Chapter 50: Male Reproductive Disorders Nursing School Test Banks

Chapter 50: Male Reproductive Disorders
Linton: Introduction to Medical-Surgical Nursing, 6th Edition

MULTIPLE CHOICE

1. A nurse is reviewing the drugs taken by a 50-year-old male patient. What medication should the nurse recognize as the most probable cause of erectile dysfunction (ED)?
a. Vasodilator for hypertension
b. Antibiotic for an upper respiratory infection
c. Antihistamine for allergies
d. Glucophage for type 2 diabetes
ANS: A
Vasodilators taken for the control of hypertension frequently cause ED.

DIF: Cognitive Level: Knowledge REF: p. 1156 OBJ: 2
TOP: Male Sexual Dysfunction KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies

2. A nurse is caring for a patient 2 hours after a transurethral resection and immediately reports to the charge nurse the presence of large clots in the catheter and drainage bag. What should the nurse anticipate the physician will order?
a. Instill ice water into the bladder.
b. Decrease the amount of fluid in the balloon of the indwelling catheter.
c. Apply traction to the catheter by taping it to the patients thigh.
d. Prescribe a potent vasoconstrictor to reduce hemorrhage.
ANS: C
Applying traction to the catheter may reduce the bleeding. An increase of fluid in the catheter balloon is also helpful, but ice water will have no better effect than the continuous bladder irrigation that is already in place.

DIF: Cognitive Level: Application REF: p. 1155 OBJ: 4
TOP: Transurethral Resection of the Prostate
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

3. A male student comes to the campus clinic complaining of painful scrotal edema, nausea, vomiting, chills, and fever. What should the nurse recognize these signs and symptoms as being associated with?
a. Orchitis
b. Epididymitis
c. Urethritis
d. Cystitis
ANS: B
Signs and symptoms of epididymitis are painful scrotal edema, nausea, vomiting, chills, and fever.

DIF: Cognitive Level: Comprehension REF: p. 1147 OBJ: 2
TOP: Epididymitis KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

4. What should a nurse explain to a young man being treated for infertility as the purpose of a semen analysis?
a. Determine the history of sexually transmitted infections.
b. Evaluate the potential for genetic problems.
c. Determine whether any urethral obstructions are present.
d. Microscopically assess the sperm for number and motility.
ANS: D
Analysis of the semen is performed to assess male fertility based on number, appearance, and motility of the sperm.

DIF: Cognitive Level: Knowledge REF: p. 1142 OBJ: 2
TOP: Semen Analysis KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

5. Which instruction should increase the comfort of a patient who is recovering from prostatitis?
a. Avoid bathing for 2 days.
b. Exercise.
c. Take stool softeners.
d. Limit fluid intake.
ANS: C
Stool softeners may be prescribed to prevent constipation, which is painful with prostatitis. Fluid intake is also encouraged to reduce the risk of constipation.

DIF: Cognitive Level: Comprehension REF: p. 1146 OBJ: 4
TOP: Prostatitis KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

6. What is the purpose of the urethral smear?
a. Screens for human immunodeficiency viral (HIV) infection
b. Detects sexually transmitted infections
c. Verifies fertility through a sperm count
d. Eliminates concerns of prostate problems
ANS: B
A sterile swab is inserted into the urethra to obtain a specimen to detect sexually transmitted infections.

DIF: Cognitive Level: Knowledge REF: p. 1145 OBJ: 3
TOP: Diagnostic Tests KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

7. A patient is placed on diethylstilbestrol (DES) for prostate cancer. What should the nurse explain as a possible side effect of the medication?
a. Gynecomastia
b. Pruritus
c. Constipation
d. Tinnitus
ANS: A
Gynecomastia is a side effect of DES.

DIF: Cognitive Level: Knowledge REF: p. 1152-1153
OBJ: 4 TOP: Drug Therapy for Male Reproductive System
KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies

8. Which statement by a patient indicates he understands the teaching relative to how to perform a testicular self-examination?
a. Its not necessary to feel the testes; just look at them in a mirror.
b. The best time to do a self-examination is after a shower, when my body is warm.
c. It doesnt really matter when I do it; just do it sometime.
d. The physician is really the best person to check this for me.
ANS: B
The examination is best done after a warm bath or shower.

