NSG 1135 EXAM QUESTIONS AND ANSWERS
Identify the structures that provide transport of sperm. - CORRECT ANSWER✅✅Sperm are transported
along a series of ducts. First, the testis is capped by the epididymis, the main storage site for sperm. The
lower part of the epididymis is continuous with a muscular duct, the vas deferens, which then
approximates with other vessels to form the spermatic cord. The spermatic cord eventually joins the
duct of the seminal vesicle to form the ejaculatory duct, which empties into the urethra.
Describe the significance of the inguinal canal and the femoral canal. - CORRECT
ANSWER✅✅Knowledge of these anatomic areas in the groin is useful because they are potential sites
for a hernia, which is a portion of bowel protruding through a weak area in the musculature.
List the pros and cons of circumcision of the male newborn. - CORRECT ANSWER✅✅Circumcision: •
Pros: conforms to some cultures' values; part of one's religious value system; prevention of phimosis
and inflammation of the glans penis and foreskin, may decrease the incidence of urinary tract infection
in the infant. • Cons: the procedure has a very small risk for complications, such as sepsis, amputation of
the distal edge of the glans, removal of an excessive amount of foreskin, urethrocutaneous fistula, and
significant pain for the infant.
Discuss ways of creating an environment that will provide psychological comfort for the man and the
examiner during examination of the male genitalia - CORRECT ANSWER✅✅Before performing the
examination, take time to consider your own feelings, and, if necessary, discuss them with a more
experienced examiner. Be sure to provide privacy and proper draping for the examination. The
examiner's demeanor should be confident and relaxed, unhurried yet businesslike. Use a firm,
deliberate touch, not a soft, stroking one. If an erection occurs, do not stop the examination or leave the
room; this increases embarrassment and focuses on the erection. Reassure the male that this is a
normal physiologic response to touch and continue with the rest of the examination.
List teaching points to include with the teaching of testicular self-examination. - CORRECT
ANSWER✅✅T = timing, once a month
S = shower, warm water relaxes scrotal sac
E= examine, check for changes, report changes immediately
A good time to examine the testic1es is during the shower or bath, when your hands are warm and
soapy and the scrotum is warm. Cold hands stimulate a muscle (cremasteric) reflex, retracting the
scrotal contents. The procedure is simple. Hold the scrotum in the palm of your hand and gently feel
,each testicle using your thumb and first two fingers. If it hurts, you are using too much pressure. The
testicle is egg shaped and movable. It feels rubbery with a smooth surface, like a peeled hard-boiled egg.
The epididymis is on top and behind the testicle; it feels a bit softer. The cord feels like thick, straight
strands of string. Abnormal lumps are rare and usually not worrisome. But, if you ever notice a firm,
painless lump; a hard or an overall enlarged testicle, call your provider for a further check.
List laboratory tests to assess urinary function. - CORRECT ANSWER✅✅Laboratory tests for assessing
urinary function include the following:
• A urinalysis shows a color of pale yellow to amber due to the presence of urochrome pigments.
• Specific gravity measures the concentration of urine, from very dilute at 1.003 to concentrated at
1.030.
• Serum analysis of kidney function is measured with creatinine, an end product of muscle metabolism.
• Blood urea nitrogen (BUN) measures urea, an end product of protein metabolism.
Discuss the rationale for making certain that the testes have descended in the male infant. - CORRECT
ANSWER✅✅Undescended testes have histologic changes by age 6, and the result is decreased
spermatogenesis and infertility.
Phimosis - CORRECT ANSWER✅✅Nonretractable foreskin forming a pointy tip with a tiny orifice.
Foreskin is advanced and so tight that it is impossible to retract over glans. May be congenital or
acquired from adhesions secondary to infection. Poor hygiene leads to retained dirt and smegma, which
increases risk for inflammation, calculus formation, obstructive uropathy.
Paraphimosis - CORRECT ANSWER✅✅Foreskin is retracted and fixed. Once retracted behind glans, a
tight or inflamed foreskin cannot return to its original position. Constriction impedes circulation, so glans
swells. A medical emergency; the constricting band prevents venous and lymphatic return from the
glans and compromises arterial circulation.
