TB-Chapter 25 Male Genitourinary System PDF

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PHYSICAL EXAMINATION AND HEALTH ASSESSMENT 8TH EDITION JARVIS TEST BANK

TestBank-PhysicalExaminationandHealthAssessment8e(byJarvis)

382

Chapter25:MaleGenitourinarySystem MULTIPLECHOICE 1.Theexternalmalegenitalstructuresincludethe: a.

Testis.

b.

Scrotum.

c.

Epididymis.

d.

Vasdeferens.

ANS:B Theexternalmalegenitalstructuresincludethepenisandscrotum.Thetestis,epididymis,andvasdeferensare internalstructures. DIF:CognitiveLevel:Remembering(Knowledge) MSC:ClientNeeds:General 2.Anaccessoryglandularstructureforthemalegenitalorgansisthe: a.

Testis.

b.

Scrotum.

c.

Prostate.

d.

Vasdeferens.

NURSINGTB.COM

ANS:C Glandularstructuresaccessorytothemalegenitalorgansaretheprostate,seminalvesicles,andbulbourethral glands. DIF:CognitiveLevel:Remembering(Knowledge) MSC:ClientNeeds:General 3.Whichofthesestatementsistrueregardingthepenis? a.

Theurethralmeatusislocatedontheventralsideofthepenis.

b.

Theprepuceisthefoldofforeskincoveringtheshaftofthepenis.

c.

Thepenisismadeupoftwocylindricalcolumnsoferectiletissue.

NURSINGTB.COM

PHYSICAL EXAMINATION AND HEALTH ASSESSMENT 8TH EDITION JARVIS TEST BANK TestBank-PhysicalExaminationandHealthAssessment8e(byJarvis)

d.

383

Thecorpusspongiosumexpandsintoaconeoferectiletissuecalledtheglans.

ANS:D Atthedistalendoftheshaft,thecorpusspongiosumexpandsintoaconeoferectiletissue,theglans.Thepeni ismadeupofthreecylindricalcolumnsoferectiletissue.Theskinthatcoverstheglansofthepenisisthe prepuce.Theurethralmeatusformsatthetipoftheglans. DIF:CognitiveLevel:Remembering(Knowledge) MSC:ClientNeeds:General 4.Whenperformingagenitalexaminationona25-year-oldman,thenursenoticesdeeplypigmented,wrinkled scrotalskinwithlargesebaceousfollicles.Onthebasisofthisinformation,thenursewould: a.

Squeezetheglanstocheckforthepresenceofdischarge.

b.

Considerthisfindingasnormal,andproceedwiththeexamination.

c.

Assessthetesticlesforthepresenceofmassesorpainlesslumps.

d.

Obtainamoredetailedhistory,focusingonanyscrotalabnormalitiesthepatienthasnoticed.

ANS:B NURSINGTB.COM Afteradolescence,thescrotalskinisdeeplypigmentedandhaslargesebaceousfolliclesandappears corrugated.

DIF:CognitiveLevel:Applying(Application) MSC:ClientNeeds:HealthPromotionandMaintenance 5.Whichstatementconcerningthetestesistrue? a.

Thelymphaticvesselsofthetestesdrainintotheabdominallymphnodes.

b.

Thevasdeferensislocatedalongtheinferiorportionofeachtestis.

c.

Therighttestisislowerthantheleftbecausetherightspermaticcordislonger.

d.

Thecremastermusclecontractsinresponsetocoldanddrawsthetesticlesclosertothebody.

ANS:D Whenitiscold,thecremastermusclecontracts,whichraisesthescrotalsacandbringsthetestesclosertothe bodytoabsorbheatnecessaryforspermviability.Thelymphaticvesselsofthetestesdrainintotheinguinal lymphnodes.Thevasdeferensislocatedalongtheupperportionofeachtestis.Thelefttestisislowerthanthe rightbecausetheleftspermaticcordislonger. DIF:CognitiveLevel:Remembering(Knowledge)

NURSINGTB.COM

PHYSICAL EXAMINATION AND HEALTH ASSESSMENT 8TH EDITION JARVIS TEST BANK TestBank-PhysicalExaminationandHealthAssessment8e(byJarvis)

384

MSC:ClientNeeds:General 6.Amalepatientwithpossiblefertilityproblemsasksthenursewherespermisproduced.Thenurseknows thatspermproductionoccursinthe: a.

