HHA PrepU: Chapter 26 Male Genitalia

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A teenage male client comes to the ED with severe left testicular pain and vomiting. Elevation of his left testicle does not lessen the pain. What could these symptoms indicate for this patient?

-Left testicular torsion
-Epididymitis
-Hydrocele
-Testicular cancer
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A teenage male client comes to the ED with severe left testicular pain and vomiting. Elevation of his left testicle does not lessen the pain. What could these symptoms indicate for this patient?

-Left testicular torsion
-Epididymitis
-Hydrocele
-Testicular cancer
-Left testicular torsion
Signs of testicular torsion include acute pain that is not relieved by elevating the testicle, nausea, and vomiting. Epididymitis usually presents in adult males. The client presents with unilateral pain to one testis, but fever, dysuria, and possibly urethral discharge. Hydrocele is the accumulation of fluid around a testicle. This condition usually presents as a non-tender and soft testicle. Often testicular cancer presents lump or swelling, which may or may not be painful. The condition could also present with pain in the abdomen or low back.
The nurse is documenting current health concerns during the health history of an older adult male client. Identification of what may help most at this time?

-Number of sexual partners
-Number of sexually transmitted infections
-Sexual preference
-Previous problems
-Previous problems
Identification of previous problems may help when documenting current health concerns. The other options are distracters for this question and would not be helpful in documenting current health concerns.
During a health assessment interview, a nurse learns that the client has a family history of colorectal cancer. What information should the nurse give the client about reducing the risk for colorectal cancer? Select all that apply.

-Get regular exercise for at least 30 minutes every day
-Limit exposure to cadmium and sheet metal work
-Avoid taking vitamin A supplements
-Fecal occult blood test (FOBT) should be done yearly
-Consume foods with adequate folic acid
-Get regular exercise for at least 30 minutes every day
-Fecal occult blood test (FOBT) should be done yearly
-Consume foods with adequate folic acid
The nurse should ask the client to get regular exercise for at least 30 minutes every day, have a fecal occult blood test (FOBT) every year, and include foods with adequate folic acid in the diet. The nurse informs clients who are likely to have prostate cancer to limit exposure to cadmium and sheet metal work and to avoid taking vitamin A supplements.
A client presents to the health care clinic with reports of black stool. The client denies the ingestion of iron supplements or taking Pepto-Bismol. The nurse recognizes that the black stools could be an indication of what disease process?

-Gastrointestinal bleeding
-Lack of bile pigment
-Increased fat content
-Cancer of the colon
-Gastrointestinal bleeding
Black stools may indicate gastrointestinal bleeding in this client who has not been receiving iron supplements or taking Pepto-Bismol. Clay-colored stool results from the lack of bile pigment. Yellow stool suggests increased fat content or steatorrhea. Cancer of the rectum or colon may be indicated by blood detected in the stool.
A nurse observes that the mucosa of the rectum and the rectal wall of a female client protrudes out through the anal opening. It appears as a red, doughnut-like mass with radiating folds. How should the nurse document this condition of the rectum?

-prolapse
-Rectal polyps
-shelf
-cancer
-prolapse
The nurse should document this condition as rectal prolapse. Soft structures like nodules that may be present in the muscular anal ring are called rectal polyps. They are rather common and occur in varying size and number. If cancer metastasizes to the peritoneal cavity, it may be felt as a nodular, hard, shelf-like structure called rectal shelf that protrudes onto the anterior surface of the rectum in the area of the rectouterine pouch in women. Rectal cancer may feel like a firm nodule, an ulcerated nodule with rolled edges, or, as it grows, a large, irregularly shaped, fixed, hard nodule.
Which of the following statements is true of prostate cancer?

-Survival rates are low.
-It is one of the less common forms of cancer.
-Family history does not appear to be a risk factor.
-Ethnicity is a risk factor.
-Ethnicity is a risk factor.
While prostate cancer is the most commonly diagnosed cancer in men and the third leading type resulting in death, the proportion of men diagnosed with prostate cancer who survive is high. Lung and colon cancers are more common causes of mortality. Genetics appear to account for several cases. The rate of prostate cancer is highest in men of African ancestry.