Hypospadias - CORRECT ANSWER✅✅A congenital disorder of the urethra (1 in 300 baby boys) in which
the urethral meatus opens on the ventral (under)side of the glans or shaft. About 90% of openings are
on or near the head of the penis with a groove extending from the meatus to the expected location at
the tip. Shiny tissue extends from the meatus to the tip and the foreskin is not fully developed,leaving
the ventral side of the glans uncov-ered. Circumcision can proceed if parents desire this; surgical
correction of hypospadias can be at age 3 months or older.
,Tinea Cruris - CORRECT ANSWER✅✅A fungal infection in the crural fold, not extending to
scrotum,occurring in postpubertal males ("jock itch") after sweating or wearing layers of occlusive
clothing. It forms a red-brown half-moon shape with well-defined borders.
Genital Herpes-HSV-2 Infection - CORRECT ANSWER✅✅Clusters of small vesicles with surrounding
erythema, which are often painful and erupt on the glans, foreskin, or anus. These rupture to form
superficial ulcers. May have mild tingling before outbreak or shooting pain in buttock or leg. An STI, the
initial infection lasts 7 to 10 days and is treated with oral antivirals. The virus remains dormant
indefinitely; recurrent infections last 3 to 10 days with milder symptoms.
Syphilitic Chancre - CORRECT ANSWER✅✅Begins within 2 to 4 weeks of infection as a small, solitary,
silvery papule that erodes to a red, round or oval, superficial ulcer with a yellowish serous discharge.
Palpation reveals a nontender indurated base that can be lifted like a button between the thumb and
the finger. Lymph nodes enlarge early but are nontender. This is an STI easily treated with penicillin
G;but untreated it leads to cardiac and neurologic problems and blindness. Almost eradicated in the
United 1957; epidemics recur cyclically every 7 to 10 years.
Penile warts (condylomata acuminata, HPV) - CORRECT ANSWER✅✅Soft, pointed, moist, fleshy,
painless papules may be single or multiple in a cauliflower-like patch. Color may be gray, pale yeLlow, or
pink in white males and black or translucent gray-black in black males. They occur on shaft of penis,
.behind corona, or around the anus where they may grow into large, grapelike clusters.
These are caused by the human papillomavirus (HPV)and are one of the most common STIs. The HPV
infection is correlated with early onset of sexual activity, infrequent use of contraception, and multiple
sexual partners.
The vaccine Gardasil is indicated for prevention of genital warts; approval was re-confirmed in 2014 for
boys and men ages 9 to 26 years. It also reduces HPV-related disease in women, such as cervical cancer.
Epididymitis - CORRECT ANSWER✅✅Subjective: Severe pain of sudden onset in scrotum, relieved by
elevation (positive Prehn sign); also rapid swelling, fever
Objective: Inspection-Enlarged scrotum; reddened
, Palpation-Exquisitely tender; epididymis enlarged,indurated; hard to distinguish from testis. Overlying
scrotal skin may be thick and edematous
Laboratory-White blood cells and bacteria in urine
A: Tender swelling of epididymis
Varicocele - CORRECT ANSWER✅✅Subjective: Dull pain; constant pulling or dragging feeling; or may be
asymptomatic
Objective: Inspection-Usually no sign; or bluish color through light scrotal skin standing, feel soft,
irregular mass posterior to and above testis; collapses when supine, refills upright; feels distinctive, like
a "bag of worms"
Testis on side of varicocele may be smaller due to impaired
A: Soft mass on spermatic cord
Spermatocele - CORRECT ANSWER✅✅S: Painless, usually found on examination
O:Inspection-Does transilluminate higher in the scrotum than a hydrocele,and the sperm may fluoresce
Palpation-Round, freely movable mass lying above and behind testis; if large, feels like a third testis
A: Free cystic mass on epididymis
Early Testicular Tumor - CORRECT ANSWER✅✅S: Painless, found on examination; may have history of
undescended testicle or familial testicular cancer.
