LeMone & Burke's Medical-Surgical Nursing, 7e (Bauldoff/Gubrud/Carno)

Chapter 47 Assessing the Male and Female Reproductive Systems

1) A 40-year-old male seeks medical attention for impotence. Which patient statement should the nurse further investigate? Select all that apply.

1. "I take medications to help me sleep several times per week."

2. "I had the mumps when I was a boy."

3. "I had a vasectomy 4 years ago."

4. "I have had diabetes for several years."

5. "My wife has a history of cervical cancer."

Page Ref: 1742

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Physiological Adaptation

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 47.2 Outline the components of the assessment of the male reproductive system, including topics for the health assessment interview, techniques for physical assessment, and the diagnostic tests used in the assessment.

MNL Learning Outcome: 3. Interpret abnormal findings of the male and female reproductive systems collected during assessment.

2) While collecting data from a couple experiencing infertility, the male partner, age 52, asks why information about his mother's pregnancy is important. How should the nurse respond?

1. "Collecting information about a patient's immediate family is required."

2. "Medication exposure during pregnancy may impact the long-range fertility of the woman's male children."

3. "If your mother experienced infertility, you are at a higher risk for infertility."

4. "Although the greater concerns relate to the female's mother, we collect information on both of you to create a more balanced picture."

Page Ref: 1742

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance: Techniques of Physical Assessment

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.4. Communicate effectively with all members of the healthcare team, including the patient and the patient's support network | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Communication and Documentation

Learning Outcome: 47.1 Describe the anatomy, physiology, and functions of the male reproductive system, and identify abnormal findings that may indicate impairment of the reproductive system.

MNL Learning Outcome: 1. Utilize appropriate techniques to perform a health history and physical assessment of the male and female reproductive systems.

3) The nurse is performing an assessment of a female patient's breasts. Which finding indicates the need for further assessment? Select all that apply.

1. The breasts are not the same size.

2. The breasts do not display prominent veins.

3. The nipples are flat.

4. The breasts are reddened.

5. There is an area of dimpled skin.

Page Ref: 1749

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Physiological Adaptation

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 47.4 Outline the components of the assessment of the female reproductive system, including topics for the health assessment interview, techniques for physical assessment, and the diagnostic tests used in the assessment.

MNL Learning Outcome: 3. Interpret abnormal findings of the male and female reproductive systems collected during assessment.

4) A patient is scheduled to have a vaginal examination and a Pap smear. Which patient statement indicates understanding of the nurse's instruction concerning the test and preparation?

1. "I cannot bathe for 36 hours prior to the examination."

2. "I should not douche the day before my examination."

3. "My period will not be a reason to defer my vaginal examination."

4. "My physician will use Vaseline to lubricate the speculum and prevent discomfort."

Page Ref: 1751

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Reduction of Risk Potential

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.9. Monitor client outcomes to evaluate the effectiveness of psychobiological interventions | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Evaluation/Teaching/Learning

Learning Outcome: 47.4 Outline the components of the assessment of the female reproductive system, including topics for the health assessment interview, techniques for physical assessment, and the diagnostic tests used in the assessment.

MNL Learning Outcome: 1. Utilize appropriate techniques to perform a health history and physical assessment of the male and female reproductive systems.

5) An adolescent patient is having a first vaginal examination. Which speculum should the nurse prepare for this examination?

1. Graves speculum

2. Pederson speculum

3. Killian speculum

4. Vienna speculum

Page Ref: 1751

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance: Techniques of Physical Assessment

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 47.4 Outline the components of the assessment of the female reproductive system, including topics for the health assessment interview, techniques for physical assessment, and the diagnostic tests used in the assessment.

MNL Learning Outcome: 1. Utilize appropriate techniques to perform a health history and physical assessment of the male and female reproductive systems.

6) A pregnant patient overhears the examiner referring to a positive Hegar sign and asks what this means. Which response by the nurse best explains this sign?

