diagnostic test that allows for a scope to be inserted through the urethra to view the bladder. It is not used to diagnose prostate cancer.

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 21.6: Discuss the objectives for the male reproductive system as presented in Healthy People 2020.

Question 25

Type: MCSA

The nurse is assessing a male client who has epididymitis. The nurse would appropriately educate the client using which of the following statements?

1. You will have a decrease in testosterone production.

2. Your sperm maturity may be affected.

3. There will be a decrease in blood flow to your penis.

4. There may be erectile difficulties.

Correct Answer: 2

Rationale 1: Testosterone is produced within the testes. Inflammation of the epididymis will not impact testosterone production.

Rationale 2: The final storage area for sperm is the epididymis. Inflammation of this area may impact sperm maturity.

Rationale 3: The epididymis does not impact blood flow to the penis.

Rationale 4: The epididymis does not have a role in the achievement of an erection.

Global Rationale: The epididymis does not produce testosterone. The epididymis is the final area for the storage and maturation of sperm. Inflammation of the epididymis can impact the sperms maturity. The epididymis does not impact the blood flow to the penis. The epididymis does not have an influence on the ability to achieve an erection.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 21.7: Apply critical thinking in selected simulations related to physical assessment of the male reproductive system.

Question 26

Type: MCSA

During the well-child assessment on a 2-year-old male the nurse notes that the testes are not descended. The nurse would correctly choose which of the following actions?

1. Report the finding to the healthcare provider.

2. Ask the parent if the child has had any surgeries.

3. Proceed with palpation of the scrotum.

4. Inquire about the childs voiding patterns.

Correct Answer: 1

Rationale 1: Undescended testes, called cryptorchidism, is a common finding, especially if the infant is preterm. The testes should descend spontaneously within the first year of life. If both testes do not descend, the male will be infertile and will be at a greater risk for the development of testicular cancer.

Rationale 2: The presence of surgical histories will not influence the condition or the actions that must be taken next.

Rationale 3: Palpation of scrotum will not promote the testicles to descend. The healthcare provider must be notified.

Rationale 4: Voiding patterns are not related to the occurrence of cryptorchidism.

Global Rationale: Undescended testes, or cryptochidism, is common in preterm infants, but should resolve spontaneously by 1 year of age. If unresolved, the condition can lead to infertility in the male and at risk for testicular cancer. This abnormal finding should be reported to the healthcare provider. Previous surgeries and voiding patterns are not relevant to this situation, and palpation will not be possible.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 21.7: Apply critical thinking in selected simulations related to physical assessment of the male reproductive system.

Question 27

Type: MCSA

A couple is seeking infertility information from the nurse. Which of the following statements made by the couple would indicate the need for intervention by the nurse?

1. We have been to two doctors already.

2. We have intercourse at least three times a week.

3. We are using temperature tracking for ovulation prediction.

4. We have been trying to conceive for a year.

Correct Answer: 4

Rationale 1: The number of healthcare providers being seen by the family are not relevant to the nurses immediate actions.

Rationale 2: The couple is engaging in sexual intercourse. This indicates a lack of intercourse should not be of issue.

Rationale 3: The use of the basal body temperature to assess for ovulation is recommended as an initial step in attempting to conceive.

Rationale 4: Couples are not considered for infertility treatment until they have tried to conceive for at least one year.

Global Rationale: Couples are not considered for infertility treatment until they have tried to conceive for at least one year. Temperature tracking for ovulation and frequent intercourse are suggested when trying to conceive. The number of healthcare providers the couple has been to is not relevant information in this situation.

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 21.7: Apply critical thinking in selected simulations related to physical assessment of the male reproductive system.

Question 28

Type: MCSA

The nurse is examining a male adolescent with suspected spermatic cord torsion. The nurse would anticipate which of the following as a priority intervention?

1. Medicate for pain with narcotics.

2. Prepare for surgery.

3. Elevate the scrotum.

4. Administer anti-inflammatory medications.

Correct Answer: 2

Rationale 1: Medication for pain with narcotics may be ordered by the healthcare provider. It does not, however, present a higher priority than preparing the client for surgery.