Which of the following would the nurse expect to be done to assess the size of the prostate?

-Digital rectal examination
-Transillumination
-Pelvic examination
-Bladder percussion
-Digital rectal examination
A digital rectal examination is performed to assess the prostate for size as well as evidence of tumor. Transillumination is used to determine the density of scrotal tissue. Pelvic examination is performed to evaluate female reproductive structures. Bladder percussion reveals information about the status of the bladder.
An adolescent present at the free clinic with a collection of fluid in the tunica vaginalis of the testes. The nurse knows that the term that defines this condition is what?

-Cryptorchidism
-Orchitis
-Hydrocele
-Prostatism
-Hydrocele
A hydrocele refers to a collection of fluid in the tunica vaginalis of the testes. Cryptorchidism is the most common congenital defect in males; characterized by failure of one or both of the testes to descend into the scrotum. Orchitis is an inflammation of the testes (testicular congestion) caused by pyogenic, viral, spirochetal, parasitic, traumatic, chemical, or unknown factors. Prostatism is an obstructive and irritative symptom complex that includes increased frequency and hesitancy in starting urination, a decrease in the volume and force of the urinary stream, acute urinary retention, and recurrent urinary tract infections.
An uncircumcised, 78 year-old male has presented at the clinic complaining that he cannot retract his foreskin over his glans. On examination it is noted that the foreskin is very constricted. What is this condition called?

-Bowen's disease
-Peyronie's disease
-Phimosis
-Priapism
-Phimosis
Phimosis is the term used to describe a condition in which the foreskin is constricted so it cannot be retracted over the glans. Bowen's disease is an in situ carcinoma of the penis. Peyronie's disease is an acquired, benign condition that involves the buildup of fibrous plaques in the sheath of the corpus cavernosum. Priapism is an uncontrolled, persistent erection of the penis from either neural or vascular causes, including medications, sickle cell thrombosis, leukemic cell infiltration, spinal cord tumors, and tumor invasion of the penis or its vessels.
During a physical examination, the nurse inspects the eternal genitalia of a male client. Which of the following would the nurse identify as an abnormality?

-Absence of urethral discharge
-Skin lesions
-Prepuce covering the glans penis
-Slightly pendulous scrotum
-Skin lesions
During a physical examination, the nurse inspects the external genitalia, looking for abnormalities such as skin lesions and urethral discharge. Prepuce covering the glans penis is a normal finding in an uncircumcised male. The scrotum is normally pendulous, and with increasing age, it becomes more pendulous.
Which of the following should nurses teach all men, especially those who have had cryptorchidism? -Need for blood tests to measure serum acid phosphate levels. -Importance of regular monitoring of prostate-specific antigen (PSA) levels. -Need to undergo a baseline and follow up lymph node biopsies. -How to perform a testicular self-examination.-How to perform a testicular self-examination. The nurses should teach all men, especially those who have had cryptorchidism, to perform testicular self-examination to detect any abnormal mass in the scrotum. The nurse instructs the clients to examine the testicles monthly, preferably when warm, such as in the shower. Having regular PSA levels, lymph node biopsies, and blood tests for measuring serum acid phosphatase are for the clients who are treated for prostate cancer.On palpation of a client's prostate, a nurse detects hard, fixed, and irregular nodules on the prostate. Which condition should the nurse most suspect in this client? -Acute prostatitis -Benign prostatic hypertrophy -Hydrocele -Prostate cancer-Prostate cancer The prostate is normally nontender and rubbery. A swollen and tender prostate may indicate acute prostatitis. An enlarged smooth, firm, slightly elastic prostate that may not have a median sulcus suggests benign prostatic hypertrophy. A hard area on the prostate or hard, fixed, irregular nodules on the prostate suggest cancer. Hydrocele is a painless swelling of the scrotum.A nurse examining a client's external genitalia notices that his scrotum and testes draw up and he shivers. This phenomenon is known as which of the following? -Patellar reflex -Rooting reflex -Cremasteric reflex -Vasovagal reflex-Cremasteric reflex The scrotum can maintain temperature control because the cremaster muscle is sensitive to changes in temperature. The muscle contracts when too cold, raising the scrotum and testes upward toward the body for warmth (cremasteric reflex). This accounts for the wrinkled appearance of the scrotal skin. The patellar