Chapter 40: Care of Men with Reproductive Disorders My Nursing Test Banks

Chapter 40: Care of Men with Reproductive Disorders

MULTIPLE CHOICE

1. In counseling a man with erectile dysfunction about a prescription for sildenafil (Viagra), the nurse would suggest a different remedy if the patient was:

a.

over 50 years of age.

b.

taking nitroglycerin for angina.

c.

more than 50 pounds overweight.

d.

a long-term diabetic.

ANS: B

Viagra is contraindicated if the patient is also taking nitrates because the combination can cause significant hypotension. Age, weight, and diabetes are not contraindications for the use of Viagra.

DIF: Cognitive Level: Application REF: 925 OBJ: 2 (theory)

TOP: Erectile Dysfunction: Viagra KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Pharmacological Therapies

2. The nurse reminds a 68-year-old man that a man of any age can reproduce if he:

a.

can maintain an erection.

b.

can ejaculate.

c.

has a high sperm count.

d.

can participate in intercourse.

ANS: D

If a man can participate in intercourse, he can still reproduce, even with a low sperm count.

DIF: Cognitive Level: Analysis REF: 920 OBJ: 1 (theory)

TOP: Sperm Production KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

3. The patient who has been given a prescription for tadalafil (Cialis) is warned about the possibility of the complication of:

a.

priapism.

b.

obstructed urethra.

c.

hydronephrosis.

d.

urethritis.

ANS: A

Cialis can cause priapism, a persistent erection that can develop into a urologic emergency as penile vessels may become thrombosed. Urethral obstruction is not associated with the use of tadalafil (Cialis). Hydronephrosis refers to dilation of the renal pelvis and is not associated with the use of tadalafil (Cialis). Urethritis refers to infection or inflammation of the urethra and is not associated with the use of tadalafil (Cialis).

DIF: Cognitive Level: Application REF: 924 OBJ: 2 (theory)

TOP: Erectile Dysfunction: Cialis KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Pharmacological Therapies

4. In interviewing a patient who is seeking assistance at the urology clinic for erectile dysfunction, the nurse might begin the interview by saying:

a.

When was the last time you were impotent?

b.

Do you attempt to have intercourse every week?

c.

What medications have you tried previously?

d.

What experiences have you had with erectile dysfunction?

ANS: D

Asking open-ended questions will help the patient respond with information that can be used in a plan of care.

DIF: Cognitive Level: Application REF: 923 OBJ: 2 (theory)

TOP: ED: Interview KEY: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

5. The nurse understands that the clinical definition of sterility is failure to conceive after _____ months of frequent, unprotected sex.

a.

6

b.

12

c.

18

d.

24

ANS: B

A couple who, after 1 year of unprotected sex, has not conceived is considered to be sterile.

DIF: Cognitive Level: Comprehension REF: 924 OBJ: 3 (theory)

TOP: Sterility: Definition KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

6. The nurse is aware that of the known infertility causes approximately ____% are due to male factors.

a.

15

b.

25

c.

35

d.

45

ANS: B

Of the known cases of infertility, 25% to 30% are due to male factors.

DIF: Cognitive Level: Comprehension REF: 924 OBJ: 3 (theory)

TOP: Male Infertility KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

7. The nurse explains to a male patient undergoing infertility studies that his luteinizing hormone (LH) is low and his follicle-stimulating hormone (FSH) is high, which indicates that the patient is _____ testosterone and has _____ spermatogenesis.

a.

making; decreased

b.

not making; decreased

c.

making; high

d.

not making; high

ANS: A

A low LH means there is adequate stimulation of testosterone. A high FSH means there is a low or decreased spermatogenesis.

DIF: Cognitive Level: Analysis REF: 924 OBJ: 4 (theory)

TOP: Infertility Tests: LH and FSH KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

8. As part of a teaching plan for a young man who is undergoing fertility studies, the nurse would include:

a.

engaging in intercourse in the evening when testosterone levels are high.

b.

relaxing in a hot bath or Jacuzzi to stimulate spermatogenesis.

c.

wearing boxer shorts instead of jockey shorts.

d.

not engaging in intercourse except during the fertile period of the partner.