1. Hegar sign refers to the softening of the lower uterine segment during pregnancy.

2. Hegar sign refers to the skin changes noted in early pregnancy.

3. Hegar sign refers to the softening of the cervix during the early stages of pregnancy.

4. Hegar sign refers to the changes in color of the vaginal mucosa during pregnancy.

Page Ref: 1751

Cognitive Level: Analyzing

Client Need & Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.4. Communicate effectively with all members of the healthcare team, including the patient and the patient's support network | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Communication and Documentation

Learning Outcome: 47.4 Outline the components of the assessment of the female reproductive system, including topics for the health assessment interview, techniques for physical assessment, and the diagnostic tests used in the assessment.

MNL Learning Outcome: 2. Recognize normal findings of the male and female reproductive systems collected during assessment and health promotion activities to support the health of these body systems.

7) During the bimanual examination of a patient's uterus, the nurse notes that the uterus is tilted toward the back. What should the nurse explain to the patient about this finding?

1. The uterus of a patient who has carried a child to term is frequently in a tilted-back position.

2. The uterus may be tilted backward (retroverted) or angled backward (retroflexed).

3. The uterus of a patient with fibroid tumors frequently tilts back under the weight of the tumors.

4. The backward tilt of the uterus is consistent with pregnancy in the second or third trimester.

Page Ref: 1751

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance: Techniques of Physical Assessment

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.4. Communicate effectively with all members of the healthcare team, including the patient and the patient's support network | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Communication and Documentation

Learning Outcome: 47.4 Outline the components of the assessment of the female reproductive system, including topics for the health assessment interview, techniques for physical assessment, and the diagnostic tests used in the assessment.

MNL Learning Outcome: 2. Recognize normal findings of the male and female reproductive systems collected during assessment and health promotion activities to support the health of these body systems.

8) The nurse is conducting a presentation to a group of women concerning menopause. Which statement by a participant indicates an understanding about the process? Select all that apply.

1. "Lubrication for intercourse will not be as necessary after menopause."

2. "My risk for vaginal infections declines as my estrogen levels decrease during menopause."

3. "My uterus will shrink in size after menopause."

4. "My skin will thicken after menopause."

5. "I should start practicing Kegel exercises."

Page Ref: 1756

Cognitive Level: Analyzing

Client Need & Sub: Health Promotion and Maintenance: Aging Process

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.9. Monitor client outcomes to evaluate the effectiveness of psychobiological interventions | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Evaluation/Teaching/Learning

Learning Outcome: 47.5 Differentiate considerations for assessing the reproductive systems of older adults and of individuals in the LGBTQI population.

MNL Learning Outcome: 2. Recognize normal findings of the male and female reproductive systems collected during assessment and health promotion activities to support the health of these body systems.

9) The nurse is scheduling a hysterosalpingogram test for a patient. When planning the test, which information from the patient's history will the nurse need?

1. Date of the patient's last menstrual period (LMP)

2. Number of past pregnancies the patient has had

3. Type of contraceptive being used by the patient and her partner

4. Patient's age at menarche

Page Ref: 1754

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance: Health Screening

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 47.4 Outline the components of the assessment of the female reproductive system, including topics for the health assessment interview, techniques for physical assessment, and the diagnostic tests used in the assessment.

MNL Learning Outcome: 4. Recognize the purpose of and related nursing interventions for patients undergoing diagnostic tests for assessment of the male and female reproductive systems.

10) A patient is scheduled to have an endometrial biopsy. After the nurse provides education concerning the test, which patient statement indicates an understanding of the procedure?

1. "I may need a strong pain medication for the first several days after the test."

2. "I may not have a regular menstrual cycle for 3 to 6 months after the test."

3. "If I have bleeding after the procedure, I can use junior-size tampons."

4. "I should avoid sexual intercourse in the days following the procedure."