reflex occurs when a physician strikes the patellar tendon of the knee and the leg jerks. The rooting reflex occurs in infants when they turn their heads toward anything that strokes the cheek or mouth. The vasovagal reflex is a contraction of muscles in the gastrointestinal tract in response to distension of the tract following consumption of food and drink.The nurse is preparing an instructional session for male clients about preventing penile cancer. Which non-modifiable risk factor should the nurse include in the teaching? -Poor personal hygiene -History of human papilloma virus -Sexual promiscuity -Age 60 years or older-Age 60 years or older Age is not a modifiable risk factor for penile cancer. Phimosis, poor personal hygiene, sexual promiscutiy, using tobacco products, and HPV are all modifiable risk factors for penile cancer.The nurse is assessing male genitalia and finds clusters of pimple-like clear vesicles. The nurse recognizes this as what? -Herpes -Syphilis -Gonorrhea -Chlamydia-Herpes Herpes is associated with clusters of pimple-like clear vesicles. Gonorrhea has drainage. Syphilis has a chancre. Chlamydia is asymptomatic.What ethnic group has a significantly higher incidence rate of prostate cancer? -Native American -African American -Caucasian -Asian-African American For undetermined reasons, incidence rates are significantly higher in African American men than in Caucasian men: 232 cases per 100,000 compared with 146 cases per 100,000, even after adjustments for access to care. Prostate cancer occurs at an earlier age and more advanced stage in African American men.During assessment of an elderly male client, the client tells the nurse that he has had difficulty urinating for the past few weeks. The nurse should refer the client to the physician for possible -inguinal hernia. -sexually transmitted disease. -impotence. -prostate enlargement.-prostate enlargement. Difficulty urinating may indicate an infection or blockage, including prostatic enlargement.Before beginning the examination of the genitalia of an adult male client, the nurse should -ask the client to empty his bladder. -tell the client that he will remain in a supine position. -ask the client to leave his shirt in place. -tell the client that he may leave his underwear in place.-ask the client to empty his bladder. Before the examination, instruct the client to empty his bladder so that he will be comfortableThe nurse has assessed a male client and determines that one of the testes is absent. The nurse should explain to the client that this condition is termed -hypospadias. -hematocele. -cryptorchidism. -orchitis.-cryptorchidism. Absence of a testis suggests cryptorchidism (an undescended testicle).A 17-year-old male client expresses concern about feeling lumps on his testicles. What response by the nurse would best address the client's concerns? -"Do you think you have malformed testicles?" -"Don't worry, that is the way normal testicles feel." -"Lumpy testicles are not going to cause a problem with sexual performance." -"The normal testicle contains internal structures that cause lumps on the surface."-"The normal testicle contains internal structures that cause lumps on the surface." As noted by the American Cancer Society, it is normal for one testicle to be slightly larger than the other, and for one to hang lower than the other. In addition, each normal testicle has a small, coiled tube (epididymis) that can feel like a small bump on the upper or middle outer side of the testicle. Normal testicles also have blood vessels, supporting tissues, and tubes that carry sperm. The remaining options fail to address the client's concerns effectively and lack an explanation for this normal situation.An adult male client comes to the clinic for his annual physical examination. During the nursing assessment, the nurse asks, "Do you have any current or chronic illnesses such as diabetes, hypertension, respiratory problems, or cardiovascular disease?" Why does the nurse ask this question? -To assess risk for erectile dysfunction -To refer the patient to a pulmonologist -To assess risk for limited range of motion -To determine the need for involvement from an internist-To assess risk for erectile dysfunction Men with diabetes, hypertension, neurologic respiratory problems, or cardiovascular disease are at increased risk for erectile dysfunction. The other options are distracters for the question.A male infant is born with the urethral meatus opening on the underside of the penis. When providing information to the parents, what is the correct terminology to use for this condition? -Phimosis -Hypospadias -Epispadias -Paraphimosis-Hypospadias With hypospadias, the urethral meatus opens on the ventral side of the penis. The deviation of the meatus makes it difficult to urinate when standing. The physical appearance of the