NSG 6020 Week 8 Quiz 1 - Question and Answers_ latest 2020 (answered)
A 14-year-old junior high school student is brought in by his mother and father because he seems to be
developing breasts. The mother is upset because she read on the Internet that smoking marijuana leads
to breast enlargement in males. The young man adamantly denies using any tobacco, alcohol, or drugs.
He has recently noticed changes in his penis, testicles, and pubic hair pattern. Otherwise, his past
medical history is unremarkable. His parents are both in good health. He has two older brothers who
never had this problem. On examination you see a mildly overweight teenager with enlarged breast
tissue that is slightly tender on both sides. Otherwise his examination is normal. He is agreeable to taking
a drug test.
What is the most likely cause of his gynecomastia?
- Imbalance of hormones of puberty
A 30-year-old man notices a firm, 2-cm mass under his areola. He has no other symptoms and no
diagnosis of breast cancer in his first-degree relatives. What is the most likely diagnosis?
- Breast tissue - Approximately one third of adult men will have palpable breast tissue under the
areola. While males can have breast cancer, this is much less common. There are no lymph
nodes in this area
A 28-year-old musician comes to your clinic, complaining of a "spot" on his penis. He states his partner
noticed it 2 days ago and it hasn't gone away. He says it doesn't hurt. He has had no burning with
urination and no pain during intercourse. He has had several partners in the last year and uses condoms
occasionally. His past medical history consists of nongonococcal urethritis from Chlamydia and
prostatitis. His vital signs are unremarkable. On visualization of his penis there is a 6-mm red, oval ulcer
with an indurated base just proximal to the corona. On palpation the ulcer is nontender. In the inguinal
region there is nontender lymphadenopathy.
What disorder of the penis is most likely the diagnosis?
- Syphilitic chancre
A 20-year-old part-time college student comes to your clinic, complaining of growths on his penile shaft.
They have been there for about 6 weeks and haven't gone away. In fact, he thinks there may be more
now. He denies any pain with intercourse or urination. He has had three former partners and has been
with his current girlfriend for 6 months. He says that because she is on the pill they don't use condoms.
He denies any fever, weight loss, or night sweats. He is engaged to be married and has no children. On
visualization of his penis you see several moist papules along all sides of his penile shaft and even two on
the corona. He has been circumcised. On palpation of his inguinal region there is no inguinal
lymphadenopathy.
Which abnormality of the penis does this patient most likely have?
- Condylomata acuminate
A 29-year-old married computer programmer comes to your clinic, complaining of "something
strange" going on in his scrotum. Last month while he was doing his testicular self-examination he
felt a lump in his left testis. He waited a month and felt the area again, but the lump was still
there. He has had some aching in his left testis but denies any pain with urination or sexual
intercourse. He denies any fever, malaise, or night sweats. His past medical history consists of
groin surgery when he was a baby and a tonsillectomy as a teenager. His parents are both healthy.
This study source was downloaded by 100000832361371 from CourseHero.com on 07-16-2022 07:11:33 GMT -05:00
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, On visualization the penis is circumcised with no lesions; there is a scar in his right inguinal region.
There is no lymphadenopathy. Palpation of his scrotum is unremarkable on the right but indicates
a large mass on the left. Placing a finger through the inguinal ring on the right, you have the
patient bear down. Nothing is felt. You attempt to place your finger through the left inguinal ring
but cannot get above the mass. On rectal examination his prostate is unremarkable.
What disorder of the testes is most likely the diagnosis?
- Scrotal (inguinal) hernia
A 32-year-old white male comes to your clinic, complaining of aching on the right side of his testicle.
He has felt this aching for several months. He states that as the day progresses the aching increases,
but when he wakes up in the morning he is pain-free. He denies any pain with urination and states
that the pain doesn't change with sexual activity. He denies any fatigue, weight gain, weight loss,
fever, or night sweats. His past medical history is unremarkable. He is a married hospital
administrator with two children. He notes that he and his wife have been trying to have another
baby this year but have so far been unsuccessful despite frequent intercourse. He denies using
tobacco, alcohol, or illegal drugs. His father has high blood pressure but his mother is healthy. On
examination you see a young man appearing his stated age with unremarkable vital signs. On
visualization of his penis, he is circumcised with no lesions. He has no scars along his inguinal area,
and palpation of the area shows no lymphadenopathy. On palpation of his scrotum you feel testes
with no discrete masses. Upon placing your finger through the right inguinal ring you feel what
seems like a bunch of spaghetti. Asking him to bear down, you feel no bulges. The left inguinal ring is
unremarkable, with no bulges on bearing down. His prostate examination is unremarkable.
