NR304 EXAM 2 LATEST UPDATE
1. During the health history, a man tells you he has trouble in starting his urine stream when he
arrives at the toilet. This symptom is known as:
a. Urgency.
b. Dribbling.
c. Frequency.
d. Hesitancy. - ANSWER-d. Hesitancy.
2. A parent of three biologic daughters has a 10-year-old boy the family adopted at age 2 years. The
parent is learning about raising boys and asks you the first physical sign of puberty in the male
genitalia:
a. Testes and scrotum begin to enlarge.
b. Penis enlarges and lengthens.
c. Dark coarse hair grows over entire pubis.
d. Scrotal skin assumes same pigment as the abdomen and thighs. - ANSWER-a. Testes and scrotum
begin to enlarge.
3. During the health history, a 64-year-old man tells you he "never has sex anymore." Check the
following appropriate follow-up questions you could use that are associated with withdrawal from
sex. Select all that apply.
a. "Have you been told about any side effects of your medications?"
b. "Let's ask your provider for a blood test to detect decreased sperm production."
c. "Would you say you have had feelings of depression in the last few months?"
d. "How many alcohol drinks do you have each day?"
e. "This is an expected outcome in aging men."
f. "Have you experienced the loss of your spouse or your partner?" - ANSWER-a. "Have you been told
about any side effects of your medications?"
c. "Would you say you have had feelings of depression in the last few months?"
d. "How many alcohol drinks do you have each day?"
,f. "Have you experienced the loss of your spouse or your partner?"
4. A mother and father in the 7th month of their first pregnancy ask you about the benefits of
circumcising their expected baby boy. Check all the facts you can share to help them with their
decision.
a. In the United States, circumcising baby boys is a proven way to prevent HIV transmission later in
life.
b. Removal of the foreskin decreases the incidence of urinary tract infections in very young infants.
c. Most surgical risks of infant circumcision are minor and treatable.
d. In the United States, circumcision protects against acquiring human papillomavirus and syphilis
later in life. - ANSWER-b. Removal of the foreskin decreases the incidence of urinary tract infections
in very young infants.
c. Most surgical risks of infant circumcision are minor and treatable.
5. You perform a genital examination on a 48-year-old man and note deeply pigmented wrinkled
scrotal skin, with multiple, yellowish, 1-cm, firm, nontender nodules. What would be your next most
appropriate action?
a. Ask about any family history of testicular cancer in the father or brothers.
b. Consider these sebaceous follicles an expected finding and proceed with the examination.
c. Assess the scrotum using transillumination.
d. Obtain a detailed history focusing on any scrotal abnormalities the man has noticed. - ANSWER-b.
Consider these sebaceous follicles an expected finding and proceed with the examination.
6. You perform a genital examination on a 25-year-old man and palpate testes that feel ovoid and
movable yet somewhat sensitive to compression. What is your next most appropriate action?
a. Ask another examiner to repeat the examination.
b. Search for subcutaneous plaques that may be painful.
c. Ask the man if he has noticed anything unusual in his own exams.
d. Consider this an expected finding and proceed with the examination. - ANSWER-d. Consider this
an expected finding and proceed with the examination.
7. You are an advanced provider about to inspect and palpate a 55-year-old man for a suspected
inguinal hernia. What is your best instruction to prepare this man?
a. "Hold your breath and cough when I ask you to."
b. "I will ask you to bear down when my gloved finger is in the inguinal canal."
,c. "I will ask you to turn you head and cough when my gloved finger is in the inguinal canal."
d. "Please assume a lying-down position on the exam table for the hernia check." - ANSWER-b. "I will
ask you to bear down when my gloved finger is in the inguinal canal."
8. You are about to examine the genitalia of a 93-year-old man who has an adhesion of the prepuce
of the head of the penis, making the foreskin impossible to retract. You recognize this as:
a. Paraphimosis.
b. Phimosis.
c. Smegma.
d. Dyschezia. - ANSWER-b. Phimosis.
9. During assessment of a newborn baby boy, you note the urethral meatus is positioned ventrally,
on the underside of the penis. Your next best action is to: Select all that apply.
a. Notice if the penis is straight or curved.
b. Note that this is consistent with uncircumcised baby boys and proceed with the exam.
c. Assure the parents that they can proceed with the planned circumcision at this time.
d. Ask a physician or AP provider to repeat the examination. - ANSWER-a. Notice if the penis is
straight or curved.
and
d. Ask a physician or AP provider to repeat the examination.
10. A 1-month-old, uncircumcised boy comes to your clinic for a well-baby check-up. How would you
proceed with the genital exam?
a. Elicit the cremasteric reflex.
b. Assess the glans for redness or lesions.
c. Avoid retracting the foreskin.
d. Note any dirt or smegma that has collected under the foreskin. - ANSWER-c. Avoid retracting the
foreskin.