O: Palpation-Firm nodule or harder-than-normal section of testicle; testicular swelling occurs in most
Identify the structures that provide transport of sperm. - CORRECT ANSWER✅✅Sperm are transported
along a series of ducts. First, the testis is capped by the epididymis, the main storage site for sperm. The
lower part of the epididymis is continuous with a muscular duct, the vas deferens, which then
approximates with other vessels to form the spermatic cord. The spermatic cord eventually joins the
duct of the seminal vesicle to form the ejaculatory duct, which empties into the urethra.
Describe the significance of the inguinal canal and the femoral canal. - CORRECT
ANSWER✅✅Knowledge of these anatomic areas in the groin is useful because they are potential sites
for a hernia, which is a portion of bowel protruding through a weak area in the musculature.
List the pros and cons of circumcision of the male newborn. - CORRECT ANSWER✅✅Circumcision: •
Pros: conforms to some cultures' values; part of one's religious value system; prevention of phimosis
and inflammation of the glans penis and foreskin, may decrease the incidence of urinary tract infection
in the infant. • Cons: the procedure has a very small risk for complications, such as sepsis, amputation of
the distal edge of the glans, removal of an excessive amount of foreskin, urethrocutaneous fistula, and
significant pain for the infant.
Discuss ways of creating an environment that will provide psychological comfort for the man and the
examiner during examination of the male genitalia - CORRECT ANSWER✅✅Before performing the
examination, take time to consider your own feelings, and, if necessary, discuss them with a more
experienced examiner. Be sure to provide privacy and proper draping for the examination. The
examiner's demeanor should be confident and relaxed, unhurried yet businesslike. Use a firm,
deliberate touch, not a soft, stroking one. If an erection occurs, do not stop the examination or leave the
room; this increases embarrassment and focuses on the erection. Reassure the male that this is a
normal physiologic response to touch and continue with the rest of the examination.
List teaching points to include with the teaching of testicular self-examination. - CORRECT
ANSWER✅✅T = timing, once a month
S = shower, warm water relaxes scrotal sac
E= examine, check for changes, report changes immediately
A good time to examine the testic1es is during the shower or bath, when your hands are warm and
soapy and the scrotum is warm. Cold hands stimulate a muscle (cremasteric) reflex, retracting the
scrotal contents. The procedure is simple. Hold the scrotum in the palm of your hand and gently feel
,each testicle using your thumb and first two fingers. If it hurts, you are using too much pressure. The
testicle is egg shaped and movable. It feels rubbery with a smooth surface, like a peeled hard-boiled egg.
The epididymis is on top and behind the testicle; it feels a bit softer. The cord feels like thick, straight
strands of string. Abnormal lumps are rare and usually not worrisome. But, if you ever notice a firm,
painless lump; a hard or an overall enlarged testicle, call your provider for a further check.
List laboratory tests to assess urinary function. - CORRECT ANSWER✅✅Laboratory tests for assessing
urinary function include the following:
• A urinalysis shows a color of pale yellow to amber due to the presence of urochrome pigments.
• Specific gravity measures the concentration of urine, from very dilute at 1.003 to concentrated at
1.030.
• Serum analysis of kidney function is measured with creatinine, an end product of muscle metabolism.
• Blood urea nitrogen (BUN) measures urea, an end product of protein metabolism.
Discuss the rationale for making certain that the testes have descended in the male infant. - CORRECT
ANSWER✅✅Undescended testes have histologic changes by age 6, and the result is decreased
spermatogenesis and infertility.
Phimosis - CORRECT ANSWER✅✅Nonretractable foreskin forming a pointy tip with a tiny orifice.
Foreskin is advanced and so tight that it is impossible to retract over glans. May be congenital or
acquired from adhesions secondary to infection. Poor hygiene leads to retained dirt and smegma, which
increases risk for inflammation, calculus formation, obstructive uropathy.
Paraphimosis - CORRECT ANSWER✅✅Foreskin is retracted and fixed. Once retracted behind glans, a
tight or inflamed foreskin cannot return to its original position. Constriction impedes circulation, so glans
swells. A medical emergency; the constricting band prevents venous and lymphatic return from the
glans and compromises arterial circulation.