DIF: Cognitive Level: Comprehension REF: p. 1161 OBJ: 6
TOP: Testicular Cancer KEY: Nursing Process Step: Evaluation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

9. What should a patients home instructions following a vasectomy include?
a. Postoperative care consists of warm Sitz baths.
b. Vasectomies should be seen as usually permanent but are sometimes reversible.
c. Sexual intercourse should be delayed for up to 3 months.
d. The surgical procedure may interfere with ejaculation.
ANS: B
Although a vasectomy can sometimes be successfully reversed, it should be considered permanent.

DIF: Cognitive Level: Comprehension REF: p. 1160 OBJ: 6
TOP: Vasectomy KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

10. When conducting an initial assessment on a 65-year-old male patient, a nurse assesses a mass in the left testicle that on transillumination glows red. What should the nurse note this indicates the presence of?
a. Phimosis
b. A hydrocele
c. Smegma
d. A hematocele
ANS: B
A hydrocele will glow red on transillumination, but a hematocele will not. Phimosis is a foreskin that will not retract over the glans, and smegma is a cheeselike substance found under the foreskin.

DIF: Cognitive Level: Comprehension REF: p. 1142 OBJ: 2
TOP: Health Assessment KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

11. A mother of a newborn with cryptorchidism asks if this condition will be permanent. What is the nurses best response?
a. Yes, but your child can develop normally with hormone replacement therapy.
b. No, several medical and surgical remedies can be performed after your babys first birthday.
c. Yes, but the undescended testicle is still able to function in a normal manner.
d. No, the process of sexual maturity will cause it to descend at puberty.
ANS: B
Partial or incomplete descent of the testicles may be resolved by medical or surgical implementation. Medical implementation starts between the first and second years of life.

DIF: Cognitive Level: Comprehension REF: p. 1159 OBJ: 6
TOP: Cryptorchidism KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

12. What should a nurse inform a 50-year-old patient who has been prescribed nilutamide (Nilandron), a testosterone blocker, to expect while taking this drug?
a. His urine will have a fishy odor.
b. Liver functions will need to be monitored.
c. Skin rash will appear on his face.
d. Episodes of hypotension will occur.
ANS: B
The drug nilutamide (Nilandron) is hepatoxic. While taking the drug, the patient will have to have periodic evaluations of his liver function. The patient should also be informed to report any jaundice or darkening of the urine.

DIF: Cognitive Level: Comprehension REF: p. 1153 OBJ: 6
TOP: Testosterone Blockers KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Pharmacological Therapies

13. A patient has been prescribed flutamide (Eulexin) for the treatment of prostate cancer. What possible side effect should the nurse remind the patient might occur?
a. Incontinence
b. Insomnia
c. Weight loss
d. Hot flashes
ANS: D
Hot flashes, ED, edema, hypertension, and confusion are some of the side effects of flutamide.

DIF: Cognitive Level: Knowledge REF: p. 1153 OBJ: 4
TOP: Flutamide KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies

14. A 60-year-old man who had a prostatectomy 3 weeks earlier asks if the ongoing incontinence will ever stop. What should the nurse understand about this procedure in order to answer the patient?
a. Postprostatectomy incontinence is usually permanent.
b. Postprostatectomy incontinence usually clears up in 6 months.
c. Although the constant dribbling will stop, stress incontinence will continue.
d. Postprostatectomy incontinence frequently requires a second surgery to correct the problem.
ANS: B
Postprostatectomy incontinence clears up in approximately 6 months in most patients.

DIF: Cognitive Level: Knowledge REF: p. 1152 OBJ: 4
TOP: Postprostatectomy Incontinence KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

15. After an accident at a track meet, a young male runner is brought to the emergency department complaining of intense pain in his scrotum and nausea and vomiting. What should the nurse suspect based on these initial findings?
a. Cryptorchidism
b. Testicular torsion
c. Varicocele
d. Epididymitis
ANS: B
Symptoms of testicular torsion are intense pain, often accompanied by nausea and vomiting.

