NURS 5432 Module 4 Men's Health and STDs Questions with
Complete Solutions | 100% Correct Answers with Detailed
Rationales (2026/2027 Edition)
Family Nurse Practitioner I Examination
University of Texas at Arlington
Module 4: Men's Health and Sexually Transmitted Diseases
2026/2027 Edition
SECTION 1: Testicular and Scrotal Disorders
Question 1
A 6-month-old male infant is brought to the clinic for a well-child visit. The parents note
that his right testicle has never been palpable in the scrotum. Physical examination
confirms a non-palpable right testis with an empty right hemiscrotum. The left testis is
normally descended. What is the most appropriate next step in management?
A. Reassure the parents and schedule re-evaluation at 12 months of age
B. Refer for orchiopexy immediately, as the window for optimal intervention has already
passed
C. Refer to pediatric urology for orchiopexy between 6 and 18 months of age
D. Order a scrotal ultrasound to locate the testis and defer surgical decision until
imaging results are available
Correct Answer: C
Rationale: The American Urological Association (AUA) and pediatric urology guidelines
recommend orchiopexy between 6 and 18 months of age for cryptorchidism to optimize
future fertility and reduce the risk of testicular malignancy. Reassurance and delayed
,evaluation (A) is inappropriate because spontaneous descent after 6 months is unlikely.
Immediate orchiopexy (B) is not necessary at exactly 6 months, but referral should be
made within the 6–18 month window. Scrotal ultrasound (D) is not the initial diagnostic
step; physical examination by a pediatric urologist and laparoscopic evaluation if
needed are preferred, as ultrasound has poor sensitivity for non-palpable testes.
Question 2
A 24-year-old sexually active male presents with acute onset of unilateral scrotal pain,
dysuria, and mild fever. Physical examination reveals a tender, swollen epididymis with
normal testicular lie. The cremasteric reflex is intact. Prehn's sign is positive. What is
the first-line pharmacologic regimen?
A. Levofloxacin 500 mg PO daily for 10 days
B. Doxycycline 100 mg PO BID for 10 days plus ceftriaxone 500 mg IM once
C. Ciprofloxacin 500 mg PO BID for 7 days
D. Azithromycin 1 g PO once plus ceftriaxone 500 mg IM once
Correct Answer: B
Rationale: In males under 35 years of age who are sexually active, epididymitis is most
commonly caused by Chlamydia trachomatis or Neisseria gonorrhoeae. The CDC STI
Treatment Guidelines recommend doxycycline 100 mg PO BID for 10 days plus
ceftriaxone 500 mg IM once. Levofloxacin (A) is indicated for epididymitis in men over
35 or those with enteric organisms. Ciprofloxacin (C) is used for acute bacterial
prostatitis, not epididymitis in young sexually active men. Azithromycin (D) is not the
preferred chlamydia treatment for epididymitis; doxycycline is first-line.
Question 3
,A 52-year-old male presents with gradual onset of unilateral scrotal pain and swelling.
He denies urethral discharge, dysuria, or recent sexual activity outside a monogamous
relationship. Physical examination reveals a tender, indurated epididymis. Urinalysis
shows pyuria but no bacteria on Gram stain. What is the most appropriate antibiotic
regimen?
A. Doxycycline 100 mg PO BID for 10 days plus ceftriaxone 500 mg IM once
B. Levofloxacin 500 mg PO daily for 10 days
C. Trimethoprim-sulfamethoxazole DS PO BID for 3 days
D. Metronidazole 500 mg PO BID for 7 days
Correct Answer: B
Rationale: In men over 35 years of age with epididymitis, enteric gram-negative bacilli
(e.g., E. coli) are the most common pathogens, and sexually transmitted causes are less
likely. The recommended treatment is levofloxacin 500 mg PO daily for 10 days or
ofloxacin 300 mg PO BID for 10 days. Doxycycline plus ceftriaxone (A) is indicated for
sexually transmitted epididymitis in men under 35. TMP-SMX (C) is a secondary option
for chronic prostatitis, not first-line for acute epididymitis in this age group.
Metronidazole (D) is used for trichomoniasis or anaerobic infections, not typical
epididymitis.
Question 4
A 16-year-old male awakens at 2:00 AM with sudden, severe left testicular pain that
woke him from sleep. He denies trauma, dysuria, or urethral discharge. Physical
examination reveals a high-riding, horizontally oriented left testis with an absent
cremasteric reflex. The scrotum is edematous but without erythema. What is the priority
intervention?
, A. Obtain a scrotal ultrasound with Doppler to confirm the diagnosis before proceeding
B. Administer ceftriaxone and doxycycline empirically for epididymitis
C. Perform immediate manual detorsion and prepare for emergent urologic surgery
D. Prescribe NSAIDs and schedule follow-up in 24 hours
Correct Answer: C
Rationale: This presentation is classic for testicular torsion: acute onset pain,
high-riding testis, horizontal lie, and absent cremasteric reflex. This is a urologic
emergency requiring immediate intervention. Manual detorsion should be attempted if
surgical delay is anticipated, but emergent surgical exploration is mandatory. Scrotal
ultrasound (A) should not delay surgical intervention if clinical suspicion is high.
Antibiotics for epididymitis (B) are inappropriate given the classic torsion presentation.
NSAIDs and delayed follow-up (D) would result in testicular infarction.
Question 5
A 3-month-old infant is brought to the clinic with parental concern about a right-sided
scrotal swelling that has been present since birth and increases when the infant cries.
The swelling is painless, and the testis is palpable. Transillumination reveals a glowing,
homogeneous red appearance. What is the most likely diagnosis?