Page Ref: 1754

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Reduction of Risk Potential

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.9. Monitor client outcomes to evaluate the effectiveness of psychobiological interventions | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Evaluation/Teaching/Learning

Learning Outcome: 47.4 Outline the components of the assessment of the female reproductive system, including topics for the health assessment interview, techniques for physical assessment, and the diagnostic tests used in the assessment.

MNL Learning Outcome: 4. Recognize the purpose of and related nursing interventions for patients undergoing diagnostic tests for assessment of the male and female reproductive systems.

11) During the vaginal examination of a 33-year-old patient, a nontender mass at the posterolateral portion of the labia majora is noted. What should the nurse suspect is occurring with the patient?

1. Rectocele

2. Fistula

3. Bartholin cyst

4. Cyst of Skene's gland

Page Ref: 1750

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Reduction of Risk Potential

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 47.4 Outline the components of the assessment of the female reproductive system, including topics for the health assessment interview, techniques for physical assessment, and the diagnostic tests used in the assessment.

MNL Learning Outcome: 3. Interpret abnormal findings of the male and female reproductive systems collected during assessment.

12) An 18-year-old female patient who reports feeling two nonpainful ulcerations on the labia asks if they might be herpes simplex. What response should the nurse make?

1. "Those spots do sound consistent with herpes simplex."

2. "Have you been having sex with new partners?"

3. "Herpes lesions are usually painful."

4. "The lesions you describe are most consistent with genital warts."

Page Ref: 1750

Cognitive Level: Applying

Client Need & Sub: Physiological Integrity: Reduction of Risk Potential

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.4. Communicate effectively with all members of the healthcare team, including the patient and the patient's support network | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Assessment/Communication and Documentation

Learning Outcome: 47.4 Outline the components of the assessment of the female reproductive system, including topics for the health assessment interview, techniques for physical assessment, and the diagnostic tests used in the assessment.

MNL Learning Outcome: 3. Interpret abnormal findings of the male and female reproductive systems collected during assessment.

13) The nipples of a 22-year-old female patient's breasts are pointing in different directions. What action should the nurse take?

1. The findings should be documented as normal.

2. The nurse will need to question the patient to determine if she is breastfeeding.

3. The finding will need to be reported for follow-up hormone level assessments.

4. The finding will need to be reported for further testing to rule out a malignancy.

Page Ref: 1749

Cognitive Level: Applying

Client Need & Sub: Physiological Integrity: Physiological Adaptation

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 47.4 Outline the components of the assessment of the female reproductive system, including topics for the health assessment interview, techniques for physical assessment, and the diagnostic tests used in the assessment.

MNL Learning Outcome: 3. Interpret abnormal findings of the male and female reproductive systems collected during assessment.

14) A patient who had an exploratory laparoscopic surgical procedure 36 hours ago reports feeling shoulder pain. How should the nurse respond?

1. "The surgical table is famous for causing patients shoulder pain after procedures."

2. "You are likely not sleeping well, which can lead to shoulder discomfort."

3. "This pain is caused by the gases used during the surgical procedure."

4. "This pain should go away soon."

Page Ref: 1755

Cognitive Level: Applying

Client Need & Sub: Physiological Integrity: Reduction of Risk Potential

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome: 47.4 Outline the components of the assessment of the female reproductive system, including topics for the health assessment interview, techniques for physical assessment, and the diagnostic tests used in the assessment.

MNL Learning Outcome: 4. Recognize the purpose of and related nursing interventions for patients undergoing diagnostic tests for assessment of the male and female reproductive systems.

15) A patient who had a laparoscopic surgical procedure calls the clinical facility with complaints of vaginal discharge. What action should the nurse take first?

1. Document the complaint.

2. Notify the healthcare provider.

3. Ask the patient to come to the clinic immediately.

4. Check if the patient has been prescribed an antibiotic.

Page Ref: 1755

Cognitive Level: Applying

Client Need & Sub: Physiological Integrity: Reduction of Risk Potential

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 47.4 Outline the components of the assessment of the female reproductive system, including topics for the health assessment interview, techniques for physical assessment, and the diagnostic tests used in the assessment.