penis is altered, sometimes causing body image disturbances. Phimosis is when the prepuce cannot be retracted over the glans. Paraphimosis occurs when the retracted prepuce cannot be placed back over the glans. Epispadias occurs when the urethral meatus opens on the dorsal surface of the penis.What information should nurse include in the teaching plan for a client considering a vasectomy? -offers permanent birth control -increases the amount of ejaculate -protects from sexually transmitted infection -May causes urinary incontinence-offers permanent birth control Vasectomy is a method of permanent birth control which results in decreased, not increased, amounts of ejaculate. Vasectomy offers no protection from sexually transmitted infections (STIs). Prostatectomy, not vasectomy, causes urinary incontinence.Which position should a nurse assist a client to assume to ensure comfort during the examination of the anus, rectum, and prostate of a male client? -Knee-chest -Lithotomy -Standing -Left lateral-Left lateral The most frequently used position for examination of the anus, rectum, and prostate is the left lateral as it is usually more comfortable for the client. Besides, this position allows adequate inspection and palpation of the anus, rectum, and prostate. The client's torso and legs should be draped during the examination to lessen the feeling of vulnerability. Lithotomy position is logical for the female client who is already in that position for the vaginal examination. In the knee-chest position the client stands and bends over the table. Some examiners find it easy to examine the client when the client is standing and bending over the examination table with his hips flexed, this position may not be comfortable for all clients.While reviewing the medical record before examining a male clinic patient, the nurse notes that the urinary meatus is located on the top of the glans of the penis. The nurse understands the correct term for this congenital defect is -epispadias -hypospadias -hydrocele -varicocele-epispadiasMr. Jackson, 50 years old, has had discomfort between his scrotum and anus. He also has had some fevers and dysuria. Rectal examination is halted by tenderness anteriorly, but no frank mass is palpable. What is the most likely diagnosis? -Prostate cancer -Colon cancer -Prostatitis -Colonic polyp-Prostatitis This examination, associated with a history of dysuria, frequency, and incomplete voiding, should lead to a suspicion of acute prostatitis. Prostate cancer, colon cancer, and polyps should not ordinarily cause systemic symptoms such as fever.The nurse is preparing a presentation for a local community group about prostate cancer and possible dietary risk factors. Which of the following would the nurse most likely include? -High-iron -High-calorie -High fiber -High-fat diet-High-fat diet Although the case of prostatic cancer is unknown, there seems to be a relationship with increased testosterone levels and a diet high in fat. No other dietary links have been suggested.A 68-year-old man comes to the clinic reporting that he is having difficulty obtaining an erection. When reviewing the patient's history what might the nurse note that contributes to impotence? -Past history of infection -History of hypertension -Use of multivitamins -Lack of exercise-History of hypertension Past history of infection, lack of exercise, and use of vitamins do not contribute to impotence. Vascular problems cause about half the cases of impotence in men older than 50 years.A client comes to the Emergency Department complaining of sudden sharp testicular pain. Further examination reveals torsion of the spermatic cord. Which of the following would the nurse expect to do next? -Apply scrotal support. -Prepare the client for surgery. -Apply a dressing over the scrotum. -Prepare the client for circumcision.-Prepare the client for surgery. For the client with torsion, immediate surgery is necessary to prevent atropy of the spermatic cord and preserve fertility. Analgesics would be given preoperatively. Postoperatively, a scrotal support is applied and dressings are inspected for drainage. Circumcision is done to relieve phimosis or paraphimosis.Which client would the nurse identify as being at highest risk for the development of testicular cancer? -A 45-year-old white man with a history of hypertension. -A 25-year-old man with a history of cryptorchidism. -A 39-year-old African-American man who is HIV-negative. -A 75-year-old white man with erectile dysfunction.