Testes.

b.

Prostate.

c.

Epididymis.

d.

Vasdeferens.

ANS:A Spermproductionoccursinthetestes,notintheotherstructureslisted. DIF:CognitiveLevel:Remembering(Knowledge) MSC:ClientNeeds:PhysiologicIntegrity 7.A62-year-oldmanstatesthathisphysiciantoldhimthathehasaninguinalhernia.Heasksthenurseto explainwhataherniais.Thenurseshould: a.

Tellhimnottoworryandthatmostmenhisagedevelophernias. NURSINGTB.COM

b.

Explainthataherniaisoftentheresultofprenatalgrowthabnormalities.

c.

Referhimtohisphysicianforadditionalconsultationbecausethephysicianmadetheinitial diagnosis.

d.

Explainthataherniaisaloopofbowelprotrudingthroughaweakspotintheabdominalmuscles.

ANS:D Aherniaisaloopofbowelprotrudingthroughaweakspotinthemusculature.Theotheroptionsarenot correctresponsestothepatientsquestion. DIF:CognitiveLevel:Applying(Application) MSC:ClientNeeds:PhysiologicIntegrity 8.Themotherofa10-year-oldboyasksthenursetodiscusstherecognitionofpuberty.Thenurseshouldreply bysaying: a.

Pubertyusuallybeginsaround15yearsofage.

b.

Thefirstsignofpubertyisanenlargementofthetestes.

c.

Thepenissizedoesnotincreaseuntilabout16yearsofage.

NURSINGTB.COM

PHYSICAL EXAMINATION AND HEALTH ASSESSMENT 8TH EDITION JARVIS TEST BANK TestBank-PhysicalExaminationandHealthAssessment8e(byJarvis)

d.

385

Thedevelopmentofpubichairprecedestesticularorpenisenlargement.

ANS:B Pubertybeginssometimebetweenage9forAfricanAmericansandage10forCaucasiansandHispanics.The firstsignisanenlargementofthetestes.Pubichairappearsnext,andthenpenissizeincreases. DIF:CognitiveLevel:Applying(Application) MSC:ClientNeeds:HealthPromotionandMaintenance 9.Duringanexaminationofanagingman,thenurserecognizesthatnormalchangestoexpectwouldbe: a.

Enlargedscrotalsac.

b.

Increasedpubichair.

c.

Decreasedpenissize.

d.

Increasedrugaeoverthescrotum.

ANS:C Intheagingman,theamountofpubichairdecreases,thepenissizedecreases,andtherugaeoverthescrotal NURSINGTB.COM sacdecreases.Thescrotalsacdoesnotenlarge. DIF:CognitiveLevel:Understanding(Comprehension) MSC:ClientNeeds:HealthPromotionandMaintenance 10.Anoldermanisconcernedabouthissexualperformance.Thenurseknowsthatintheabsenceofdisease,a withdrawalfromsexualactivitylaterinlifemaybeattributableto: a.

Sideeffectsofmedications.

b.

Decreasedlibidowithaging.

c.

Decreasedspermproduction.

d.

Decreasedpleasurefromsexualintercourse.

ANS:A Intheabsenceofdisease,awithdrawalfromsexualactivitymaybeattributabletosideeffectsofmedications suchasantihypertensives,antidepressants,sedatives,psychotropics,antispasmotics,tranquilizersornarcotics, andestrogens.Theotheroptionsarenotcorrect. DIF:CognitiveLevel:Understanding(Comprehension) MSC:ClientNeeds:HealthPromotionandMaintenance

NURSINGTB.COM

PHYSICAL EXAMINATION AND HEALTH ASSESSMENT 8TH EDITION JARVIS TEST BANK TestBank-PhysicalExaminationandHealthAssessment8e(byJarvis)

386

11.A59-year-oldpatienthasbeendiagnosedwithprostatitisandisbeingseenattheclinicforcomplaintsof burningandpainduringurination.Heisexperiencing: a.