Rationale 2: Torsion of the spermatic cord requires immediate surgical intervention, making this the priority for the nurse in this situation.

Rationale 3: The scrotum may be elevated after the procedure but elevation is not a priority in the preoperative period.

Rationale 4: The administration of anti-inflammatory medications is not indicated for this client.

Global Rationale: Torsion of the spermatic cord requires immediate surgical intervention, making this the priority for the nurse in this situation. Medication for pain with narcotics may be ordered by the healthcare provider. It does not, however, present a higher priority than preparing the client for surgery. The scrotum may be elevated after the procedure but elevation is not a priority in the preoperative period. The administration of anti-inflammatory medications is not indicated for this client.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 21.7: Apply critical thinking in selected simulations related to physical assessment of the male reproductive system.

Question 29

Type: MCSA

A male is being seen at the urologist office with concerns relating to his fertility. Which of the following factors may warrant further investigation?

1. The client was treated for gonorrhea 2 years ago.

2. The client has a history of genital herpes simplex.

3. The clients medical history indicates a past history of marijuana use.

4. The client works in a paint manufacturing company.

Correct Answer: 4

Rationale 1: Gonorrhea in a male has not been linked to infertility. In addition, there are no factors provided to infer that damage has resulted from the disease.

Rationale 2: Men with genital herpes simplex are not infertile.

Rationale 3: A history of marijuana use is not associated with male-related infertility.

Rationale 4: Chronic exposure to chemicals has been implicated in the development of male caused infertility.

Global Rationale: The responsibility of the nurse includes making additional inquiries on factors that may be related to the concerns associated with infertility. Chronic exposure to chemicals has been implicated in the development of male-caused infertility. Gonorrhea in a male has not been linked to infertility. In addition, there are no factors provided to infer that damage has resulted from the disease. Men with genital herpes simplex are not infertile. A history of marijuana use is not associated with male-related infertility.

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 21.7: Apply critical thinking in selected simulations related to physical assessment of the male reproductive system.

Question 30

Type: MCSA

The parents of a 9-year-old boy voice concerns about the seemingly advanced level of sexual maturity of their son. The examination reveals the child has thick pubic hair and enlarged genitalia. Which treatment intervention may be anticipated by the nurse?

1. Administration of estrogen to reduce the impact of escalating testosterone levels

2. Continued observation of the rate of maturation for the next 6 to 9 months

3. Referral to an endocrinologist

4. Reduction of processed foods in the diet to reduce hormone exposure

Correct Answer: 3

Rationale 1: Estrogen is not administered to males to manage precocious puberty. A prompt diagnosis of the condition is warranted.

Rationale 2: A prompt diagnosis of the condition is warranted. It would be inappropriate to continue observation for the next 6 to 9 months.

Rationale 3: Precocious puberty may be idiopathic or caused by a genetic trait, lesions in the pituitary gland or hypothalamus, or testicular tumors. Referral to an endocrinologist may be required for definitive diagnosis.

Rationale 4: While processed foods may contain excess hormones and chemicals the child in the scenario will need a prompt diagnosis of this condition.

Global Rationale: Precocious puberty is an endocrine disorder characterized by the development of adult male characteristics in males under age 10. It includes dense pubic hair, penile enlargement, and enlargement of the testes. Precocious puberty may be idiopathic or caused by a genetic trait, lesions in the pituitary gland or hypothalamus, or testicular tumors. Referral to an endocrinologist may be required for definitive diagnosis. Estrogen is not administered to males to manage precocious puberty. A prompt diagnosis of the condition is warranted. It would be inappropriate to continue observation for the next 6 to 9 months. While processed foods may contain excess hormones and chemicals the child in the scenario will need a prompt diagnosis of this condition.

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 21.7: Apply critical thinking in selected simulations related to physical assessment of the male reproductive system.

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