ANS: C

The heat from close body contact from wearing jockey shorts reduces spermatogenesis. Sexual intercourse will not increase testosterone levels. Heat will reduce sperm count, not increase it.

DIF: Cognitive Level: Comprehension REF: 925 OBJ: 3 (theory)

TOP: Infertility: Teaching Plan KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

9. A young man who has been diagnosed as sterile says to the nurse, I am not much of a man or a husband. The nurses most therapeutic response would be:

a.

I know you feel awful, but you can always adopt.

b.

How do you feel about artificial insemination?

c.

What about this sterility diagnosis concerns you the most?

d.

Sterility isnt the end of the world, is it?

ANS: C

Use of open-ended questions demonstrates a caring attitude and a willingness to listen. Telling the patient that she knows how he feels is incorrect and will be viewed as insincere. The patient feels less masculine as a result of infertility. It is premature and inappropriate to discuss options for alternative means of conception. Telling the patient that the diagnosis is not the end of the world minimizes the patients concerns.

DIF: Cognitive Level: Application REF: 925 OBJ: 8 (theory)

TOP: Sterility: Self-Concept KEY: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

10. The nurse cautions a boys health class at the high school that, when using a latex condom, one should:

a.

use petroleum jelly as a lubricant.

b.

leave room at the tip for a reservoir for semen.

c.

if intercourse does not occur, remove and reuse the condom.

d.

apply the condom immediately before ejaculation.

ANS: B

Leaving room at the tip of a condom guards against spillage of semen. Petroleum jelly deteriorates latex condoms. Only water-based lubricants should be used. Condoms should be applied only one time. A condom should be applied with erection; sperm is secreted in pre-ejaculate.

DIF: Cognitive Level: Comprehension REF: 920 OBJ: 3 (theory)

TOP: Contraception: Condoms KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential

11. After a fall on a bicycle, a 15-year-old boy is brought to the emergency department complaining of nausea and sudden and acute scrotal pain. There is an absence of the cremasteric reflex. The nurse interprets these findings as being indicative of:

a.

hydrocele.

b.

varicocele.

c.

orchiditis.

d.

torsion of testicle.

ANS: D

Torsion of the testicle causes acute scrotal pain, absence of the cremasteric reflex, and nausea and vomiting. This is seen after an accident. Hydrocele refers to accumulation of fluid in the scrotum. Many times the cause is unknown. Hydrocele causes enlargement of the scrotum and usually is painless, but the weight and added bulk of the fluid can cause discomfort. Dilation and clumping of the tributary vessels of the spermatic vein causes the painful swelling called varicocele.

DIF: Cognitive Level: Comprehension REF: 926 OBJ: 6 (theory)

TOP: Torsion: Signs and Symptoms KEY: Nursing Process Step: Assessment

MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

12. The main symptom that alerts a person to the presence of benign prostatic hyperplasia (BPH) is:

a.

difficulty voiding.

b.

hematuria.

c.

pain in scrotum.

d.

pain on voiding.

ANS: A

Difficulty urinating is the first symptom noticed by a person who has BPH.

DIF: Cognitive Level: Comprehension REF: 927 OBJ: 6 (theory)

TOP: BPH: Signs and Symptoms KEY: Nursing Process Step: Planning

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

13. The nurse reinforces the physicians instructions to a person with BPH who is taking the 5-alpha-reductase inhibitor finasteride (Proscar) that the drug will:

a.

relax the prostate.

b.

reduce prostate size.

c.

reduce urine production.

d.

relax smooth muscle.

ANS: B

Finasteride (Proscar) is used to reduce the size of the prostate. It does not relax the prostate, reduce urine production, or relax smooth muscle.

