WALDEN UNIVERSITY NRNP 6531 FINAL EXAM
QUESTIONS AND VERIFIED DETAILED ANSWERS
NEW!!/A+ GRADE
A client 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.
A client had excessive blood loss and prolonged hypotension during surgery. His
postoperativeurine output is sharply decreased, and his blood urea nitrogen (BUN) is
elevated. The most likely cause for the change is acute:
• Prerenal inflammation
• Bladder outlet obstruction
• Tubular necrosis
• Intrarenal nephrotoxicity
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?
• Inguinal herniation and peritonitis
• Renal colic and cardiac ischemia
• Pancreatitis and Crohn ' s disease
• Polyarteritis nodosa and ulcerative colitis
The most common type of hernia is a(n):
• indirect inguinal hernia.
• direct inguinal hernia.
• femoral hernia.
,• umbilical 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):
• indirect inguinal hernia.
• direct inguinal hernia.
• femoral hernia.
• strangulated hernia.
A 35 year old sexually active man presents with a 1 week history of fever and pain over the
leftscrotum. It is accompanied by frequency and dysuria. The scrotum is edematous and
tender totouch. 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?
• Acute urinary tract infection
• Acute pyelonephritis
• Acute orthitis
• Acute epididymitis
Orchitis is caused by which of the following?
• Mumps virus
• Measles virus
• Chlamydia trachomatis
• Chronic urinary tract infections that are not treated adequately
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 andthe urine dipstick is negative for leukocytes, nitrites, and blood. The most likely
diagnosis is:
• Acute epididymitis
• Severe salmonella infection
• Testicular torsion
• Acute orchitis
,What type of follow up should this client receive?
• Refer to a urologist within 48 hours
• Refer him to the emergency department as soon as possible
• Prescribe ibuprofen (advil) 600 mg QID for pain
• Order a testicular ultrasound for further evaluation
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:
• unilateral loss of the cremasteric reflex.
• the affected testicle held higher in the scrotum.
• testicular swelling.
• relief of pain with scrotal elevation.
In assessing a man with testicular torsion, the NP is most likely to note:
• elevated PSA level.
• white blood cells reported in urinalysis.
• left testicle most often affected.
• increased testicular blood flow by color-flow Doppler ultrasound.
Anticipated organ survival exceeds 85% with testicular decompression within how many
hours of torsion?
• 1
• 6
• 16
• 24
To prevent a recurrence of testicular torsion, which of the following is recommended?
• use of a scrotal support
• avoidance of testicular trauma
• orchiopexy
• limiting the number of sexual partners
, 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?
• X-ray
• Ultrasound
• Technetium scan
• Physical examination
The nurse practitioner recognizes that the most common cause of epididymitis in a young
manis:
A chlamydia
B E. coli
C mycoplasma
D Proteus species
Your 25-year-old male client has had a fever, dysuria, low back pain, and scrotal
edema.Which of the following is likely the diagnosis?
A acute bacteria
prostatitisB acute
pyelonephritis
C epididymitis
D urinary tract infection
The action of a 5 alpha-reductace inhibitor in the treatment of BPH is to:
•reduce action of androgens in the prostate.
Milton, a 72 year old unmarried, sexually active white man presents to your clinic with
complaints of hesitancy, urgency, and occasional uncontrolled dribbling. Although you
suspectbenign prostatic hypertrophy, what else should your differential diagnosis include?
•Urethral stricture (may develop as a result of sexually transmitted diseases and should
beconsidered in a sexually active individual no matter what the age)
Harry has BPH and complains of some incontinence. Your first step in diagnosing overflow
incontinence would be to order a:
QUESTIONS AND VERIFIED DETAILED ANSWERS
NEW!!/A+ GRADE
A client 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.
A client had excessive blood loss and prolonged hypotension during surgery. His
postoperativeurine output is sharply decreased, and his blood urea nitrogen (BUN) is
elevated. The most likely cause for the change is acute:
• Prerenal inflammation
• Bladder outlet obstruction
• Tubular necrosis
• Intrarenal nephrotoxicity
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?
• Inguinal herniation and peritonitis
• Renal colic and cardiac ischemia
• Pancreatitis and Crohn ' s disease
• Polyarteritis nodosa and ulcerative colitis
The most common type of hernia is a(n):
• indirect inguinal hernia.
• direct inguinal hernia.
• femoral hernia.
,• umbilical 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):
• indirect inguinal hernia.
• direct inguinal hernia.
• femoral hernia.
• strangulated hernia.
A 35 year old sexually active man presents with a 1 week history of fever and pain over the
leftscrotum. It is accompanied by frequency and dysuria. The scrotum is edematous and
tender totouch. 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?
• Acute urinary tract infection
• Acute pyelonephritis
• Acute orthitis
• Acute epididymitis
Orchitis is caused by which of the following?
• Mumps virus
• Measles virus
• Chlamydia trachomatis
• Chronic urinary tract infections that are not treated adequately
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 andthe urine dipstick is negative for leukocytes, nitrites, and blood. The most likely
diagnosis is:
• Acute epididymitis
• Severe salmonella infection
• Testicular torsion
• Acute orchitis
,What type of follow up should this client receive?
• Refer to a urologist within 48 hours
• Refer him to the emergency department as soon as possible
• Prescribe ibuprofen (advil) 600 mg QID for pain
• Order a testicular ultrasound for further evaluation
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:
• unilateral loss of the cremasteric reflex.
• the affected testicle held higher in the scrotum.
• testicular swelling.
• relief of pain with scrotal elevation.
In assessing a man with testicular torsion, the NP is most likely to note:
• elevated PSA level.
• white blood cells reported in urinalysis.
• left testicle most often affected.
• increased testicular blood flow by color-flow Doppler ultrasound.
Anticipated organ survival exceeds 85% with testicular decompression within how many
hours of torsion?
• 1
• 6
• 16
• 24
To prevent a recurrence of testicular torsion, which of the following is recommended?
• use of a scrotal support
• avoidance of testicular trauma
• orchiopexy
• limiting the number of sexual partners
, 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?
• X-ray
• Ultrasound
• Technetium scan
• Physical examination
The nurse practitioner recognizes that the most common cause of epididymitis in a young
manis:
A chlamydia
B E. coli
C mycoplasma
D Proteus species
Your 25-year-old male client has had a fever, dysuria, low back pain, and scrotal
edema.Which of the following is likely the diagnosis?
A acute bacteria
prostatitisB acute
pyelonephritis
C epididymitis
D urinary tract infection
The action of a 5 alpha-reductace inhibitor in the treatment of BPH is to:
•reduce action of androgens in the prostate.
Milton, a 72 year old unmarried, sexually active white man presents to your clinic with
complaints of hesitancy, urgency, and occasional uncontrolled dribbling. Although you
suspectbenign prostatic hypertrophy, what else should your differential diagnosis include?
•Urethral stricture (may develop as a result of sexually transmitted diseases and should
beconsidered in a sexually active individual no matter what the age)
Harry has BPH and complains of some incontinence. Your first step in diagnosing overflow
incontinence would be to order a:
