Chapter 25: Male Genitourinary System
Jarvis: Physical Examination and Health Assessment, 8th Edition
MULTIPLE CHOICE
1. Which is a structure of the external male genital?
a.
Testis
b.
Scrotum
c.
Epididymis
d.
Vas deferens
2. Which is an accessory glandular structure for the male genital organs?
a.
Testis
b.
Scrotum
c.
Prostate
d.
Vas deferens
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 cylindric columns of erectile tissue.
d.
The corpus spongiosum expands into a cone of erectile tissue called the glans.
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, how should the nurse proceed?
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.
5. Which statement concerning the testes is true?
a.
The vas deferens is located along the inferior portion of each testis.
b.
The lymphatic vessels of the testes drain into the abdominal lymph nodes.
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.
6. A male patient with possible fertility problems asks the nurse where sperm is produced.
Which answer should the nurse give the patient?
a.
Testes
b.
Prostate
c.
Epididymis
d.
Vas deferens
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. Which response by the nurse is best?
a.
“Don’t worry, most men your age develop hernias.”
b.
“A hernia is often the result of a prenatal growth abnormality.”
c.
“You should talk to your physician since he or she made the initial diagnosis.”
d.
“A hernia is a loop of bowel protruding through a weak spot in the abdominal
muscles.”
8. The mother of a 10-year-old boy asks the nurse about the recognition of puberty. How should
the nurse reply?
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.”
d.
“The development of pubic hair precedes testicular or penis enlargement.”
9. During an examination of an aging man, the nurse recognizes that which finding is an
expected or normal change?
a.
Enlarged scrotal sac
b.
Increased pubic hair
c.
Decreased penis size
d.
Increased rugae over the scrotum
10. An older man is concerned about his sexual performance. In addition to a disease, what else
should the nurse explain can cause a withdrawal from sexual activity later in life?
a.
Decreased sperm production
b.
Side effects of medications
c.
Decreased libido with aging
d.
Decreased pleasure from sexual intercourse
11. A 59-year-old patient has been diagnosed with prostatitis and is being seen at the clinic for
reports of burning and pain during urination. How should the nurse document this finding?
a.
Dysuria
b.
Nocturia
c.
Polyuria
d.
Hematuria
12. When the nurse is conducting a 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 don’t masturbate, do you?”
c.
“Have you had sex in the last 6 months?”
d.
“Often adolescents your age have questions about sexual activity.”
13. 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?”
14. When the nurse is performing a genital examination on a male patient, the patient has an
erection. How should the nurse respond?
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.
15. The nurse is examining the glans and knows which finding is normal for this area?
a.
Hair is without pest inhabitants.
b.
The skin is wrinkled and without lesions.
c.
Smegma may be present under the foreskin of an uncircumcised male.
d.
The meatus may have a slight discharge when the glans is compressed.
16. When performing a genitourinary assessment, the nurse notices that the urethral meatus is
ventrally positioned. What does this indicate?
a.
Hypospadias
b.
A result of phimosis
c.
Probably due to a stricture
d.
Often associated with aging
17. The nurse is performing a genital examination on a male patient and notices urethral drainage.
What should the nurse do when collecting urethral discharge for microscopic examination and
culture?
a.
Ask the patient to urinate into a sterile cup.
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 examiner’s thumb and forefinger, and collect any
discharge.
18. When assessing the scrotum of a male patient, the nurse notices the presence of multiple firm,
nontender, yellow 1-cm nodules. What does this finding indicate?
a.
Urethritis
b.
Sebaceous cysts
c.
Subcutaneous plaques
d.
Due to an inflammation of the epididymis
19. When performing a scrotal assessment, the nurse notices that the scrotal contents show a red
glow with transillumination. How should the nurse proceed?
a.
Assess the patient for the presence of a hernia.
b.
Suspect the presence of serous fluid in the scrotum.
c.
Refer the patient for evaluation of a mass in the scrotum.
d.
Consider this finding normal and proceed with the examination.
20. 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 the inguinal canal only if a bulge is present in the inguinal region during
inspection
c.
Palpating for the vertical chain of lymph nodes along the groin, inferior to the
inguinal ligament
d.
Having the patient shift his weight onto the left (unexamined) leg when palpating
for a hernia on the right side
21. The nurse is aware that which statement is true regarding the incidence of testicular cancer?
a.
The cure rate for testicular cancer is low.
b.
Testicular cancer is the most common cancer in men aged 30 to 50 years.
c.
The early symptoms of testicular cancer are pain and induration.
d.
Men with a history of cryptorchidism are at the greatest risk for the development
of testicular cancer.
22. The nurse is describing how to perform a testicular self-examination to a patient. Which
statement is most appropriate?
a.
“A good time to examine your testicles is just before you take a shower.”
b.
“The testicle is egg shaped and movable. It feels firm and has a lumpy
consistency.”
c.
“If you notice an enlarged testicle or a painless lump, call your health care
provider.”
d.
“Perform a testicular examination at least once a week to detect the early stages of
testicular cancer.”
23. A 2-month-old uncircumcised infant has been brought to the clinic for a well-baby checkup.
How would the nurse proceed with the genital examination?
a.
Elicit the cremasteric reflex.
b.
The glans is assessed for redness or lesions.
c.
Retracting the foreskin should be avoided until the infant is 3 months old.
d.
