Nokea
The physician and nurse are completing a physical examination of the male genitalia. Which assessment finding(s) is documented? Select all that apply.
- A. Inspection for urethral drainage
- B. Cultures
- C. Digital rectal examination
- D. Transillumination
- E. Palpation of the testes
- F. Prostate-specific antigen level
Correct Answer: A,C,D,E
Rationale: The nurse and physician document the physical assessment including inspection of external genitalia and noting any drainage. A digital rectal examination and transillumination also provide physical assessment data of the status of the prostate gland. Cultures and prostate-specific antigen levels provide diagnostic information but are not part of the physical assessment.
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The nurse is instructing a couple in the early stages of infertility testing who has just found that the male has a slightly low sperm count. Which easy change can a nurse suggest to a male client?
- A. Avoid riding on motorcycles
- B. Wear loose fitting underwear instead of tight ones.
- C. Take a general multivitamin.
- D. Increase sexual intercourse to every day.
Correct Answer: B
Rationale: Wearing loose fitting underwear allows the scrotum to pull the testes closer to the body to maintain proper temperature for sperm production or allow the testes to be farther from the body. Because the testes cannot produce viable sperm when temperatures are at or above body temperature, their location within the scrotal sac ensures optimal conditions. There is no evidence that the client cannot ride motorcycles. Taking a general multivitamin is encouraged for overall health. Daily sexual intercourse is not encouraged because it is most important to have sufficient sperm present during a female's ovulation period.
A client presents with symptoms of menstrual difficulties and infertility. Which hormone is essential in the maintenance of the endometrium?
- A. Estrogen
- B. Progesterone
- C. Testosterone
- D. Prolactin
Correct Answer: B
Rationale: Without a high level of progesterone, the endometrium (uterine lining) degenerates and sheds. Estrogen is a hormone that is essential for menstruation and prepares the uterus for pregnancy. Women produce testosterone, which maintains muscle mass, bone strength, and sex drive. Prolactin is produced by the pituitary gland and stimulates lactation.
A nurse is employed by a fertility clinic. Diagnostic testing is being completed to determine the source of the male not producing viable sperm to enable ovum fertilization. Which male structures does the nurse consider if the problem is narrowed to sperm survivability?
- A. Bartholin glands
- B. Prostate gland
- C. Cowper glands
- D. Vas deferens
Correct Answer: B
Rationale: The accessory structure of the prostate gland contains secretory cells that produce alkaline fluid. The prostatic fluid mixes with sperm. The alkalinity of the prostatic fluid neutralizes the acidic metabolic wastes released by the sperm and counteracts the acid pH within the vagina to ensure mass survival of the sperm. The Cowper glands add lubrication for penetration of the vagina.
The nurse is conducting a health history. When a middle-aged client reports last having a menstrual period 6 months ago. Upon further questioning, the client also states symptoms of hot flashes and mood fluctuations. Which question should the nurse ask next?
- A. Do you feel like hurting yourself?
- B. Are you finished having children?
- C. When was your first menstrual period?
- D. Are you taking any hormone replacement therapy?
Correct Answer: D
Rationale: To ensure a thorough health history, a client who exhibits symptoms of perimenopause should be assessed for the use of hormone replacement therapy to alleviate the symptoms. This information adds to the data reported by the client. Asking if the client is having thoughts of self-harm may be extreme with the report of mood fluctuations. Asking if the client is finished having children produces little additional data. Asking the first menstrual period is part of the health history but not the best question to ask after the client's statement.
The client states to the nurse that he is very anxious about having prostate cancer ever since his prostate-specific antigen (PSA) test came back elevated. The client asks, 'Which diagnostic test produces definitive results if cancer is present?' The nurse is most correct to state which of the following?
- A. Transrectal ultrasonography
- B. Tissue biopsy
- C. Tumor marker studies
- D. Digital rectal exam
Correct Answer: B
Rationale: Obtaining an actual piece of the tissue and analyzing it for cancer is a definitive test when cancer is found. A transrectal ultrasonography is a test to view the prostate gland from different angles. This test provides additional data on the status of the prostate gland. The tumor marker studies include the prostate-specific antigen (PSA) level. This antigen indicates a potential problem but is not definitive. PSA elevations have been noted for reasons other than cancer. A digital rectal exam provides data on the shape, size, and texture of the prostate gland.