DIF: Cognitive Level: Comprehension REF: p. 1159 OBJ: 4
TOP: Testicular Torsion KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

16. After a physician has left the room of a 30-year-old man who has been diagnosed with testicular cancer, the patient covers his face with both hands and sighs. What is the nurses most therapeutic intervention at this time?
a. Ask the patient, Do you want to talk about your cancer?
b. Leave the room and pull the door closed.
c. Go to the nurses station and call the patients wife.
d. Complete the patient care as quickly as possible.
ANS: A
You can help the patient through active listening, providing information, and referring him for counseling as needed.

DIF: Cognitive Level: Application REF: p. 1162-1163
OBJ: 6 TOP: Patient with Testicular Cancer
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

17. A nurse is formulating a teaching plan for a patient with acute prostatitis. What information should be included regarding treatment?
a. There will be a 2-week period with a temporary catheter and the instillation of antibiotics in the bladder.
b. There will be a 4-week course of antibiotics and anti-inflammatory drugs.
c. There will be a 6-week course of broad spectrum antibiotics followed by a prostatectomy.
d. There will be a 16-week protocol of Sitz baths and the use of a sturdy scrotal support.
ANS: B
Acute bacterial prostatitis is treated with antibiotics, analgesics, anti-inflammatory drugs, and Sitz baths for a period of 4 weeks. Chronic prostatitis requires a 16-week period of antibiotic therapy.

DIF: Cognitive Level: Comprehension REF: p. 1146-1147
OBJ: 4 TOP: Prostatitis KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

18. A patient is recovering after surgery to correct a testicular torsion. Which possibility should the nurse caution the young patient about?
a. Reoccurrence
b. Infertility
c. Orchiditis
d. Significant risk of prostatic hypertrophy
ANS: B
After testicular torsion is corrected, lower sperm counts and infertility may follow.

DIF: Cognitive Level: Knowledge REF: p. 1159 OBJ: 6
TOP: Testicular Torsion KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

19. What can men who have sustained spinal cord injuries with resultant ED use to aid in the ability to have sexual intercourse?
a. Testosterone injections
b. Papaverine penile injections
c. Inflatable penile implants
d. Oral sildenafil (Viagra)
ANS: C
Penile implants may be prescribed for patients with the inability to initiate, fill, or restore an erection.

DIF: Cognitive Level: Knowledge REF: p. 1156 OBJ: 4
TOP: Erectile Dysfunction KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

20. A nurse is assessing a young man who is being treated for sterility and inquires whether the young man had any common childhood disease that may be the cause of sterility. What childhood disease might result in sterility?
a. Mumps
b. Chicken pox
c. Measles
d. Scarlet fever
ANS: A
Mumps in a man or pubescent boy may result in acute orchitis or epididymitis. Infections that ascend to the epididymis may result in decreased fertility.

DIF: Cognitive Level: Knowledge REF: p. 1159 OBJ: 2
TOP: Mumps KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

21. A patient has an elevation in the prostatic-specific antigen (PSA) level from 4 to 6 ng/L. What should the nurse suspect to be the cause?
a. Possibility of prostatic cancer
b. ED
c. Probability of orchiditis
d. Significant indication of Peyronie disease
ANS: A
PSA levels over 4 ng/L may indicate cancer of the prostate; further studies are needed.

DIF: Cognitive Level: Comprehension REF: p. 1152 OBJ: 3
TOP: PSA KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

22. A patient who had a prostatectomy 1 year earlier now has elevations in serum alkaline phosphatase and calcium levels. What should the nurse be aware that this indicates?
a. Reduction of cancer risk
b. Orchiditis
c. Testicular cancer
d. Metastasis
ANS: D
Elevations of the tumor marker alkaline phosphatase and an increased level of calcium indicate metastasis to the bone.