-A 25-year-old man with a history of cryptorchidism. Testicular cancer is most common in between 15 and 34 years of age and is the leading cause of cancer deaths in men between 25 to 34 years of age. Its incidence is higher in Caucasians and men with a history of cryptorchidism. Other clients at risk are those with a family history of the disease, those who are HIV-positive or have developed AIDS, and those who already have had cancer in one testicle.After teaching a group of student about structural abnormalities of the male reproductive system, the instructor determines that the teaching was successful when the students identify which of the following as an example? -Erectile dysfunction -Prostatitis -Cryptorchidism -Priapism-Cryptorchidism Structural abnormalities include cryptorchidism, torsion of the spermatic cord, phimosis, paraphimosis, hydrocele, spermatocele, and varicocele. Erectile dysfunction and priapism are erection disorders. Prostatitis is an infectious disorder.A nurse examines the external genitalia of a client who has been diagnosed with the mumps. The scrotum appears enlarged and reddened. How should the nurse document this condition? -Orchitis -Cryptorchidism -Epididymitis -Hydrocele-Orchitis The nurse should document this condition as orchitis, which is the inflammation of the testes, associated frequently with mumps; the scrotum appears enlarged and reddened. Cryptorchidism is the failure of one or both testicles to descend into the scrotum, resulting in a condition in which the scrotum appears underdeveloped and the testis cannot be palpated. Epididymitis is an infection of the epididymis; the scrotum appears enlarged, reddened, and swollen, and a tender epididymis is palpated. Hydrocele appears as a swelling in the scrotum and is usually painless.A nurse prepares a male client for a physical assessment of the external genitalia. Which instruction is appropriate for the nurse to give the client before the examination? -Ask the client to not empty the bladder before the examination -Explain that he may need to lie supine -Reassure him that it is not unusual to have an erection during the examination -Request that the client avoid talking-Reassure him that it is not unusual to have an erection during the examination The nurse should reassure the client that it is not unusual to have an erection during the examination; this will avoid unnecessary embarrassment in the client. The nurse should ask the client to empty the bladder before the examination so that he will be comfortable during the examination. The client should be informed that he may need to stand for most of the examination. The nurse should encourage the client to ask questions during the examination, and, at the same time, ease the client's anxiety by explaining in detail the significance of each portion of the examination.During the assessment of a client, the nurse recognizes that which of the client's lifestyle practices may predispose to the development of an inguinal hernia? -Exposure to radiation -Strenuous activity -Erectile dysfunction -Stress and inhibition-Strenuous activity Strenuous activity and heavy lifting may predispose a client to the development of an inguinal hernia. Exposure to radiation and certain chemicals increases the risk of developing cancer. Erectile dysfunction occurs frequently in adult males and may be attributed to various factors, some of which include the use of alcohol, diabetes, or depression. Fear can cause stress and inhibition and decrease sexual satisfaction.A nurse examines the external genitalia of a client and observes that the scrotum is underdeveloped and the testis cannot be palpated. How should the nurse document this condition? -Orchitis -Cryptorchidism -Epididymitis -Hydrocele-Cryptorchidism The nurse should document this condition as cryptorchidism, a condition in which the scrotum appears underdeveloped and the testis cannot be palpated. Cryptorchidism is the failure of one or both testicles to descend into the scrotum. Orchitis is the inflammation of the testes, associated frequently with mumps; the scrotum appears enlarged and reddened. Epididymitis is an infection of the epididymis; the scrotum appears enlarged, reddened, and swollen, and a tender epididymis is palpated. Hydrocele appears as a swelling in the scrotum and is usually painless.When performing the physical assessment of a client, the nurse notes the presence of a small cyst that contains hair, which is located midline in the sacrococcygeal area and has a palpable sinus tract. How should the nurse document this finding? -External hemorrhoid -Pilonidal cyst -Anal fissure -Perianal abscess-Pilonidal cyst A pilonidal cyst is a congenital disorder characterized by a small dimple or cyst/sinus that contains hair. External hemorrhoids are usually painless papules below the anorectal junction, caused by varicose veins. Anal fissures are splits in the tissue of the anal canal caused by trauma. Perianal abscess is a cavity of pus, caused by infection in the skin around the anal opening.On inspecting a client's external genitalia, a nurse notes that he is uncircumcised. This means that which of the following covers the glans of the