DIF: Cognitive Level: Comprehension REF: 927 OBJ: 7 (theory)

TOP: BPH: Drug Therapy KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Pharmacological Therapies

14. The wife of a patient who has just returned to the unit after a TURP is alarmed about the blood clots and pieces of tissue returning in the indwelling catheter bag. The nurses best response is:

a.

Dont worry. All these patients bleed. Its no big deal.

b.

Blood clots and tissue are expected for the first few days.

c.

Ill notify the surgeon immediately. He will be able to stop this hemorrhage.

d.

Bleeding will completely clear up in about 8 hours.

ANS: B

Honest answers about expected blood and clots will alleviate anxiety. The presence of blood clots in the urinary collection is anticipated and normal. Telling the patient that the loss of blood is no big deal trivializes the occurrence and is not therapeutic. There is no indication that the patient is hemorrhaging. Bleeding is anticipated for the first few days after surgery. The bleeding is not limited to only 8 hours after the procedure.

DIF: Cognitive Level: Application REF: 928 OBJ: 10 (theory)

TOP: TURP: Bleeding KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

15. On the first postoperative day, a patient with a TURP complains of abdominal pain and the bladder is greatly distended. The nurse should:

a.

inform the charge nurse of this complication.

b.

irrigate the indwelling catheter with 20 to 30 mL of normal saline.

c.

increase continuous bladder irrigation flow rate to flush out the clot.

d.

turn the patient to the right side.

ANS: B

Additional irrigation will dislodge the clot that is occluding the catheter. Increasing continuous bladder irrigation will add fluid to the bladder and increase pain. It is within the primary care nurses role to perform the intervention with notification of the charge nurse. There is no benefit from turning the patient to the right side.

DIF: Cognitive Level: Analysis REF: 928 OBJ: 10 (theory)

TOP: Prostatectomy: Occluded Catheter KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

16. The nurse explains to a patient considering various methods to relieve his hypertrophied prostate that transurethral microwave thermotherapy (TUMT) removes prostatic tissue by:

a.

cauterizing prostatic tissue with a resectoscope.

b.

coagulating prostatic tissue with a transurethral probe.

c.

using radiofrequency needles to coagulate the prostate.

d.

vaporizing and desiccating prostatic tissue.

ANS: B

The TUMT procedure uses heat to coagulate the prostatic tissue with a probe.

DIF: Cognitive Level: Implementation REF: 929 OBJ: 9 (theory)

TOP: TUMT: Technique KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

17. A patient who had a suprapubic prostatectomy is depressed that he still has the suprapubic catheter in place. He asks, When can I get rid of this catheter? The nurses most informative response would be that the suprapubic catheter will be removed when the urine residual after voiding has decreased to _____ mL.

a.

150

b.

125

c.

95

d.

75

ANS: D

The suprapubic catheter is removed when the urine residual after voiding reduces to 75 mL.

DIF: Cognitive Level: Comprehension REF: 929 OBJ: 3 (clinical)

TOP: Suprapubic Prostatectomy: Suprapubic Catheter

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

18. The nurse advises a patient that the best time to perform his monthly testicular self-examination is:

a.

in the morning when testosterone level is high.

b.

12 to 24 hours after ejaculation has occurred.

c.

after bathing when scrotal skin is relaxed.

d.

in the evening when testosterone level is low.

ANS: C

Testicular self-examinations are best done after a warm bath or shower when the scrotal skin is relaxed. Testosterone levels and ejaculation will not alter the results of the testicular self-examination.

DIF: Cognitive Level: Comprehension REF: 933 OBJ: 11 (theory)

TOP: Testicular Self-Examination: Timing

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

19. A postoperative prostatectomy patient is discouraged that he is still dribbling and wearing a protective pad 1 month after surgery. Which suggestion by the nurse would be most helpful to the patient?

a.

Eating a low-residue diet to reduce the amount of urine

b.

Drinking grapefruit juice to tighten the urinary sphincter of the bladder

c.

Acquiring an indwelling catheter to prevent leakage

d.