Dysuria.

b.

Nocturia.

c.

Polyuria.

d.

Hematuria.

ANS:A Dysuria(burningwithurination)iscommonwithacutecystitis,prostatitis,andurethritis.Nocturiaisvoiding duringthenight.Polyuriaisvoidinginexcessivequantities.Hematuriaisvoidingwithbloodintheurine. DIF:CognitiveLevel:Applying(Application) MSC:ClientNeeds:PhysiologicIntegrity:PhysiologicAdaptation 12.A45-year-oldmotheroftwochildrenisseenattheclinicforcomplaintsoflosingmyurinewhenIsneeze. Thenursedocumentsthatsheisexperiencing: a.

Urinaryfrequency.

b.

Enuresis.

c.

Stressincontinence.

d.

Urgeincontinence.

NURSINGTB.COM

ANS:C Stressincontinenceisinvoluntaryurinelosswithphysicalstrain,sneezing,orcoughingthatoccursasaresult toweaknessofthepelvicfloor.Urinaryfrequencyisurinatingmoretimesthanusual(morethanfivetosix timesperday).Enuresisisinvoluntarypassageofurineatnightafterage5to6years(bedwetting).Urge incontinenceisinvoluntaryurinelossfromoveractivedetrusormuscleinthebladder.Itcontracts,causingan urgentneedtovoid. DIF:CognitiveLevel:Applying(Application) MSC:ClientNeeds:PhysiologicIntegrity:PhysiologicAdaptation 13.Whenthenurseisconductingsexualhistoryfromamaleadolescent,whichstatementwouldbemost appropriatetouseatthebeginningoftheinterview? a.

Doyouusecondoms?

b.

Youdontmasturbate,doyou?

NURSINGTB.COM

PHYSICAL EXAMINATION AND HEALTH ASSESSMENT 8TH EDITION JARVIS TEST BANK TestBank-PhysicalExaminationandHealthAssessment8e(byJarvis)

c.

Haveyouhadsexinthelast6months?

d.

Oftenadolescentsyouragehavequestionsaboutsexualactivity.

387

ANS:D Theinterviewshouldbeginwithapermissionstatement,whichconveysthatitisnormalandacceptableto thinkorfeelacertainway.Soundingjudgmentalshouldbeavoided. DIF:CognitiveLevel:Analyzing(Analysis) MSC:ClientNeeds:HealthPromotionandMaintenance 14.Whichofthesestatementsismostappropriatewhenthenurseisobtainingagenitourinaryhistoryfroman olderman? a.

Doyouneedtogetupatnighttourinate?

b.

Doyouexperiencenocturnalemissions,orwetdreams?

c.

Doyouknowhowtoperformatesticularself-examination?

d.

Hasanyoneevertouchedyourgenitalswhenyoudidnotwantthemto? NURSINGTB.COM

ANS:A

Theoldermalepatientshouldbeaskedaboutthepresenceofnocturia.Awakingatnighttourinatemaybe attributabletoadiureticmedication,fluidretentionfrommildheartfailureorvaricoseveins,orfluidingestion 3hoursbeforebedtime,especiallycoffeeandalcohol.Theotherquestionsaremoreappropriateforyounger men. DIF:CognitiveLevel:Analyzing(Analysis) MSC:ClientNeeds:HealthPromotionandMaintenance 15.Whenthenurseisperformingagenitalexaminationonamalepatient,thepatienthasanerection.The nursesmostappropriateactionorresponseisto: a.

Askthepatientifhewouldlikesomeoneelsetoexaminehim.

b.

Continuewiththeexaminationasthoughnothinghashappened.

c.

Stoptheexamination,leavetheroomwhilestatingthattheexaminationwillresumeatalatertime.

d.