Any dirt or smegma that has collected under the foreskin should be noted.
24. A 2-year-old boy has been diagnosed with physiologic cryptorchidism. Considering this
diagnosis, what will the nurse most likely observe during the assessment?
a.
Testes that are hard and painful to palpation
b.
Atrophic scrotum and a bilateral absence of the testis
c.
Absence of the testis in the scrotum, but the testis can be milked down
d.
Testes that migrate into the abdomen when the child squats or sits cross-legged
25. What is a common assessment finding in a boy younger than 2 years old?
a.
Inflamed and tender spermatic cord
b.
Presence of a hernia in the scrotum
c.
Penis that looks large in relation to the scrotum
d.
Presence of a hydrocele, or fluid in the scrotum
26. During an examination of an aging man, what finding would the nurse expect?
a.
Change in scrotal color
b.
Decrease in the size of the penis
c.
Enlargement of the testes and scrotum
d.
Increase in the number of rugae over the scrotal sac
27. When performing a genital assessment on a middle-aged man, the nurse notices multiple soft,
moist, painless papules in the shape of cauliflower-like patches scattered across the shaft of
the penis. What does this finding suggest?
a.
Carcinoma
b.
Genital warts
c.
Genital herpes
d.
Syphilitic chancres
28. When performing a genitourinary assessment on a 16-year-old male adolescent, the nurse
notices a swelling in the scrotum that increases with increased intra-abdominal pressure and
decreases when he is lying down. The patient reports pain when straining. What do these
findings indicate?
a.
Femoral hernia
b.
Incisional hernia
c.
Direct inguinal hernia
d.
Indirect inguinal hernia
29. When the nurse is performing a testicular examination on a 25-year-old man, which finding is
considered normal?
a.
Nontender subcutaneous plaques
b.
Scrotal area that is dry, scaly, and nodular
c.
Testes that feel oval and movable and are slightly sensitive to compression
d.
Single, hard, circumscribed, movable mass, less than 1 cm under the surface of the
testes
30. The nurse is inspecting the scrotum and testes of a 43-year-old man. Which finding would
require additional follow-up and evaluation?
a.
Skin on the scrotum is taut.
b.
Left testicle hangs lower than the right testicle.
c.
Scrotal skin has yellowish 1-cm nodules that are firm and nontender.
d.
Testes move closer to the body in response to cold temperatures.
31. A 55-year-old man is experiencing severe pain of sudden onset in the scrotal area. It is
somewhat relieved by elevation. On examination the nurse notices an enlarged, red scrotum
that is very tender to palpation. Distinguishing the epididymis from the testis is difficult, and
the scrotal skin is thick and edematous. What do these findings suggest?
a.
A varicocele
b.
Epididymitis
c.
A spermatocele
d.
Testicular torsion
32. The nurse is performing a genitourinary assessment on a 50-year-old obese male laborer. On
examination, the nurse notices a painless round swelling close to the pubis in the area of the
internal inguinal ring that is easily reduced when the individual is supine. What type of hernia
do these findings suggest?
a.
Scrotal
b.
Femoral
c.
Direct inguinal
d.
Indirect inguinal
33. The nurse is providing patient teaching about an erectile dysfunction drug. One of the drug’s
potential side effects is prolonged, painful erection of the penis without sexual stimulation.
What is the medical term for this condition?
a.
Orchitis
b.
Phimosis
c.
Stricture
d.
Priapism
34. During an examination, the nurse notices that a male patient has a red, round, superficial ulcer
with a yellowish serous discharge on his penis. On palpation, the nurse finds a nontender base
that feels like a small button between the thumb and fingers. What do these findings indicate?
a.
Genital warts
b.
Herpes infection
c.
Carcinoma lesion
d.
Syphilitic chancre
35. During a health history, a patient tells the nurse that he has trouble in starting his urine stream.
How should the nurse document this finding?
a.
Urgency
b.
Dribbling
c.
Frequency
d.
Hesitancy
36. During a genital examination, the nurse notices that a male patient has clusters of small
vesicles on the glans, surrounded by erythema. What does this finding suggest?
a.
Genital warts
b.
Genital herpes
c.
Peyronie disease
d.
Syphilitic chancres
37. During a physical examination, the nurse finds that a male patient’s foreskin is fixed and tight
and will not retract over the glans. What is this condition called?
a.
Phimosis
b.
Epispadias
c.
Peyronie disease
d.
Urethral stricture
MULTIPLE RESPONSE
1. A 55-year-old man is in the clinic for a yearly checkup. He is worried because his father died
of prostate cancer. The nurse knows which tests should be performed at this time? (Select all
that apply.)
a.
Urinalysis
b.
Prostate biopsy
c.
Transrectal ultrasound
d.
Digital rectal examination (DRE)
e.
Blood test for prostate-specific antigen (PSA)
2. A 16-year-old boy is brought to the clinic for a problem that he refused to let his mother see.
The nurse examines him, and finds that he has scrotal swelling on the left side. He had the
mumps the previous week, and the nurse suspects that he has orchitis. Which of the following
assessment findings support this diagnosis? (Select all that apply.)
a.
Swollen testis
b.
Mass that transilluminates
c.
Scrotal skin that is reddened
d.
Mass that does not transilluminate
e.
Scrotum that is tender upon palpation
f.
Scrotum that is nontender upon palpation