Chapter 21: Male Genitalia

Study Questions

Chapter 21: Male Genitalia

You are assessing the genitalia of your male patient and make the following observations: He has pubic hair with texture and curl similar to that of an adult, but it has not spread to his thighs, and his scrotum is darkened. What would be his developmental stage, according to Tanner?

(a)1

(b)2

(d)5

Answer: c

Rationale: Stage 4 is just before full adult size and appearance.

Testicular cancer is most likely for men of the following race:

(a)Caucasians

(b)AfricanAmericans

(c)Asians

(d)Native Americans

Answer: a

Rationale: Caucasians have a higher incidence of testicular cancer than other races.

Your patient is an uncircumcised young man. His general hygiene is poor. Which of the following would not beappropriate in teaching him about self-care?

(a)You can preface your remarks with, “When you take your daily shower or bath…”

(b)Advise him that he should not retract the foreskin to cleanse the head of his penis while showering.

(c)Advise him to retract the foreskin to cleanse the head of his penis while showering.

(d)Advise him to replace the foreskin after cleansing and drying.

Answer: b

Rationale: Answer (a) lets him know that this is the norm in our society. He may not be aware that his hygiene is below the standard. Uncircumcised males should retract the foreskin, wash and dry the head of the penis, and replace the foreskin to keep that area clean.

Your patient presents with pain and swelling on his distal penis. He is uncircumcised, and the foreskin is retracted. He has been unable to replace it to its proper position. This is called:

(a)priapism

(b)urethritis

(c)paraphimosis

(d)hypospadias

Answer: c

Rationale: The retracted foreskin can act as a constrictor and may cause tissue necrosis. The situation must be treated promptly.

Questions 5and 6refer to the following: Your patient is a 35-year-old man who presents with scrotal swelling. You note a large, pear-sized mass in the scrotum. The skin is stretched, shiny, and erythematous, giving the penis a shortened appearance.

This is most likely a(n):

(a)inguinal hernia.

(b)hydrocele.

(c)spermatocele.

(d)varicocele.

Answer: b

Rationale: This appearance is typical of a hydrocele.

You transilluminate the scrotum and note a red glow. This is seen with (choose two):

(a)inguinal hernia.

(b)hydrocele.

(c)spermatocele.

(d)varicocele.

Answer: b, c

Rationale: A red glow indicates serous fluid in the scrotal sac, as may occur with hydrocele and spermatocele.

Your patient presents with an enlarged, retracted, painful testicle. He denies injury. You elevate the testicle until it is fully supported, but that does not lessen his pain. You suspect:

(a)epididymitis.

(b)cryptorchidism.

(c)testicular torsion.

(d)inguinal hernia.

Answer: c

Rationale: The pain of epididymitis lessens with elevation. Testicular torsion causes venous obstruction and is a surgical emergency.

Your patient is 45yearsold and presents with an aching lump in the groin area. He works on a loading dock and is overweight. He admits to smoking twopacks per day for 30 years. You suspect this type of hernia:

(a)umbilical

(b)indirect inguinal

(c)direct inguinal

(d)femoral

Answer: c

Rationale: This patient profile and his symptoms are characteristic of a direct inguinal hernia.

Your patient is a 75-year-old man who is concerned about impotence, because it takes him longer to achieve an erection and to become re-aroused. He is worried that his wife of 55 years will be disappointed without daily sexual activity. Appropriate interventions would include:

(a)assessing him for comorbid conditions, such as vascular disease and diabetes mellitus.

(b)encouraging him to keep taking all of his medications, to keep his overall health good.

(c)reassuring him that the longer period of re-arousal is normal with advancing age.

(d)trying to allay his anxiety, which can lead to further problems.

Answer: b

Rationale: Some medications may lead to impotence so it is important to review them, not just encourage the patient to continue taking them. Answers (a), (c), and (d) are true. Men can be extremely concerned about any decline in sexual function.