penis? -Urethral meatus -Prepuce -Corpus cavernosa -Corpus spongiosum-Prepuce If the man has not been circumcised, a hood-like fold of skin called the foreskin, or prepuce, covers the glans. In the center of the corpus spongiosum is the urethra, which travels through the shaft and opens as a slit at the tip of the glans as the urethral meatus. The shaft of the penis is composed of three cylindrical masses of vascular erectile tissue that are bound together by fibrous tissue—two corpora cavernosa on the dorsal side and the corpus spongiosum on the ventral side.The rectum is lined with folds of mucosa, and each fold contains a network of arteries, veins, and visceral nerves. When these veins undergo chronic pressure, the result may be -polyps. -tumors. -fissures. -hemorrhoids.-hemorrhoids. The anorectal junction is not palpable, but may be visualized during internal examination. The folds contain a network of arteries, veins, and visceral nerves. If the veins in these folds undergo chronic pressure, they may become engorged with blood, forming hemorrhoids.The nurse suspects that a male client may have a hernia. The nurse should further assess the client for -bruising at the site. -urinary tract infection. -cysts at the spermatic cord. -bowel sounds at the bulge.-bowel sounds at the bulge. Bowel sounds auscultated over the mass indicate the presence of bowel and thus a scrotal herniaA patient presents at the clinic with severe scrotal pain. What is the presumptive diagnosis? -Testicular torsion -Priapism -Hydrocele -Varicocele-Testicular torsion Any patient with scrotal pain should be presumed to have testicular torsion until another diagnosis can be proven.An adult male client comes to the clinic complaining of awakening at night to void and voiding more than once in a 2-hour time period. The client has a history of bladder irritation. What would be an appropriate nursing diagnosis for this client? -Ineffective sexuality pattern -Risk for infection -Risk for urge incontinence -Urinary retention-Risk for urge incontinence The most appropriate nursing diagnosis is risk for urge incontinence related to irritation of bladder. Risk factors for this diagnosis are voiding more than once every 2 hours and awakening at night. urinary retention would be a concern if the client was unable to urinate, or urinated frequently with only small amounts of urine voided. Frequent urination at night is not a risk for infection. The symptoms noted are not related to ineffective sexuality pattern.During the physical examination of the genitalia for an uncircumcised client, the nurse asks the client to retract the foreskin of the penis. The nurse observes that the foreskin is tight and cannot be retracted. How should the nurse document this condition? -Paraphimosis -Epispadias -Hypospadias -Phimosis-Phimosis This condition should be documented as phimosis; wherein, the client's foreskin is so tight that it cannot be retracted. A foreskin that once retracted and can not be returned to cover the glans is called paraphimosis. Epispadias is the displacement of the urinary meatus to the dorsal surface of the penis. Hypospadias is the displacement of the urinary meatus to the ventral surface of the penis.A client reports the new onset of mucous in the stool. How should the nurse document this in the client's history? -Steatorrhea -Diarrhea -Change in bowel habits -Fecal incontinence-Steatorrhea The proper term for mucus in the stool is steatorrhea, which indicates the presence of excessive fat in the stool. Diarrhea is an increase in the frequency of loose stool. Change in bowel habits is not specific to the problem the client reported. Fecal incontinence is the inappropriate release or inability to control the bowels.Which client should a nurse recognize has the highest risk to develop prostate cancer? -35-year-old African American male with a diet high in fat -65-year-old Caucasian male whose father had prostate cancer at age 55 -70-year-old Asian male who is not circumcised and eat a low fat diet -60-year-old male who works in a tire and rubber manufacturing plant-65-year-old Caucasian male whose father had prostate cancer at age 55 Age, African American race, and having a bother or father who was diagnosed with prostate cancer before the age of 60 are the greatest risk factors. Therefore, the older male with a first-degree relative has the highest risk.A 60-year-old coach comes to the clinic complaining of difficulty starting to urinate for the last several months. He believes the problem is steadily getting worse. When asked he says he has a very weak stream, and it feels like it takes 10 minutes to empty his bladder. He also has the urge to go to the bathroom more often than he used to. He denies any blood or sediment in his urine and any pain with urination. He has had no fever, weight gain, weight loss, or