MNL Learning Outcome: 4. Recognize the purpose of and related nursing interventions for patients undergoing diagnostic tests for assessment of the male and female reproductive systems.

16) The nurse provides aftercare teaching to a patient recovering from a colposcopy. Which patient statement indicates an understanding of the information? Select all that apply.

1. "I will need to avoid heavy lifting for the next 4 weeks."

2. "I should douche at the end of 1 week to remove vaginal discharge."

3. "I can take ibuprofen for pain if needed."

4. "I will have some light vaginal discharge."

5. "I will report a temperature elevation to the physician's office."

Page Ref: 1753

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Reduction of Risk Potential

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.9. Monitor client outcomes to evaluate the effectiveness of psychobiological interventions | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Evaluation/Teaching/Learning

Learning Outcome: 47.4 Outline the components of the assessment of the female reproductive system, including topics for the health assessment interview, techniques for physical assessment, and the diagnostic tests used in the assessment.

MNL Learning Outcome: 4. Recognize the purpose of and related nursing interventions for patients undergoing diagnostic tests for assessment of the male and female reproductive systems.

17) A female patient reports the inability to conceive as being because of the spouse's choice of underwear. What should the nurse consider about this patient's statement regarding sperm production?

1. Tight male underwear inhibits sperm production.

2. Tight male underwear impedes blood flow to the penis.

3. Tight underwear may increase heat in the genital area.

4. The patient is repeating an "old wives' tale."

Page Ref: 1741

Cognitive Level: Analyzing

Client Need & Sub: Health Promotion and Maintenance: Techniques of Physical Assessment

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 47.1 Describe the anatomy, physiology, and functions of the male reproductive system, and identify abnormal findings that may indicate impairment of the reproductive system.

MNL Learning Outcome: 3. Interpret abnormal findings of the male and female reproductive systems collected during assessment.

18) A male patient was born with only one testis. What might be an effect of this anatomical change?

1. May need testosterone replacement therapy

2. May be sterile

3. May need estrogen replacement therapy

4. Will have a normal level of sperm production

Page Ref: 1741

Cognitive Level: Analyzing

Client Need & Sub: Health Promotion and Maintenance: Techniques of Physical Assessment

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 47.1 Describe the anatomy, physiology, and functions of the male reproductive system, and identify abnormal findings that may indicate impairment of the reproductive system.

MNL Learning Outcome: 3. Interpret abnormal findings of the male and female reproductive systems collected during assessment.

19) A male patient has an infection of the epididymis. What reduction might occur in the patient's body because of this infection?

1. Testosterone production

2. Mature sperm

3. Blood flow to the penis

4. Ability to sustain an erection

Page Ref: 1741

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Physiological Adaptation

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 47.1 Describe the anatomy, physiology, and functions of the male reproductive system, and identify abnormal findings that may indicate impairment of the reproductive system.

MNL Learning Outcome: 3. Interpret abnormal findings of the male and female reproductive systems collected during assessment.

20) The analysis of a patient's semen indicates the patient could have difficulty impregnating his spouse. Which volume of sperm per milliliter does this patient most likely have?

1. 150 million

2. 100 million

3. 50 million

4. 5 million

Page Ref: 1742, 1745

Cognitive Level: Analyzing

Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 47.2 Outline the components of the assessment of the male reproductive system, including topics for the health assessment interview, techniques for physical assessment, and the diagnostic tests used in the assessment.

MNL Learning Outcome: 4. Recognize the purpose of and related nursing interventions for patients undergoing diagnostic tests for assessment of the male and female reproductive systems.

21) An analysis of a patient's sperm shows the sperm are not developing motility. Which body structure should the nurse suspect is not functioning at the optimal level in this patient?

