NR 546 final exam: week 7 reproductive (Question and Correct Answers) Grade A+

sensation of orgasm. He isotherwise healthy and is not on any medications. What is the most likely cause of his problem - Psychogenic Multiple processes must take place in order for a male to sustain an erection. Various cues stimulate sympathetic outflow from higher brain centers to the T11-L2 levels of the spinal cord and parasympathetic outflow from S2 to S4 reflex arcs. Local vasodilatation within the penis erectile tissue results from increased levels of which of the following? - Nitric oxide (NO) and cyclic guanosine monophosphate (cGMP) The human papillomavirus (HPV) can cause genital warts in males and females as well as cervicalcancer in females. Vaccination against HPV is available and should be offered to males between what ages? - 9-21 years A 32-year-old male complains of a painless, cystic mass just above his left testicle. During the physical examination, a strong flashlight is placed behind the scrotum through the area in question and transillumination is noted. What is the most likely diagnosis - Spermatocele A 25-year-old graduate student presents to the clinic complaining of scrotal pain, which has beenincreasing over the past 2 days. He is sexually active and has had unprotected intercourse with multiplepartners in the past couple of weeks. On examination, some mild to moderate swelling of the scrotumon the right and tenderness with palpation of the right testicle are notes. What is the most likelydiagnosis? - acute epididymitis A 32-year-old elementary teacher requests a workup for infertility. He and his wife have been trying to conceive for the last 2 years. He reports that his wife has been evaluated and does not appear to have any infertility issues. The overall examination does not reveal any significant abnormalities. He is of average height and weight and has normal secondary sex characteristics of the genitalia. Of the following, which would be most likely be abnormal and causing male infertility - follicle stimulating hormone (FSH) While performing a physical examination on male patients, it is possible to palpate multiple structures in relation to the inguinal canal and related hernias. Which of the following is not palpable during an external examination of the abdominal wall or inguinal region - Internal inguinal ring A 20-year-old college student presents for his annual physical examination. He recently became sexually active and is inquiring about the best means of preventing sexually transmitted infections (STIs).Of the following, which would be the most effective means of prevention? - male condoms A 21-year-old college student presents to the student health clinic for a full physical examination. Heis generally healthy; however, he reports that he has had sexual intercourse with multiple partners inthe past couple of months. He noticed a small lesion on the shaft of his penis a few days ago. While performing the examination, he unwillingly achieves an erection. How should the clinician proceed at this point - explain this is normal and finish the exam A 45-year-old driver's education instructor presents to the clinic for heavy periods and pelvic painduring her menses. She reached menarche at age 13 years and has had regular periods except duringher pregnancies. She is a G4P3013 and does not use birth control as her husband has had a vasectomy.She states this has been going on for about a year but seems to be getting worse. Her last period was 1week ago. On bimanual exam, a large midline mass halfway to the umbilicus is palpated. Each adnexalarea is nonpalpable. Her rectal exam is normal. Her body mass index (BMI) is 27. What is the bestexplanation for her physical finding - fibroids 2. A 32-year-old G0 woman comes for evaluation on why she and her husband have been unable to getpregnant. Her husband has been married before and has two other children, ages 7 and 4 years. Thepatient relates she began her periods at age 12 and has been fairly regular ever since. She began oralcontraceptive pills from when she got married until last year, when she began to try for a pregnancy.Before this she had regular cycles for 10 years. She has had a history of five prior partners. She relatesshe was once treated for a severe genital infection when she was in college. Based on this patient's history, what is the best explanation for her infertility? - prior PID A 24-year-old retail clerk presents to the clinic for an annual exam. Her last Pap was 3 years ago andwas normal. She is a G0 and is currently not sexually active although she has had two lifetime partners.She is on oral contraceptive pills for cycle control and has no medical problems. Based on guidelines, theclinician proceeds to perform a Pap smear and places the speculum. There are two layers of cells,squamous and columnar. Where is the most important area to obtain cells for a Pap smear? - transformation zone A 35-year-old grade school teacher presents for her annual exam. Her last Pap smear was 4 years ago and normal. She is a G1P1 with a 6-year-old child. She has had four lifetime partners but only one partner in the last 12 years. Otherwise she has no complaints. A speculum exam is done followed by a bimanual examination during which a rectovaginal mass is palpated. Which of the following exam findings would be most reassuring that this is not a colonic mass? - the mass dents with digital pressure A 21-year-old college student presents for her first annual exam. She has been sexually active for 1year and has had two partners. She is not aware of having had any sexually transmitted diseases (STIs).She is using condoms for birth control and STI prevention but admits to not always using them regularly.Her last menses was 2 weeks ago. On speculum exam, an unusual appearance is noted, which is diagnosed as warts. What is the best description for these lesions - raised friable or lobed lesions A 23-year-old female comes to the clinic to discuss her birth control options. Although she has beensexually active since age 16 years, she has been with one partner for the last year. She has decided todiscontinue condoms and would like a different birth control option. She has not had a pelvic exam for 2years. She had a normal Pap smear that year and negative sexually transmitted infection (STI) testing.Her last menstrual period was 2 days ago. She states that she is still spotting. She also states that she last had sex with her boyfriend 1 week ago, so the clinician elects to postpone her speculum exam. What is the best explanation for the decision to postpone her exam - she is on her menses An 18-year-old high school senior presents to the clinic complaining of a vaginal discharge. She statesthat it is thick and yellow and that she has had some recent pelvic pain. She is sexually active and is notusing any type of birth control or sexually transmitted infection (STI) prevention. She denies any burningwith urination, nausea, vomiting, or diarrhea. She has had some fever and chills with a temperature upto 101.5ºF. Her last menstrual period was last week. After a physical exam, she is diagnosed with pelvicinflammatory disease (PID). Visualization of purulent discharge in which of the following areas wouldbest support a diagnosis of PID - cervical os A 27-year-old G0 bus driver presents to the clinic complaining of an itchy vaginal discharge for the lastweek. She reached menarche at age 12 years, became sexually active at age 18 years, and has had atotal of five sexual partners. She has been with her current partner for 1 month. She is on oral contraceptive pills and does not use condoms as she is allergic to latex. Her last menstrual period was 3weeks ago. She is not having any pelvic pain, fever, nausea, or vomiting. Her vitals are normal with abody mass index of 22. The clinician places the metal medium Graves speculum in the vagina but cannot find the cervix. What is the best next maneuver to visualize the cervix - Withdraw the speculum slightly and reposition it on a different slope A 63-year-old office worker comes to the clinic for her women's health exam. Her last Pap smear was5 years ago and was normal. She is married and has been with the same sexual partner for the last 35years. After performing the majority of the exam, the clinician decides to do a speculum exam to collectcytology for Pap smear. What is the correct position to have the patient in for her speculum exam? - lithotomy A 68-year-old retired patient presents to the clinic complaining about feeling like something is falling out of her vagina. She is a G6P6007 and had all her children vaginally, even the twins. She went through menopause at age 55 years, and, for the last few months, she has felt this falling sensation. On exam, an anterior bulge in the vaginal wall is apparent when she bears down. Weakness in which muscle would best account for the anterior bulge in the vaginal wall - levatori ani A 49-year-old male nurse experiences fecal incontinence after a motor vehicle accident that left himparalyzed below the waist. He asks his rehabilitation physician about the