night sweats. His medical history includes type 2 diabetes and high blood pressure treated with medications. He does not smoke but drinks a six pack of beer weekly. He has been married for 35 years. His mother died of a myocardial infarction in her 70s, and the client's father is currently in his 80s with high blood pressure and arthritis. Examination reveals a mildly obese alert and cooperative man. His blood pressure is 130/70 with a heart rate of 80. He is afebrile, and his cardiac, lung, and abdominal examinations are normal. Visualization of the anus shows no inflammation, masses, or fissures. Digital rectal examination reveals a smooth, enlarged prostate. No discrete masses are felt. There is no blood on the glove. An analysis of the urine shows no red blood cells, white blood cells, or bacteria. What disorder of the anus, rectum, or prostate is most likely? -Benign prostatic hyperplasia (BPH) -Prostatitis -Prostate cancer -Anorectal cancer-Benign prostatic hyperplasia (BPH) BPH becomes more prevalent during the fifth decade and is often associated with hesitancy in starting a stream, decreased strength of stream, nocturia, and leaking of urine. On examination an enlarged, symmetrical, firm prostate is palpated. The anterior lobe cannot be felt. These clients may also develop UTIs secondary to their obstruction.When palpating the rectal mucosa, how does the nurse rotate the examining hand? -From the nurse's left, then to the right -Anteriorly, then posteriorly -Counterclockwise, then clockwise -Clockwise, then counterclockwise-Clockwise, then counterclockwise To palpate the rectal mucosa, the nurse rotates the hand clockwise to palpate the right side of the client's rectal mucosa, then counterclockwise to palpate the surface posteriorly and on the client's left side.After positioning a 34-year-old client for examination of the anal region, the nurse notes a small opening above the gluteal crease that contains a tuft of hair. How should the nurse interpret this assessment finding? -A pilonidal cyst appears to be a sinus but is in fact superficial. -The pilonidal cyst is a particular form of scarring that results from sacral pressure. -The cyst and sinus confirm an infectious process that necessitates antibiotic coverage. -The pilonidal cyst and sinus are usually benign, but can occasionally become infected or develop further sinuses.-The pilonidal cyst and sinus are usually benign, but can occasionally become infected or develop further sinuses. A pilonidal cyst is a congenital, and usually asymptomatic, tract that can become a problem if infection or sinus formation results. It alone does not indicate infection.During DRE, a 46-year-old client cries out in pain as the nurse palpates his swollen, firm prostate. Which of the following problems should the nurse first suspect? -Prostatitis -Benign prostatic hyperplasia -Prostate cancer -Rectal cancer-Prostatitis The hallmarks of prostatitis are a tender, swollen, firm prostate. Tenderness is not normally present in cases of BPH or prostate cancer.Upon observation, the nurse documents that a male child's urethral meatus is located on the underside of his penis. What is the term for this structural abnormality? -Hypospadias -Epispadias -Cryptorchidism -Phimosis-Hypospadias A urethral meatus located on the underside of the penis is called hypospadias. A meatus located on the upper surface is called epispadias. These congenital conditions are usually repaired surgically at a young age if they are severe. Cryptorchidism is an undescended testicle, and with phimosis, the foreskin becomes so tight that it will not retract over the glans penis.When assessing a client during the physical examination of the genitalia, the nurse palpates the scrotal contents. Which finding should the nurse recognize as an indication that an infection or cysts are present? -Palpable and tortuous veins -Beaded or thickened cord -Smooth, nontender cord -Left testicle is slightly lower than the right-Beaded or thickened cord A beaded or thickened cord indicates infection or cysts. The presence of palpable and tortuous veins indicates varicocele. A smooth, nontender, and rope-like cord is a normal finding. In most men, one testicle hangs lower than the other; in 65% of males, the left hangs lower than the right.Upon inspection and palpation of the front of the client's thigh, the nurse discovers a bulge that appears when the client coughs. The nurse should document this finding as which type of hernia? -Scrotal -Incarcerated -Strangulated -Femoral-Femoral A bulge or mass on the front of the thigh in the femoral canal area is a femoral hernia. A hernia is strangulated if the blood supply is cut off. In this case, the client typically complains of extreme tenderness and nausea. A scrotal mass that remains when the client lies down and over which bowel sounds can be