1. Prostate

2. Epididymis

3. Scrotum

4. Penis

Page Ref: 1741

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Physiological Adaptation

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 47.1 Describe the anatomy, physiology, and functions of the male reproductive system, and identify abnormal findings that may indicate impairment of the reproductive system.

MNL Learning Outcome: 3. Interpret abnormal findings of the male and female reproductive systems collected during assessment.

22) A male patient's PSA (prostate-specific antigen) level is elevated. Which diagnostic test for cancer might be indicated for this patient?

1. Abdominal x-ray

2. Biopsy

3. CT scan

4. Small bowel examination

Page Ref: 1744

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Reduction of Risk Potential

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 47.2 Outline the components of the assessment of the male reproductive system, including topics for the health assessment interview, techniques for physical assessment, and the diagnostic tests used in the assessment.

MNL Learning Outcome: 4. Recognize the purpose of and related nursing interventions for patients undergoing diagnostic tests for assessment of the male and female reproductive systems.

23) A 40-year-old male patient is unable to have an erection since being prescribed an antispasmodic for a muscular back injury and hydrocortisone cream to manage a chronic integumentary condition. What should the nurse suspect this patient is experiencing?

1. Side effect of the antispasmodic medication

2. Age-related erectile dysfunction

3. Side effect of the hydrocortisone cream

4. Result of the muscular back injury

Page Ref: 1742

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 47.2 Outline the components of the assessment of the male reproductive system, including topics for the health assessment interview, techniques for physical assessment, and the diagnostic tests used in the assessment.

MNL Learning Outcome: 3. Interpret abnormal findings of the male and female reproductive systems collected during assessment.

24) The nurse is preparing to examine a male patient's reproductive organs. What should the nurse do in preparation for this examination? Select all that apply.

1. Secure a private examination room.

2. Use clean hands for the examination.

3. Ask the patient to lie down on the examination table.

4. Ask the patient to empty his bladder.

5. Make sure the room temperature is cool.

Page Ref: 1744

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance: Techniques of Physical Assessment

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 47.2 Outline the components of the assessment of the male reproductive system, including topics for the health assessment interview, techniques for physical assessment, and the diagnostic tests used in the assessment.

MNL Learning Outcome: 1. Utilize appropriate techniques to perform a health history and physical assessment of the male and female reproductive systems.

25) A female patient reports experiencing severe menstrual cramps. Which uterine structure should the nurse recognize is responsible for the patient's symptom?

1. Perimetrium

2. Myometrium

3. Endometrium

4. Cervix

Page Ref: 1746

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Physiological Adaptation

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 47.3 Describe the anatomy, physiology, and functions of the female reproductive system, and identify abnormal findings that may indicate impairment of the reproductive system.

MNL Learning Outcome: 3. Interpret abnormal findings of the male and female reproductive systems collected during assessment.

26) A female patient reports using special vitamins to "increase the production of eggs" to aid in conception. How should the nurse interpret this patient's action?

1. Proactive in attempts to become pregnant

2. Will result in improved health

3. Is anxious about nothing

4. Misinformed

Page Ref: 1747

Cognitive Level: Analyzing

Client Need & Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 47.4 Outline the components of the assessment of the female reproductive system, including topics for the health assessment interview, techniques for physical assessment, and the diagnostic tests used in the assessment.

MNL Learning Outcome: 2. Recognize normal findings of the male and female reproductive systems collected during assessment and health promotion activities to support the health of these body systems.

27) A young female patient reports having a "thin, runny discharge" from the vagina every month, about halfway through the menstrual cycle. What should the nurse realize this patient is describing?

1. Normal changes in cervical mucus

2. Evidence of a blocked vaginal gland

3. Sexual arousal response

4. Evidence of a sexually transmitted infection

Page Ref: 1747

Cognitive Level: Analyzing

Client Need & Sub: Health Promotion and Maintenance: Techniques of Physical Assessment

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 47.3 Describe the anatomy, physiology, and functions of the female reproductive system, and identify abnormal findings that may indicate impairment of the reproductive system.