A. Testicular torsion
B. Communicating hydrocele
C. Non-communicating hydrocele
D. Testicular cancer
Correct Answer: B
Complete Solutions | 100% Correct Answers with Detailed
Rationales (2026/2027 Edition)
Family Nurse Practitioner I Examination
University of Texas at Arlington
Module 4: Men's Health and Sexually Transmitted Diseases
2026/2027 Edition
SECTION 1: Testicular and Scrotal Disorders
Question 1
A 6-month-old male infant is brought to the clinic for a well-child visit. The parents note
that his right testicle has never been palpable in the scrotum. Physical examination
confirms a non-palpable right testis with an empty right hemiscrotum. The left testis is
normally descended. What is the most appropriate next step in management?
A. Reassure the parents and schedule re-evaluation at 12 months of age
B. Refer for orchiopexy immediately, as the window for optimal intervention has already
passed
C. Refer to pediatric urology for orchiopexy between 6 and 18 months of age
D. Order a scrotal ultrasound to locate the testis and defer surgical decision until
imaging results are available
Correct Answer: C
Rationale: The American Urological Association (AUA) and pediatric urology guidelines
recommend orchiopexy between 6 and 18 months of age for cryptorchidism to optimize
future fertility and reduce the risk of testicular malignancy. Reassurance and delayed
,evaluation (A) is inappropriate because spontaneous descent after 6 months is unlikely.
Immediate orchiopexy (B) is not necessary at exactly 6 months, but referral should be
made within the 6–18 month window. Scrotal ultrasound (D) is not the initial diagnostic
step; physical examination by a pediatric urologist and laparoscopic evaluation if
needed are preferred, as ultrasound has poor sensitivity for non-palpable testes.
Question 2
A 24-year-old sexually active male presents with acute onset of unilateral scrotal pain,
dysuria, and mild fever. Physical examination reveals a tender, swollen epididymis with
normal testicular lie. The cremasteric reflex is intact. Prehn's sign is positive. What is
the first-line pharmacologic regimen?
A. Levofloxacin 500 mg PO daily for 10 days
B. Doxycycline 100 mg PO BID for 10 days plus ceftriaxone 500 mg IM once
C. Ciprofloxacin 500 mg PO BID for 7 days
D. Azithromycin 1 g PO once plus ceftriaxone 500 mg IM once
Correct Answer: B
Rationale: In males under 35 years of age who are sexually active, epididymitis is most
commonly caused by Chlamydia trachomatis or Neisseria gonorrhoeae. The CDC STI
Treatment Guidelines recommend doxycycline 100 mg PO BID for 10 days plus
ceftriaxone 500 mg IM once. Levofloxacin (A) is indicated for epididymitis in men over
35 or those with enteric organisms. Ciprofloxacin (C) is used for acute bacterial
prostatitis, not epididymitis in young sexually active men. Azithromycin (D) is not the
preferred chlamydia treatment for epididymitis; doxycycline is first-line.
Question 3
,A 52-year-old male presents with gradual onset of unilateral scrotal pain and swelling.
He denies urethral discharge, dysuria, or recent sexual activity outside a monogamous
relationship. Physical examination reveals a tender, indurated epididymis. Urinalysis
shows pyuria but no bacteria on Gram stain. What is the most appropriate antibiotic
regimen?
A. Doxycycline 100 mg PO BID for 10 days plus ceftriaxone 500 mg IM once
B. Levofloxacin 500 mg PO daily for 10 days
C. Trimethoprim-sulfamethoxazole DS PO BID for 3 days
D. Metronidazole 500 mg PO BID for 7 days
Correct Answer: B
Rationale: In men over 35 years of age with epididymitis, enteric gram-negative bacilli
(e.g., E. coli) are the most common pathogens, and sexually transmitted causes are less
likely. The recommended treatment is levofloxacin 500 mg PO daily for 10 days or
ofloxacin 300 mg PO BID for 10 days. Doxycycline plus ceftriaxone (A) is indicated for
sexually transmitted epididymitis in men under 35. TMP-SMX (C) is a secondary option
for chronic prostatitis, not first-line for acute epididymitis in this age group.
Metronidazole (D) is used for trichomoniasis or anaerobic infections, not typical
epididymitis.
Question 4
A 16-year-old male awakens at 2:00 AM with sudden, severe left testicular pain that
woke him from sleep. He denies trauma, dysuria, or urethral discharge. Physical
examination reveals a high-riding, horizontally oriented left testis with an absent
cremasteric reflex. The scrotum is edematous but without erythema. What is the priority
intervention?
, A. Obtain a scrotal ultrasound with Doppler to confirm the diagnosis before proceeding
B. Administer ceftriaxone and doxycycline empirically for epididymitis
C. Perform immediate manual detorsion and prepare for emergent urologic surgery
D. Prescribe NSAIDs and schedule follow-up in 24 hours
Correct Answer: C
Rationale: This presentation is classic for testicular torsion: acute onset pain,
high-riding testis, horizontal lie, and absent cremasteric reflex. This is a urologic
emergency requiring immediate intervention. Manual detorsion should be attempted if
surgical delay is anticipated, but emergent surgical exploration is mandatory. Scrotal
ultrasound (A) should not delay surgical intervention if clinical suspicion is high.
Antibiotics for epididymitis (B) are inappropriate given the classic torsion presentation.
NSAIDs and delayed follow-up (D) would result in testicular infarction.
Question 5
A 3-month-old infant is brought to the clinic with parental concern about a right-sided
scrotal swelling that has been present since birth and increases when the infant cries.
The swelling is painless, and the testis is palpable. Transillumination reveals a glowing,
homogeneous red appearance. What is the most likely diagnosis?
A. Testicular torsion
B. Communicating hydrocele
C. Non-communicating hydrocele
D. Testicular cancer
Correct Answer: B