Practicing Kegel exercises several times a day

ANS: D

Kegel exercises increase the strength of the perineal floor muscle and will reduce dribbling. Dietary intake will not reduce the amount of urine dribbling being experienced by the patient. An indwelling catheter will not provide the restorative care needed by the patient.

DIF: Cognitive Level: Implementation REF: 935 OBJ: 10 (theory)

TOP: Dribbling: Kegel KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

20. The nurse has provided discharge instructions to a patient who has just had a vasectomy. Which statement by the patient indicates the need for further instruction?

a.

I can use a heating pad this evening for my discomfort.

b.

Taking aspirin every 4 hours will help with my pain.

c.

I should leave the compression dressing on for the first 24 hours.

d.

I should ice my scrotum once I get home.

ANS: D

Instruct the patient to use ice applications and acetaminophen or ibuprofen for scrotal pain and swelling the first 12 to 24 hours postoperatively. The patient should wear jockey shorts or a scrotal support for comfort. Heat is not recommended during the first 24 hours postoperatively. Aspirin may promote bleeding. The patient will not have a compression dressing.

DIF: Cognitive Level: Application REF: 920 OBJ: 3 (theory)

TOP: Permanent Contraception: Vasectomy

KEY: Nursing Process Step: Evaluation

MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential

21. The nurse is caring for a patient in the initial hours after having surgery to manage an enlarged prostate. The patients postoperative care includes continuous bladder irrigation. Which statement by the patient indicates understanding of the postoperative period?

a.

I will likely have to have this bladder irrigation for the first 5 to 7 days.

b.

My urine will likely be a dark tea color as a result of the blood it contains.

c.

I will need to have my bladder irrigated for the first 2 to 3 days.

d.

Bladder spasms should be reported as they can often signal serious complications.

ANS: C

Bladder irrigation will be continuous for approximately 2 to 3 days. The urine will be bloody and may be colored as red, pink, or watermelon during the initial postoperative period. Tea color urine is not associated with this surgical procedure. Bladder spasms are normal and do not necessarily signal complications.

DIF: Cognitive Level: Application REF: 928 OBJ: 11 (theory)

TOP: Benign Prostatic Hyperplasia: Postoperative Care

KEY: Nursing Process Step: Evaluation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

MULTIPLE RESPONSE

22. The nurse is conducting a presentation to a health class for male high school students. A student questions the nurse about what semen really is. Which characteristic(s) should be included in the response about the content of semen? (Select all that apply.)

a.

A thick, fructose-filled fluid from seminal vesicles

b.

Prostaglandins for sperm motility

c.

Thin, milky secretions from prostate gland

d.

Mucus from bulbourethral gland for lubrication

e.

Spermatozoa

ANS: A, B, C, E

Mucus from the bulbourethral gland is not part of the semen.

DIF: Cognitive Level: Comprehension REF: 919 OBJ: 5 (theory)

TOP: Semen: Contents KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

23. The nurse lists the age-related changes in the male reproductive tract, which include: (Select all that apply.)

a.

pendulous scrotum.

b.

prostate enlargement.

c.

decrease in testosterone.

d.

increase in ejaculate volume.

e.

shortened arousal time.

ANS: A, B, C

The volume of ejaculate decreases and the arousal time lengthens.

DIF: Cognitive Level: Comprehension REF: 920 OBJ: 1 (theory)

TOP: Age-Related Changes KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

24. The nurse planning discharge instruction for a patient who just had a vasectomy would include: (Select all that apply.)

a.

using a scrotal support for comfort.

b.

applying an ice pack to the scrotum for the first 24 hours.

c.

resuming sexual intercourse immediately.

d.

using another method of birth control until the sperm count is negative.

e.

returning for a follow-up sperm count in 6 months.

ANS: A, B, D

Intercourse should be delayed for a week, and the follow-up visit should occur 1 year after the sperm count is negative to confirm that the vas deferens is not intact.