MNL Learning Outcome: 2. Recognize normal findings of the male and female reproductive systems collected during assessment and health promotion activities to support the health of these body systems.

28) During an assessment, the patient asks why the "armpit" is being assessed. How should the nurse respond? Select all that apply.

1. "I'm counting the ribs."

2. "Don't you feel your own armpits?"

3. "Breast tissue extends into this area."

4. "I'm assessing hair distribution in this area."

5. "The armpits should be part of a breast self-examination."

Page Ref: 1749

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance: Techniques of Physical Assessment

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.4. Communicate effectively with all members of the healthcare team, including the patient and the patient's support network | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Assessment/Communication and Documentation

Learning Outcome: 47.4 Outline the components of the assessment of the female reproductive system, including topics for the health assessment interview, techniques for physical assessment, and the diagnostic tests used in the assessment.

MNL Learning Outcome: 1. Utilize appropriate techniques to perform a health history and physical assessment of the male and female reproductive systems.

29) During an assessment of a female patient's internal genitalia, the nurse feels a bulge along the posterior vaginal wall. What should the nurse suspect is occurring with this patient?

1. Prolapsed uterus

2. Cystocele

3. Rectocele

4. Blocked gland

Page Ref: 1751

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Physiological Adaptation

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 47.4 Outline the components of the assessment of the female reproductive system, including topics for the health assessment interview, techniques for physical assessment, and the diagnostic tests used in the assessment.

MNL Learning Outcome: 3. Interpret abnormal findings of the male and female reproductive systems collected during assessment.

30) A female patient is scheduled for an ultrasound to examine the uterus. How should the nurse instruct the patient to prepare for the test?

1. Take a laxative the night before the test to clear the colon of feces.

2. Restrict fluids prior to the day of the test.

3. Take no food or fluids after midnight the day before the test.

4. Increase fluid intake and do not void until after the test.

Page Ref: 1755

Cognitive Level: Applying

Client Need & Sub: Physiological Integrity: Reduction of Risk Potential

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome: 47.4 Outline the components of the assessment of the female reproductive system, including topics for the health assessment interview, techniques for physical assessment, and the diagnostic tests used in the assessment.

MNL Learning Outcome: 4. Recognize the purpose of and related nursing interventions for patients undergoing diagnostic tests for assessment of the male and female reproductive systems.

31) An older female patient is experiencing growth of hair on the chin. Which age-related change should the nurse associate with this finding?

1. Increased estrogen production

2. Increased production of luteinizing hormone

3. Decreased estrogen production

4. Decreased production of follicle-stimulating hormone

Page Ref: 1756

Cognitive Level: Analyzing

Client Need & Sub: Health Promotion and Maintenance: Aging Process

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 47.5 Differentiate considerations for assessing the reproductive systems of older adults and of individuals in the LGBTQI population.

MNL Learning Outcome: 2. Recognize normal findings of the male and female reproductive systems collected during assessment and health promotion activities to support the health of these body systems.

32) During a health history, the nurse becomes concerned that a male patient is at risk for cancer of the reproductive organs. What genetic information about this patient caused the nurse's concern? Select all that apply.

1. The patient's mother has arthritis.

2. The patient's father had prostate cancer.

3. The patient's brother was treated for testicular cancer.

4. The patient was treated for cryptorchidism as a young child.

5. The patient's uncle has been diagnosed with type 2 diabetes mellitus.

Page Ref: 1742

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Reduction of Risk Potential

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 47.1 Describe the anatomy, physiology, and functions of the male reproductive system, and identify abnormal findings that may indicate impairment of the reproductive system.

MNL Learning Outcome: 1. Utilize appropriate techniques to perform a health history and physical assessment of the male and female reproductive systems.

33) After genetic testing, it is determined that a male patient is missing the sex-determining region Y gene (SRY). What manifestations should the nurse expect to assess in this patient? Select all that apply.

1. Balanitis

2. Minimal libido

3. Negative sperm production

4. No secondary sex characteristics

5. Changes in bone and muscle structure

Page Ref: 1742

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Physiological Adaptation

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 47.2 Outline the components of the assessment of the male reproductive system, including topics for the health assessment interview, techniques for physical assessment, and the diagnostic tests used in the assessment.

MNL Learning Outcome: 3. Interpret abnormal findings of the male and female reproductive systems collected during assessment.

34) A female patient is informed that she has the BRCA1 gene. On which health problems should the nurse focus when assessing this patient? Select all that apply.

1. Asthma

2. Fibromyalgia

3. Heart disease

4. Breast cancer

5. Ovarian cancer

Page Ref: 1748

Cognitive Level: Applying

Client Need & Sub: Physiological Integrity: Reduction of Risk Potential

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 47.4 Outline the components of the assessment of the female reproductive system, including topics for the health assessment interview, techniques for physical assessment, and the diagnostic tests used in the assessment.

MNL Learning Outcome: 3. Interpret abnormal findings of the male and female reproductive systems collected during assessment.

35) The nurse is preparing to assess a female adolescent diagnosed with Turner syndrome. What finding should the nurse expect because of this genetic disorder? Select all that apply.

1. Webbed neck

2. Muscle atrophy

3. Short stature

4. Facial hair growth

5. Lack of sexual development

Page Ref: 1748

Cognitive Level: Applying

Client Need & Sub: Physiological Integrity: Physiological Adaptation

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 47.4 Outline the components of the assessment of the female reproductive system, including topics for the health assessment interview, techniques for physical assessment, and the diagnostic tests used in the assessment.

MNL Learning Outcome: 3. Interpret abnormal findings of the male and female reproductive systems collected during assessment.

36) The nurse is concerned that a male patient may have breast cancer. What did the nurse assess to make this clinical decision? Select all that apply.

1. A painless nodule in the testis

2. Enlarged supraventricular nodes

3. Femoral bulge that increases with coughing

4. Tender disk of breast tissue behind the areola

5. Hard, irregular, fixed nodule in the nipple area

Page Ref: 1743

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Physiological Adaptation

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 47.2 Outline the components of the assessment of the male reproductive system, including topics for the health assessment interview, techniques for physical assessment, and the diagnostic tests used in the assessment.

MNL Learning Outcome: 3. Interpret abnormal findings of the male and female reproductive systems collected during assessment.

37) The nurse is preparing a teaching tool on testicular self-examination. Which information should the nurse include? Select all that apply.

1. Examine the testicles once a week.

2. Examine while taking a warm shower.

3. Identify the epididymis as soft and tender.

4. Identify the spermatic cord as firm and smooth.

5. Gently roll each testicle between the thumb and fingers.

Page Ref: 1757

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning/Teaching/Learning

Learning Outcome: 47.6 Summarize topics that nurses teach to promote healthy sexuality and reproduction across the lifespan.

MNL Learning Outcome: 2. Recognize normal findings of the male and female reproductive systems collected during assessment and health promotion activities to support the health of these body systems.

38) A patient with osteoarthritis is postmenopausal and is upset because intercourse is uncomfortable. What should the nurse suggest to this patient? Select all that apply.

1. Use a water-soluble vaginal lubricant.

2. Consider estrogen replacement therapy.

3. Engage in intercourse on a regular basis.

4. Adapt the position for intercourse to reduce pain.

5. Accept that sexual intercourse will need to reduced.

Page Ref: 1757

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome: 47.6 Summarize topics that nurses teach to promote healthy sexuality and reproduction across the lifespan.

MNL Learning Outcome: 2. Recognize normal findings of the male and female reproductive systems collected during assessment and health promotion activities to support the health of these body systems.