auscultated is a scrotal hernia. If the mass in the scrotum cannot be pushed into the abdomen, it could be an incarcerated hernia.A nurse examines the external genitalia of a client and observes that the scrotum is enlarged, reddened, and swollen. On palpation, the epididymis is tender and the client complains of sudden pain. How should the nurse document this condition? -Orchitis -Cryptorchidism -Epididymitis -Hydrocele-Epididymitis The nurse should document this condition as epididymitis, which is an infection of the epididymis. In this condition, the scrotum appears enlarged, reddened, and swollen, and a tender epididymis is palpated. Cryptorchidism is a condition in which the scrotum appears underdeveloped and the testis cannot be palpated. It occurs when one or both testicles fail to descend into the scrotum. Orchitis is the inflammation of the testes, associated frequently with mumps; the scrotum appears enlarged and reddened. Hydrocele appears as a swelling in the scrotum and is usually painless.A nurse is palpating the prostate of a client and finds it to be swollen, tender, firm, and warm to the touch. Which condition should the nurse most suspect? -Acute prostatitis -Hydrocele -Benign prostatic hypertrophy -Prostate cancer-Acute prostatitis The prostate is normally nontender and rubbery. A swollen and tender prostate that is firm and warm to the touch may indicate acute prostatitis. An enlarged smooth, firm, slightly elastic prostate that may not have a median sulcus suggests benign prostatic hypertrophy. A hard area on the prostate or hard, fixed, irregular nodules on the prostate suggest cancer. Hydrocele is a painless swelling of the scrotum.A client presents to the health care clinic with reports of yellow stool. Which condition should the nurse most suspect? -Gastrointestinal bleeding -Lack of bile pigment -Increased fat content -Cancer of the colon-Increased fat content Yellow stool suggests increased fat content or steatorrhea. Black stools may indicate gastrointestinal bleeding in this client who has not been receiving iron supplements or taking Pepto-Bismol. Clay-colored stool results from the lack of bile pigment. Cancer of the rectum or colon may be indicated by blood detected in the stool.A 23 year old male comes to the clinic complaining of sudden and severe pain in his scrotum. The nurse would suspect what? -Torsion of the spermatic cord -Spermatocele -Orchitis -Varicocele-Torsion of the spermatic cord Torsion of the spermatic cord is usually accompanied by a sudden, severe pain of the scrotum and is a urological emergency. A spermatocele is a sperm-filled cystic mass located on the epididymis. Orchitis is inflammation of the testes. A varicocele is an abnormal dilation of veins in the spermatic cord.The external sphincter and internal sphincter of the rectum are divided by the -anorectal junction. -rectovesical pouch. -median sulcus. -intersphincteric groove.-intersphincteric groove. Within the anus are the two sphincters that normally hold the anal canal closed except when passing gas and feces. Dividing the two sphincters is the palpable intersphincteric groove.The prostate gland consists of two lobes separated by the -median sulcus. -rectovesical pouch. -anorectal junction. -valves of Houston.-median sulcus. The prostate gland consists of two lobes separated by a shallow groove called the median sulcusWhile assessing an adult male client, the nurse detects pimple-like lesions on the client's glans. The nurse explains the need for a referral to the client. The nurse determines that the client has understood the instructions when the client says he may have -venereal warts. -herpes infection. -syphilis. -gonorrhea.-herpes infection. Pimple-like lesions from herpes are sometimes detected on the glans.A nurse examines the anal area of a client and observes the presence of a varicose vein. How should the nurse document this finding? -Perianal abscess -Anal fissure -Anorectal fistula -External hemorrhoid-External hemorrhoid Hemorrhoids are usually painless papules caused by varicose veins, either external or internal. If the hemorrhoid becomes thrombosed is can become painful and swollen. A perianal abscess is a cavity of pus caused by infection in the skin around the anal opening. An anal fissure is a split in the tissue of the anal canal caused by trauma. An anorectal fistula is a small, round opening in the skin that surrounds the anal opening. It suggests an inflammatory tract from the anus or rectum out to the skin.A patient has undergone a digital rectal examination. This assessment will allow the clinician to diagnose which of the following? -Urinary incontinence -ED -BPH -Testicular cancer-BPH A rubbery or boggy glandular consistency may indicate BPH, a common finding in men older than 60 years of age. The gland may feel soft, tender, and boggy from infection.