Reassurethepatientthatthisisanormalresponseandcontinuewiththeexamination.

ANS:D Whenthemalepatienthasanerection,thenurseshouldreassurethepatientthatthisisanormalphysiologic responsetotouchandproceedwiththerestoftheexamination.Theotherresponsesarenotcorrectandmaybe

NURSINGTB.COM

PHYSICAL EXAMINATION AND HEALTH ASSESSMENT 8TH EDITION JARVIS TEST BANK TestBank-PhysicalExaminationandHealthAssessment8e(byJarvis)

388

perceivedasjudgmental. DIF:CognitiveLevel:Applying(Application) MSC:ClientNeeds:PsychosocialIntegrity 16.Thenurseisexaminingtheglansandknowswhichfindingisnormalforthisarea? a.

Themeatusmayhaveaslightdischargewhentheglansiscompressed.

b.

Hairiswithoutpestinhabitants.

c.

Theskiniswrinkledandwithoutlesions.

d.

Smegmamaybepresentundertheforeskinofanuncircumcisedmale.

ANS:D Theglanslookssmoothandwithoutlesionsanddoesnothavehair.Themeatusshouldnothaveanydischarge whentheglansiscompressed.Somecheesysmegmamayhavecollectedundertheforeskinofan uncircumcisedmale. DIF:CognitiveLevel:Understanding(Comprehension) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare NURSINGTB.COM 17.Whenperformingagenitourinaryassessment,thenursenoticesthattheurethralmeatusisventrally positioned.Thisfindingis:

a.

Calledhypospadias.

b.

Aresultofphimosis.

c.

Probablyduetoastricture.

d.

Oftenassociatedwithaging.

ANS:A Normally,theurethralmeatusispositionedjustaboutcentrally.Hypospadiasistheventrallocationofthe urethralmeatus.Thepositionofthemeatusdoesnotchangewithaging.Phimosisistheinabilitytoretractthe foreskin.Astrictureisanarrowopeningofthemeatus. DIF:CognitiveLevel:Applying(Application) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare 18.Thenurseisperformingagenitalexaminationonamalepatientandnoticesurethraldrainage.When collectingurethraldischargeformicroscopicexaminationandculture,thenurseshould: a.

Askthepatienttourinateintoasterilecup.

NURSINGTB.COM

PHYSICAL EXAMINATION AND HEALTH ASSESSMENT 8TH EDITION JARVIS TEST BANK TestBank-PhysicalExaminationandHealthAssessment8e(byJarvis)

b.

Askthepatienttoobtainaspecimenofsemen.

c.

Insertacotton-tippedapplicatorintotheurethra.

d.

Compresstheglansbetweentheexaminersthumbandforefinger,andcollectanydischarge.

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ANS:D Ifurethraldischargeisnoticed,thentheexaminershouldcollectasmearformicroscopicexaminationand culturebycompressingtheglansanteroposteriorlybetweenthethumbandforefinger.Theotheroptionsareno correctactions. DIF:CognitiveLevel:Applying(Application) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare 19.Whenassessingthescrotumofamalepatient,thenursenoticesthepresenceofmultiplefirm,nontender, yellow1-cmnodules.Thenurseknowsthatthesenodulesaremostlikely: a.

Fromurethritis.

b.

Sebaceouscysts.

c.

Subcutaneousplaques.

d.

Fromaninflammationoftheepididymis.

NURSINGTB.COM

ANS:B Sebaceouscystsarecommonlyfoundonthescrotum.Theseyellowish1-cmnodulesarefirm,nontender,and oftenmultiple.Theotheroptionsarenotcorrect. DIF:CognitiveLevel:Analyzing(Analysis) MSC:ClientNeeds:PhysiologicIntegrity:PhysiologicAdaptation 20.Whenperformingascrotalassessment,thenursenoticesthatthescrotalcontentsshowaredglowwith transillumination.Onthebasisofthisfindingthenursewould: a.

Assessthepatientforthepresenceofahernia.

b.