Hypospadias - CORRECT ANSWER✅✅A congenital disorder of the urethra (1 in 300 baby boys) in which
the urethral meatus opens on the ventral (under)side of the glans or shaft. About 90% of openings are
on or near the head of the penis with a groove extending from the meatus to the expected location at
the tip. Shiny tissue extends from the meatus to the tip and the foreskin is not fully developed,leaving
the ventral side of the glans uncov-ered. Circumcision can proceed if parents desire this; surgical
correction of hypospadias can be at age 3 months or older.
,Tinea Cruris - CORRECT ANSWER✅✅A fungal infection in the crural fold, not extending to
scrotum,occurring in postpubertal males ("jock itch") after sweating or wearing layers of occlusive
clothing. It forms a red-brown half-moon shape with well-defined borders.
Genital Herpes-HSV-2 Infection - CORRECT ANSWER✅✅Clusters of small vesicles with surrounding
erythema, which are often painful and erupt on the glans, foreskin, or anus. These rupture to form
superficial ulcers. May have mild tingling before outbreak or shooting pain in buttock or leg. An STI, the
initial infection lasts 7 to 10 days and is treated with oral antivirals. The virus remains dormant
indefinitely; recurrent infections last 3 to 10 days with milder symptoms.
Syphilitic Chancre - CORRECT ANSWER✅✅Begins within 2 to 4 weeks of infection as a small, solitary,
silvery papule that erodes to a red, round or oval, superficial ulcer with a yellowish serous discharge.
Palpation reveals a nontender indurated base that can be lifted like a button between the thumb and
the finger. Lymph nodes enlarge early but are nontender. This is an STI easily treated with penicillin
G;but untreated it leads to cardiac and neurologic problems and blindness. Almost eradicated in the
United 1957; epidemics recur cyclically every 7 to 10 years.
Penile warts (condylomata acuminata, HPV) - CORRECT ANSWER✅✅Soft, pointed, moist, fleshy,
painless papules may be single or multiple in a cauliflower-like patch. Color may be gray, pale yeLlow, or
pink in white males and black or translucent gray-black in black males. They occur on shaft of penis,
.behind corona, or around the anus where they may grow into large, grapelike clusters.
These are caused by the human papillomavirus (HPV)and are one of the most common STIs. The HPV
infection is correlated with early onset of sexual activity, infrequent use of contraception, and multiple
sexual partners.
The vaccine Gardasil is indicated for prevention of genital warts; approval was re-confirmed in 2014 for
boys and men ages 9 to 26 years. It also reduces HPV-related disease in women, such as cervical cancer.
Epididymitis - CORRECT ANSWER✅✅Subjective: Severe pain of sudden onset in scrotum, relieved by
elevation (positive Prehn sign); also rapid swelling, fever
Objective: Inspection-Enlarged scrotum; reddened
, Palpation-Exquisitely tender; epididymis enlarged,indurated; hard to distinguish from testis. Overlying
scrotal skin may be thick and edematous
Laboratory-White blood cells and bacteria in urine
A: Tender swelling of epididymis
Varicocele - CORRECT ANSWER✅✅Subjective: Dull pain; constant pulling or dragging feeling; or may be
asymptomatic
Objective: Inspection-Usually no sign; or bluish color through light scrotal skin standing, feel soft,
irregular mass posterior to and above testis; collapses when supine, refills upright; feels distinctive, like
a "bag of worms"
Testis on side of varicocele may be smaller due to impaired
A: Soft mass on spermatic cord
Spermatocele - CORRECT ANSWER✅✅S: Painless, usually found on examination
O:Inspection-Does transilluminate higher in the scrotum than a hydrocele,and the sperm may fluoresce
Palpation-Round, freely movable mass lying above and behind testis; if large, feels like a third testis
A: Free cystic mass on epididymis
Early Testicular Tumor - CORRECT ANSWER✅✅S: Painless, found on examination; may have history of
undescended testicle or familial testicular cancer.
O: Palpation-Firm nodule or harder-than-normal section of testicle; testicular swelling occurs in most