What abnormality of the scrotum does he most likely have?
- Variocele
A 48-year-old policeman comes to your clinic, complaining of a swollen scrotum. He states it began a
couple of weeks ago and has steadily worsened. He says the longer he stands up the worse it gets,
but when he lies down it improves. He denies any pain with urination. Because he is impotent he
doesn't know if intercourse would hurt. He states he has become more tired lately and has also
gained 10 pounds in the last month. He denies any fever or weight loss. He has had some shortness
of breath with exertion. His past medical history consists of type 2 diabetes for 20 years, high blood
pressure, and coronary artery disease. He is on insulin, three high blood pressure pills, and a water
pill. He has had his gallbladder removed. He is married and has five children. He is currently on
disability because of his health problems. Both of his parents died of complications of diabetes. On
examination you see a pleasant male appearing chronically ill. He is afebrile but his blood pressure is
160/100 and his pulse is 90. His head, eyes, ears, nose, throat, and neck examinations are normal.
There are some crackles in the bases of each lung. During his cardiac examination there is an extra
heart sound. Visualization of his penis shows an uncircumcised prepuce but no lesions or masses.
Palpation of his scrotum shows generalized swelling, with no discrete masses. A gloved finger is
placed through each inguinal ring, and with bearing down there are no bulges. The prostate is
smooth and nontender.
What abnormality of the scrotum is most likely the diagnosis?
- Scrotal edema - Scrotal edema is a generalized swelling of the scrotum due to a systemic illness.
No discrete masses are palpated. In this case, with the history of diabetes, hypertension, and
This study source was downloaded by 100000832361371 from CourseHero.com on 07-16-2022 07:11:33 GMT -05:00
https://www.coursehero.com/file/32426747/NSG6020-QUIZ8docx/
A 14-year-old junior high school student is brought in by his mother and father because he seems to be
developing breasts. The mother is upset because she read on the Internet that smoking marijuana leads
to breast enlargement in males. The young man adamantly denies using any tobacco, alcohol, or drugs.
He has recently noticed changes in his penis, testicles, and pubic hair pattern. Otherwise, his past
medical history is unremarkable. His parents are both in good health. He has two older brothers who
never had this problem. On examination you see a mildly overweight teenager with enlarged breast
tissue that is slightly tender on both sides. Otherwise his examination is normal. He is agreeable to taking
a drug test.
What is the most likely cause of his gynecomastia?
- Imbalance of hormones of puberty
A 30-year-old man notices a firm, 2-cm mass under his areola. He has no other symptoms and no
diagnosis of breast cancer in his first-degree relatives. What is the most likely diagnosis?
- Breast tissue - Approximately one third of adult men will have palpable breast tissue under the
areola. While males can have breast cancer, this is much less common. There are no lymph
nodes in this area
A 28-year-old musician comes to your clinic, complaining of a "spot" on his penis. He states his partner
noticed it 2 days ago and it hasn't gone away. He says it doesn't hurt. He has had no burning with
urination and no pain during intercourse. He has had several partners in the last year and uses condoms
occasionally. His past medical history consists of nongonococcal urethritis from Chlamydia and
prostatitis. His vital signs are unremarkable. On visualization of his penis there is a 6-mm red, oval ulcer
with an indurated base just proximal to the corona. On palpation the ulcer is nontender. In the inguinal
region there is nontender lymphadenopathy.
What disorder of the penis is most likely the diagnosis?
- Syphilitic chancre
A 20-year-old part-time college student comes to your clinic, complaining of growths on his penile shaft.
They have been there for about 6 weeks and haven't gone away. In fact, he thinks there may be more
now. He denies any pain with intercourse or urination. He has had three former partners and has been
with his current girlfriend for 6 months. He says that because she is on the pill they don't use condoms.
He denies any fever, weight loss, or night sweats. He is engaged to be married and has no children. On
visualization of his penis you see several moist papules along all sides of his penile shaft and even two on
the corona. He has been circumcised. On palpation of his inguinal region there is no inguinal
lymphadenopathy.
Which abnormality of the penis does this patient most likely have?
- Condylomata acuminate
A 29-year-old married computer programmer comes to your clinic, complaining of "something
strange" going on in his scrotum. Last month while he was doing his testicular self-examination he
felt a lump in his left testis. He waited a month and felt the area again, but the lump was still
there. He has had some aching in his left testis but denies any pain with urination or sexual
intercourse. He denies any fever, malaise, or night sweats. His past medical history consists of
groin surgery when he was a baby and a tonsillectomy as a teenager. His parents are both healthy.
This study source was downloaded by 100000832361371 from CourseHero.com on 07-16-2022 07:11:33 GMT -05:00
https://www.coursehero.com/file/32426747/NSG6020-QUIZ8docx/
, On visualization the penis is circumcised with no lesions; there is a scar in his right inguinal region.
There is no lymphadenopathy. Palpation of his scrotum is unremarkable on the right but indicates
a large mass on the left. Placing a finger through the inguinal ring on the right, you have the
patient bear down. Nothing is felt. You attempt to place your finger through the left inguinal ring
but cannot get above the mass. On rectal examination his prostate is unremarkable.
What disorder of the testes is most likely the diagnosis?
- Scrotal (inguinal) hernia
A 32-year-old white male comes to your clinic, complaining of aching on the right side of his testicle.
He has felt this aching for several months. He states that as the day progresses the aching increases,
but when he wakes up in the morning he is pain-free. He denies any pain with urination and states
that the pain doesn't change with sexual activity. He denies any fatigue, weight gain, weight loss,
fever, or night sweats. His past medical history is unremarkable. He is a married hospital
administrator with two children. He notes that he and his wife have been trying to have another
baby this year but have so far been unsuccessful despite frequent intercourse. He denies using
tobacco, alcohol, or illegal drugs. His father has high blood pressure but his mother is healthy. On
examination you see a young man appearing his stated age with unremarkable vital signs. On
visualization of his penis, he is circumcised with no lesions. He has no scars along his inguinal area,
and palpation of the area shows no lymphadenopathy. On palpation of his scrotum you feel testes
with no discrete masses. Upon placing your finger through the right inguinal ring you feel what
seems like a bunch of spaghetti. Asking him to bear down, you feel no bulges. The left inguinal ring is
unremarkable, with no bulges on bearing down. His prostate examination is unremarkable.
What abnormality of the scrotum does he most likely have?
- Variocele
A 48-year-old policeman comes to your clinic, complaining of a swollen scrotum. He states it began a
couple of weeks ago and has steadily worsened. He says the longer he stands up the worse it gets,
but when he lies down it improves. He denies any pain with urination. Because he is impotent he
doesn't know if intercourse would hurt. He states he has become more tired lately and has also
gained 10 pounds in the last month. He denies any fever or weight loss. He has had some shortness
of breath with exertion. His past medical history consists of type 2 diabetes for 20 years, high blood
pressure, and coronary artery disease. He is on insulin, three high blood pressure pills, and a water
pill. He has had his gallbladder removed. He is married and has five children. He is currently on
disability because of his health problems. Both of his parents died of complications of diabetes. On
examination you see a pleasant male appearing chronically ill. He is afebrile but his blood pressure is
160/100 and his pulse is 90. His head, eyes, ears, nose, throat, and neck examinations are normal.
There are some crackles in the bases of each lung. During his cardiac examination there is an extra
heart sound. Visualization of his penis shows an uncircumcised prepuce but no lesions or masses.
Palpation of his scrotum shows generalized swelling, with no discrete masses. A gloved finger is
placed through each inguinal ring, and with bearing down there are no bulges. The prostate is
smooth and nontender.
What abnormality of the scrotum is most likely the diagnosis?
- Scrotal edema - Scrotal edema is a generalized swelling of the scrotum due to a systemic illness.
No discrete masses are palpated. In this case, with the history of diabetes, hypertension, and
This study source was downloaded by 100000832361371 from CourseHero.com on 07-16-2022 07:11:33 GMT -05:00
https://www.coursehero.com/file/32426747/NSG6020-QUIZ8docx/