Suspectthepresenceofserousfluidinthescrotum.

c.

Considerthisfindingnormal,andproceedwiththeexamination.

d.

Referthepatientforevaluationofamassinthescrotum.

ANS:B Normalscrotalcontentsdonotallowlighttopassthroughthescrotum.However,serousfluiddoes

NURSINGTB.COM

PHYSICAL EXAMINATION AND HEALTH ASSESSMENT 8TH EDITION JARVIS TEST BANK TestBank-PhysicalExaminationandHealthAssessment8e(byJarvis)

390

transilluminateandshowsasaredglow.Neitheramassnoraherniawouldtransilluminate. DIF:CognitiveLevel:Analyzing(Analysis) MSC:ClientNeeds:PhysiologicIntegrity:PhysiologicAdaptation 21.Whenthenurseisperformingagenitalexaminationonamalepatient,whichactioniscorrect? a.

Auscultatingforthepresenceofabruitoverthescrotum

b.

Palpatingfortheverticalchainoflymphnodesalongthegroin,inferiortotheinguinalligament

c.

Palpatingtheinguinalcanalonlyifabulgeispresentintheinguinalregionduringinspection

d.

Havingthepatientshifthisweightontotheleft(unexamined)legwhenpalpatingforaherniaon therightside

ANS:D Whenpalpatingforthepresenceofaherniaontherightside,themalepatientisaskedtoshifthisweightonto theleft(unexamined)leg.Auscultatingforabruitoverthescrotumisnotappropriate.Whenpalpatingfor lymphnodes,thehorizontalchainispalpated.Theinguinalcanalshouldbepalpatedwhetherabulgeispresen ornot. DIF:CognitiveLevel:Applying(Application) NURSINGTB.COM MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare

22.Thenurseisawareofwhichstatementtobetrueregardingtheincidenceoftesticularcancer? a.

Testicularcanceristhemostcommoncancerinmenaged30to50years.

b.

Theearlysymptomsoftesticularcancerarepainandinduration.

c.

Menwithahistoryofcryptorchidismareatthegreatestriskforthedevelopmentoftesticular cancer.

d.

Thecureratefortesticularcancerislow.

ANS:C Menwithundescendedtesticles(cryptorchidism)areatthegreatestriskforthedevelopmentoftesticular cancer.Theoverallincidenceoftesticularcancerisrare.Althoughtesticularcancerhasnoearlysymptoms, whendetectedearlyandtreatedbeforemetastasizing,thecurerateisalmost100%. DIF:CognitiveLevel:Understanding(Comprehension) MSC:ClientNeeds:HealthPromotionandMaintenance 23.Thenurseisdescribinghowtoperformatesticularself-examinationtoapatient.Whichstatementismost appropriate?

NURSINGTB.COM

PHYSICAL EXAMINATION AND HEALTH ASSESSMENT 8TH EDITION JARVIS TEST BANK TestBank-PhysicalExaminationandHealthAssessment8e(byJarvis)

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a.

Agoodtimetoexamineyourtesticlesisjustbeforeyoutakeashower.

b.

Ifyounoticeanenlargedtesticleorapainlesslump,callyourhealthcareprovider.

c.

Thetesticleiseggshapedandmovable.Itfeelsfirmandhasalumpyconsistency.

d.

Performatesticularexaminationatleastonceaweektodetecttheearlystagesoftesticularcancer.

ANS:B Ifthepatientnoticesafirmpainlesslump,ahardarea,oranoverallenlargedtesticle,thenheshouldcallhis healthcareproviderforfurtherevaluation.Thetesticlenormallyfeelsrubberywithasmoothsurface.Agood timetoexaminethetesticlesisduringtheshowerorbath,whenoneshandsarewarmandsoapyandthe scrotumiswarm.Testicularself-examinationshouldbeperformedonceamonth. DIF:CognitiveLevel:Applying(Application) MSC:ClientNeeds:HealthPromotionandMaintenance 24.A2-month-olduncircumcisedinfanthasbeenbroughttotheclinicforawell-babycheckup....