DIF: Cognitive Level: Comprehension REF: p. 1152 OBJ: 3
TOP: Laboratory Tests KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

23. What instruction should a nurse include when giving education about taking sildenafil (Viagra)?
a. No more than two tablets should be taken in a 24-hour period.
b. Erection occurs without stimulation.
c. Nitrates should be taken at least 4 hours before taking Viagra.
d. Tablet should be taken 1 hour before sexual activity.
ANS: D
Viagra should be taken 1 hour before sexual activity. Erection depends on stimulation. No more than one tablet a day should be taken. Persons taking nitrates should not take Viagra because of the risk of a possibly fatal myocardial infarction.

DIF: Cognitive Level: Comprehension REF: p. 1154 OBJ: 4
TOP: Sildenafil (Viagra) KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies

24. When completing a health history with a patient, a nurse should encourage the patient to describe the symptoms in objective terms. Which statement is a good example of the description of pain?
a. This spot seems to hurt more right here.
b. This pain is the worst pain in the world.
c. My pain reminds me of when I hurt my foot last year.
d. I would say my pain is a 5 on a scale from 1 to 10.
ANS: D
Encourage the patient to use descriptive terms such as stinging or aching and ask him to indicate the intensity on a scale from 1 to 10.

DIF: Cognitive Level: Application REF: p. 1140 OBJ: 2
TOP: Health History KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

MULTIPLE RESPONSE

25. What direction should a nurse provide when instructing a patient who is to have a semen analysis? (Select all that apply.)
a. Collect specimen in a rubber condom.
b. Keep the specimen at room temperature until given to the laboratory.
c. Keep the specimen container in warm tap water.
d. Bring the specimen to the laboratory within 4 hours.
e. Abstain from sexual activity 3 to 5 days before the test.
ANS: B, E
Sexual activity should be avoided for 3 to 5 days before collection. The specimen should be collected in a clean container, not a rubber condom, and presented to the laboratory within 1 hour of collection.

DIF: Cognitive Level: Application REF: p. 1142 OBJ: 3
TOP: Semen Collection KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

26. What should instructions relate to for a discharge teaching plan for a patient after undergoing a prostatectomy? (Select all that apply.)
a. Remedy for bladder spasm
b. Catheter care
c. Delay of sexual activity for 3 months
d. Perineal exercises
e. Avoidance of heavy lifting
ANS: A, B, D, E
Instruction relative to relieving bladder spasms, catheter care, perineal exercises to help reduce incontinence, and the avoidance of heavy lifting are appropriate. Sexual activity is usually resumed in 6 weeks.

DIF: Cognitive Level: Comprehension REF: p. 1152 OBJ: 6
TOP: Discharge Instructions for Prostatectomy
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

27. A nurse is performing the initial assessment on a man with a reproductive disorder. What type of interview techniques should be used to demonstrate a sensitive approach? (Select all that apply.)
a. Use open-ended questions.
b. Pin the patient down for truthful and specific information.
c. Leave sensitive questions until later in the interview.
d. Share her or his professional opinion.
e. Start most questions with why.
ANS: A, C
The use of open-ended questions encourages the patient to explain his problem in greater detail, especially if sensitive issues are left until later in the interview. Pinning the patient down, sharing professional opinion, and asking why are not therapeutic.

DIF: Cognitive Level: Application REF: p. 1140 OBJ: 6
TOP: Initial Assessment KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

COMPLETION

28. When a significant elevation in the human chorionic gonadotropin (hCG) level is noted on a laboratory report, the nurse is aware that this is a marker for _____ cancer.

ANS:
testicular
An elevation in the hCG is a marker for testicular cancer.

DIF: Cognitive Level: Knowledge REF: p. 1144 OBJ: 3
TOP: Human Chorionic Gonadotropin Report
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

29. A patient with a spinal cord injury complains to a nurse of the inability to experience an erection. The nurse explains, The _____ component of the nervous system has been affected by your injury.

ANS:
parasympathetic
Parasympathetic nerves release neurotransmitters, which cause the cavernosal arteriole walls to relax.

DIF: Cognitive Level: Knowledge REF: p. 1139 OBJ: 1
TOP: Erection with Spinal Cord Injury KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

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