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Chapter 20: Male Genitalia Ball: Seidel’s Guide to Physical Examination, 9th Edition MULTIPLE CHOICE 1. While examining an 18-year-old man, you note that his penis and testicles are more darkly pigmented th

should consider this finding to be: a. within normal limits. b. suggestive of a skin fungus. c. suggestive of psoriasis. d. caused by excessive progesterone. ANS: A

Darker pigmentation on the penis and testicles, as compared with other body skin, is a normal finding an skin fungus, psoriasis, or excessive progesterone. DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 2. In an uncircumcised male, retraction of the foreskin may reveal a cheesy white substance. This is usually a. evidence of a fungal infection. b. a collection of sebaceous material. c. indicative of penile carcinoma. d. suggestive of diabetes. ANS: B

In the uncircumcised male, smegma is formed by the secretion of sebaceous material by the glans and th epithelial cells from the prepuce. It appears as a cheesy white substance on the glans and in the fornix of lubricates the cavity between the foreskin of the penis and the glans, allowing smooth movement betwee It is not usually evidence of a fungal infection, penile carcinoma, or diabetes. DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 3. Inspection of the scrotum should reveal: a. lightly pigmented skin. b. two testes per sac. c. smooth scrotal sacs. d. the left scrotal sac lower than the right. ANS: D

The left cord is longer than the right; consequently, the left testis hangs somewhat lower. The skin of the pigmented. The scrotum has one testis per sac. The scrotum has small epidermoid cysts that give it a lum DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 4. Expected genitalia changes that occur as men age include that: a. the ejaculatory volume decreases with age. b. erections develop more quickly. c. the viability of sperm increases. d. the scrotum becomes more pendulous. ANS: D

Ejaculatory volume increases with age, erections develop more slowly, sperm viability decreases, and th pendulous with age. DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 5. Inspection of the male urethral orifice requires the examiner to: a. ask the patient to bear down.

b. c. d.

insert a small urethral speculum. press the glans between the thumb and forefinger. transilluminate the penile shaft.

ANS: C

6. You are inspecting the genitalia of an uncircumcised adult male. The foreskin is tight and cannot be easi a. chart the finding as paraphimosis. b. inquire about previous penile infections. c. retract the foreskin firmly. d. transilluminate the glans. ANS: B

This condition is phimosis and is usually congenital, or it may be related to recurrent infections or poorly should not chart this finding as paraphimosis. Retracting the foreskin forcibly would lead to further adhe worsening phimosis. Transillumination is indicated for masses of the scrotum. DIF: Cognitive Level: Applying (Application) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 7. Which type of hernia lies within the inguinal canal? a. Umbilical b. Direct c. Indirect d. Femoral ANS: C

Hernias found within the inguinal canal are called indirect hernias. DIF: Cognitive Level: Remembering (Knowledge) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 8. Which condition is of minor consequence in an adult male? a. Adhesions of the foreskin b. Continuous penile erection c. Lumps in the scrotal skin d. Venous dilation in the spermatic cord ANS: C

Lumps in the scrotal skin are related to numerous sebaceous cysts and are within normal limits. DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 9. Mr. L has an unusually thick scrotum, with edema and pitting. He has a history of cardiac problems. The

is most likely a(n): a. congenital defect that has worsened. b. indication of general fluid retention. c. normal consequence of aging. d. complication of the development of mumps. ANS: B

General fluid retention can cause scrotal thickening and pitting edema, and is usually seen as a result of disease. This swelling does not imply a condition of the genitalia, but rather a condition of these related DIF: Cognitive Level: Applying (Application) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 10. A characteristic related to syphilis or diabetic neuropathy is testicular: a. dropping, with asymmetry. b. enlargement. c. insensitivity to painful stimulation. d. recession into the abdomen. ANS: C

Diabetic neuropathy or syphilis can cause a marked reduction of tactile perceptions. Asymmetry is a nor and recession are not related to diabetes or syphilis. DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation

11. On palpation, a normal vas deferens should feel: a. beaded. b. smooth.

12. A premature infant’s scrotum will appear: a. bifid. b. loose. c. ridged. d. smooth. ANS: D

The premature male scrotum will appear underdeveloped, smooth, without rugae, and without testes; the have a loose, pendulous scrotum, with rugae and a midline raphe. DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 13. An enlarged painless testicle in an adolescent or adult male may indicate: a. epididymitis. b. testicular torsion. c. a tumor. d. an undescended testicle. ANS: C

A hard, enlarged, painless testicle can indicate a tumor in the adolescent or adult male. Epididymitis and undescended testicle is common in infants and is usually resolved by 12 months. DIF: Cognitive Level: Applying (Application) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 14. You palpate a soft, slightly tender mass in the right scrotum of an adult male. You attempt to reduce the

is no change in the mass size. Your next assessment maneuver is to: a. use two fingers to attempt to reduce the mass. b. palpate the left scrotum simultaneously. c. lift the right testicle and then compare pain level. d. transilluminate the mass. ANS: D

A soft mass is a hernia or hydrocele. If the mass can be reduced, it is probably a hernia; a nonreducible m transilluminated to determine whether it contains fluid and is possibly caused by a hydrocele. Lifting the when epididymitis is suspected. DIF: Cognitive Level: Analyzing (Analysis) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 15. The most common cancer in young men ages 15 to 30 years is: a. testicular. b. penile. c. prostate. d. anal. ANS: A

Because testicular tumors are the most common cancer occurring in young adults, self-examination is en DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 16. The most emergent cause of testicular pain in a young male is: a. testicular torsion. b. epididymitis. c. tumor. d. hydrocele. ANS: A

Testicular torsion is a surgical emergency. If surgery is performed within 12 hours after the onset of sym saved in about 90% of cases. Delayed treatment results in a much lower salvage rate. DIF: Cognitive Level: Analyzing (Analysis) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation...