Final Exam
A patient who has had a swollen, nontender scrotum for one week is found to have a
mass within the
tunica vaginalis that transilluminates readily. The family nurse practitioner suspects:
a.) a hydrocele.
b.) a varicocele.
c.) an indirect inguinal hernia.
d.) carcinoma of the testis. - answer a hydrocele.
A client had excessive blood loss and prolonged hypotension during surgery. His
postoperative urine
output is sharply decreased, and his blood urea nitrogen (BUN) is elevated. The most
likely cause for the
change is acute:
A) Prerenal inflammation
B) Bladder outlet obstruction
C) Tubular necrosis
D) Intrarenal nephrotoxicity - answer Bladder outlet obstruction
Mr. S. comes to you with scrotal pain. The examinations of his scrotum, penis, and
rectum are
normal. Which of the following conditions outside of the scrotum may present as scrotal
pain?
A. Inguinal herniation and peritonitis
B. Renal colic and cardiac ischemia
C. Pancreatitis and Crohn ' s disease
D. Polyarteritis nodosa and ulcerative colitis - answer Inguinal herniation and peritonitis
The most common type of hernia is a(n):
A. indirect inguinal hernia.
B. direct inguinal hernia.
C. femoral hernia.
D. umbilical hernia. - answer indirect inguinal hernia.
Max, age 70, is obese. He is complaining of a bulge in his groin that has been there for
months. He
states that it is not painful, but it is annoying. You note that the origin of swelling is
above the inguinal
ligament directly behind and through the external ring. You diagnose this as a(n):
A. indirect inguinal hernia.
B. direct inguinal hernia.
C. femoral hernia.
D. strangulated hernia. - answer direct inguinal hernia.
A 35 year old sexually active man presents with a 1 week history of fever and pain over
the left scrotum.
,Final Exam
It is accompanied by frequency and dysuria. The scrotum is edematous and tender to
touch. He denies
flank pain, nausea, and vomiting. He reports that eh pain is lessend when he uses
scrotal-support briefs.
The urinalysis shows 2 + blood and a large number of leukocytes. What is the most
likely diagnosis?
A. Acute urinary tract infection
B. Acute pyelonephritis
C. Acute orthitis
D. Acute epididymitis - answer Acute epididymitis
Orchitis is caused by which of the following?
A. Mumps virus
B. Measles virus
C. Chlamydia trachomatis
D. Chronic urinary tract infections that are not treated adequately - answer Mumps virus
A 10 year old boy complains of sudden onset of scrotal pain upon awakening that
morning. He is also
complaining of severe nausea and vomiting. During the physical examination, the nurse
practitioner
finds a tender, warm, and swollen left scrotum. The cremastic reflex is negative and the
urine dipstick is
negative for leukocytes, nitrites, and blood. The most likely diagnosis is:
A. Acute epididymitis
B. Severe salmonella infection
C. Testicular torsion
D. Acute orchitis - answer Testicular torsion
What type of follow up should this patient receive?
A. Refer to a urologist within 48 hours
B. Refer him to the emergency department as soon as possible
C. Prescribe ibuprofen (advil) 600 mg QID for pain
D. Order a testicular ultrasound for further evaluation - answer Refer him to the
emergency department as soon as possible
A 24-year-old man presents with sudden onset of left-sided scrotal pain. He reports
having
intermittent unilateral testicular pain in the past but not as severe as this current
episode. Confirmation
of testicular torsion would include all of the following findings except:
A. unilateral loss of the cremasteric reflex.
B. the affected testicle held higher in the scrotum.
C. testicular swelling.
D. relief of pain with scrotal elevation. - answer relief of pain with scrotal elevation
, Final Exam
In assessing a man with testicular torsion, the NP is most likely to note:
A. elevated PSA level.
B. white blood cells reported in urinalysis.
C. left testicle most often affected.
D. increased testicular blood flow by color-flow Doppler ultrasound. - answer left testicle
most often affected.
Anticipated organ survival exceeds 85% with testicular decompression within how many
hours of
torsion?
A. 1
B. 6
C. 16
D. 24 - answer 6
To prevent a recurrence of testicular torsion, which of the following is recommended?
A. use of a scrotal support
B. avoidance of testicular trauma
C. orchiopexy
D. limiting the number of sexual partners - answer orchiopexy
Jordan appears with a rapid onset of unilateral scrotal pain radiating up to the groin and
flank. You
are trying to differentiate between epididymitis and testicular torsion. Which test to
determine whether
swelling is in the testis or the epididymis should be your first choice?
A. X-ray
B. Ultrasound
C. Technetium scan
D. Physical examination - answer Ultrasound
The nurse practitioner recognizes that the most common cause of epididymitis in a
young man is:
A chlamydia
B E. coli
C mycoplasma
D Proteus species - answer Chlamydia
Your 25-year-old male patient has had a fever, dysuria, low back pain, and scrotal
edema. Which of
the following is likely the diagnosis?
A acute bacteria prostatitis
B acute pyelonephritis
C epididymitis
D urinary tract infection - answer epididymitis
A patient who has had a swollen, nontender scrotum for one week is found to have a
mass within the
tunica vaginalis that transilluminates readily. The family nurse practitioner suspects:
a.) a hydrocele.
b.) a varicocele.
c.) an indirect inguinal hernia.
d.) carcinoma of the testis. - answer a hydrocele.
A client had excessive blood loss and prolonged hypotension during surgery. His
postoperative urine
output is sharply decreased, and his blood urea nitrogen (BUN) is elevated. The most
likely cause for the
change is acute:
A) Prerenal inflammation
B) Bladder outlet obstruction
C) Tubular necrosis
D) Intrarenal nephrotoxicity - answer Bladder outlet obstruction
Mr. S. comes to you with scrotal pain. The examinations of his scrotum, penis, and
rectum are
normal. Which of the following conditions outside of the scrotum may present as scrotal
pain?
A. Inguinal herniation and peritonitis
B. Renal colic and cardiac ischemia
C. Pancreatitis and Crohn ' s disease
D. Polyarteritis nodosa and ulcerative colitis - answer Inguinal herniation and peritonitis
The most common type of hernia is a(n):
A. indirect inguinal hernia.
B. direct inguinal hernia.
C. femoral hernia.
D. umbilical hernia. - answer indirect inguinal hernia.
Max, age 70, is obese. He is complaining of a bulge in his groin that has been there for
months. He
states that it is not painful, but it is annoying. You note that the origin of swelling is
above the inguinal
ligament directly behind and through the external ring. You diagnose this as a(n):
A. indirect inguinal hernia.
B. direct inguinal hernia.
C. femoral hernia.
D. strangulated hernia. - answer direct inguinal hernia.
A 35 year old sexually active man presents with a 1 week history of fever and pain over
the left scrotum.
,Final Exam
It is accompanied by frequency and dysuria. The scrotum is edematous and tender to
touch. He denies
flank pain, nausea, and vomiting. He reports that eh pain is lessend when he uses
scrotal-support briefs.
The urinalysis shows 2 + blood and a large number of leukocytes. What is the most
likely diagnosis?
A. Acute urinary tract infection
B. Acute pyelonephritis
C. Acute orthitis
D. Acute epididymitis - answer Acute epididymitis
Orchitis is caused by which of the following?
A. Mumps virus
B. Measles virus
C. Chlamydia trachomatis
D. Chronic urinary tract infections that are not treated adequately - answer Mumps virus
A 10 year old boy complains of sudden onset of scrotal pain upon awakening that
morning. He is also
complaining of severe nausea and vomiting. During the physical examination, the nurse
practitioner
finds a tender, warm, and swollen left scrotum. The cremastic reflex is negative and the
urine dipstick is
negative for leukocytes, nitrites, and blood. The most likely diagnosis is:
A. Acute epididymitis
B. Severe salmonella infection
C. Testicular torsion
D. Acute orchitis - answer Testicular torsion
What type of follow up should this patient receive?
A. Refer to a urologist within 48 hours
B. Refer him to the emergency department as soon as possible
C. Prescribe ibuprofen (advil) 600 mg QID for pain
D. Order a testicular ultrasound for further evaluation - answer Refer him to the
emergency department as soon as possible
A 24-year-old man presents with sudden onset of left-sided scrotal pain. He reports
having
intermittent unilateral testicular pain in the past but not as severe as this current
episode. Confirmation
of testicular torsion would include all of the following findings except:
A. unilateral loss of the cremasteric reflex.
B. the affected testicle held higher in the scrotum.
C. testicular swelling.
D. relief of pain with scrotal elevation. - answer relief of pain with scrotal elevation
, Final Exam
In assessing a man with testicular torsion, the NP is most likely to note:
A. elevated PSA level.
B. white blood cells reported in urinalysis.
C. left testicle most often affected.
D. increased testicular blood flow by color-flow Doppler ultrasound. - answer left testicle
most often affected.
Anticipated organ survival exceeds 85% with testicular decompression within how many
hours of
torsion?
A. 1
B. 6
C. 16
D. 24 - answer 6
To prevent a recurrence of testicular torsion, which of the following is recommended?
A. use of a scrotal support
B. avoidance of testicular trauma
C. orchiopexy
D. limiting the number of sexual partners - answer orchiopexy
Jordan appears with a rapid onset of unilateral scrotal pain radiating up to the groin and
flank. You
are trying to differentiate between epididymitis and testicular torsion. Which test to
determine whether
swelling is in the testis or the epididymis should be your first choice?
A. X-ray
B. Ultrasound
C. Technetium scan
D. Physical examination - answer Ultrasound
The nurse practitioner recognizes that the most common cause of epididymitis in a
young man is:
A chlamydia
B E. coli
C mycoplasma
D Proteus species - answer Chlamydia
Your 25-year-old male patient has had a fever, dysuria, low back pain, and scrotal
edema. Which of
the following is likely the diagnosis?
A acute bacteria prostatitis
B acute pyelonephritis
C epididymitis
D urinary tract infection - answer epididymitis