DIF: Cognitive Level: Application REF: 920 OBJ: 3 (theory)

TOP: Vasectomy: Postprocedure Instruction

KEY: Nursing Process Step: Planning

MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

25. The patient considering a vasectomy tells the nurse he is afraid he will be impotent after the surgery. The nurse lists the expected outcome(s) of the procedure as: (Select all that apply.)

a.

remaining potent, but sterile.

b.

having a minor impact on libido.

c.

incurring no effect on performance.

d.

having no effect on amount of ejaculate.

e.

retaining some sperm for several weeks.

ANS: A, C, D, E

All options except having a minor impact on libido are postoperative expectations of a vasectomy. There is no effect on libido.

DIF: Cognitive Level: Comprehension REF: 920 OBJ: 3 (theory)

TOP: Vasectomy Outcomes KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

26. The nurse is aware that the main risk factors for benign prostatic hyperplasia (BPH) include: (Select all that apply.)

a.

increasing age.

b.

smoking.

c.

functioning testes.

d.

infrequent ejaculation.

e.

neurogenic bladder.

ANS: A, C

The major risk factors are the increasing age in conjunction with functioning testes.

DIF: Cognitive Level: Comprehension REF: 927 OBJ: 7 (theory)

TOP: BPH: Risk Factors KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

27. The nurse outlines the possible complications from benign prostatic hyperplasia (BPH), which include: (Select all that apply.)

a.

urinary tract infection.

b.

renal failure.

c.

dilation of ureters.

d.

cancer of the bladder.

e.

hydronephrosis.

ANS: A, B, C, E

Bladder cancer is not a complication of BPH.

DIF: Cognitive Level: Comprehension REF: 927 OBJ: 10 (theory)

TOP: Complication of BPH KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

28. The nurse is collecting data from a patient who has come to the ambulatory care clinic with complaints of erectile dysfunction. When reviewing the patients health history, which finding(s) would provide support for this condition? (Select all that apply.)

a.

The patient has a history of iron deficiency anemia.

b.

The patient has been treated for irritable bowel syndrome.

c.

The patient is taking medications to manage hypertension.

d.

The patient is an insulin-dependent diabetic.

e.

The patient has a history of bipolar disorder.

ANS: C, D, E

Medications and health conditions may predispose the patient to erectile dysfunction. Medications used in the management of hypertension may be associated with erectile dysfunction. Vascular changes experienced by the patient with diabetes may be associated with difficulty having and/or maintaining an erection. Depression may result in difficulty attaining an erection. Sickle cell anemia and not iron deficiency anemia is associated with erectile dysfunction. Irritable bowel syndrome does not heighten the risk for developing erectile dysfunction.

DIF: Cognitive Level: Application REF: 923 OBJ: 6 (theory)

TOP: Erectile Dysfunction: Clinical Cues

KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

MATCHING

The nurse teaches helpful terminology related to male reproductive disorders to a patient. Match the condition with the characteristic that best describes it.

a.

Hydrocele

b.

Varicocele

c.

Priapism

d.

Peyronies disease

e.

Torsion

29. Prolonged erection associated with sickle cell anemia

30. Erection curving upward preventing vaginal penetration

31. Painless enlargement of the scrotum from fluid accumulation

32. Twisting of testes and spermatic cord

33. Painful left-sided scrotal edema from clumping and dilation of vessels of the spermatic vein

29. ANS: C DIF: Cognitive Level: Knowledge REF: 926

OBJ: 6 (theory) TOP: Male Reproductive Disorders

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

30. ANS: D DIF: Cognitive Level: Knowledge REF: 927

OBJ: 6 (theory) TOP: Male Reproductive Disorders

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

31. ANS: A DIF: Cognitive Level: Knowledge REF: 925

OBJ: 6 (theory) TOP: Male Reproductive Disorders

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

32. ANS: E DIF: Cognitive Level: Knowledge REF: 926

OBJ: 6 (theory) TOP: Male Reproductive Disorders

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

33. ANS: B DIF: Cognitive Level: Knowledge REF: 926

OBJ: 6 (theory) TOP: Male Reproductive Disorders

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

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