11. You are teaching a 19-year-old how to perform a testicular self-examination. Which of the
following statements is your most appropriate?
a. "A good time to examine your testicles is just before you take a shower."
b. "If you notice an enlarged testicle or a firm lump, call your health care provider."
, c. "The testicle is egg shaped, feels soft, and has a spongy consistency."
d. "Perform testicular self-exam at least once a week." - ANSWER-b. "If you notice an enlarged
testicle or a firm lump, call your health care provider."
12. A 62-year-old man states his doctor told him he has an "inguinal hernia." He asks you to explain
what a hernia is. Your best response is:
a. Tell him not to worry and that most men his age develop hernias.
1. During the health history, a man tells you he has trouble in starting his urine stream when he
arrives at the toilet. This symptom is known as:
a. Urgency.
b. Dribbling.
c. Frequency.
d. Hesitancy. - ANSWER-d. Hesitancy.
2. A parent of three biologic daughters has a 10-year-old boy the family adopted at age 2 years. The
parent is learning about raising boys and asks you the first physical sign of puberty in the male
genitalia:
a. Testes and scrotum begin to enlarge.
b. Penis enlarges and lengthens.
c. Dark coarse hair grows over entire pubis.
d. Scrotal skin assumes same pigment as the abdomen and thighs. - ANSWER-a. Testes and scrotum
begin to enlarge.
3. During the health history, a 64-year-old man tells you he "never has sex anymore." Check the
following appropriate follow-up questions you could use that are associated with withdrawal from
sex. Select all that apply.
a. "Have you been told about any side effects of your medications?"
b. "Let's ask your provider for a blood test to detect decreased sperm production."
c. "Would you say you have had feelings of depression in the last few months?"
d. "How many alcohol drinks do you have each day?"
e. "This is an expected outcome in aging men."
f. "Have you experienced the loss of your spouse or your partner?" - ANSWER-a. "Have you been told
about any side effects of your medications?"
c. "Would you say you have had feelings of depression in the last few months?"
d. "How many alcohol drinks do you have each day?"
,f. "Have you experienced the loss of your spouse or your partner?"
4. A mother and father in the 7th month of their first pregnancy ask you about the benefits of
circumcising their expected baby boy. Check all the facts you can share to help them with their
decision.
a. In the United States, circumcising baby boys is a proven way to prevent HIV transmission later in
life.
b. Removal of the foreskin decreases the incidence of urinary tract infections in very young infants.
c. Most surgical risks of infant circumcision are minor and treatable.
d. In the United States, circumcision protects against acquiring human papillomavirus and syphilis
later in life. - ANSWER-b. Removal of the foreskin decreases the incidence of urinary tract infections
in very young infants.
c. Most surgical risks of infant circumcision are minor and treatable.
5. You perform a genital examination on a 48-year-old man and note deeply pigmented wrinkled
scrotal skin, with multiple, yellowish, 1-cm, firm, nontender nodules. What would be your next most
appropriate action?
a. Ask about any family history of testicular cancer in the father or brothers.
b. Consider these sebaceous follicles an expected finding and proceed with the examination.
c. Assess the scrotum using transillumination.
d. Obtain a detailed history focusing on any scrotal abnormalities the man has noticed. - ANSWER-b.
Consider these sebaceous follicles an expected finding and proceed with the examination.
6. You perform a genital examination on a 25-year-old man and palpate testes that feel ovoid and
movable yet somewhat sensitive to compression. What is your next most appropriate action?
a. Ask another examiner to repeat the examination.
b. Search for subcutaneous plaques that may be painful.
c. Ask the man if he has noticed anything unusual in his own exams.
d. Consider this an expected finding and proceed with the examination. - ANSWER-d. Consider this
an expected finding and proceed with the examination.
7. You are an advanced provider about to inspect and palpate a 55-year-old man for a suspected
inguinal hernia. What is your best instruction to prepare this man?
a. "Hold your breath and cough when I ask you to."
b. "I will ask you to bear down when my gloved finger is in the inguinal canal."
,c. "I will ask you to turn you head and cough when my gloved finger is in the inguinal canal."
d. "Please assume a lying-down position on the exam table for the hernia check." - ANSWER-b. "I will
ask you to bear down when my gloved finger is in the inguinal canal."
8. You are about to examine the genitalia of a 93-year-old man who has an adhesion of the prepuce
of the head of the penis, making the foreskin impossible to retract. You recognize this as:
a. Paraphimosis.
b. Phimosis.
c. Smegma.
d. Dyschezia. - ANSWER-b. Phimosis.
9. During assessment of a newborn baby boy, you note the urethral meatus is positioned ventrally,
on the underside of the penis. Your next best action is to: Select all that apply.
a. Notice if the penis is straight or curved.
b. Note that this is consistent with uncircumcised baby boys and proceed with the exam.
c. Assure the parents that they can proceed with the planned circumcision at this time.
d. Ask a physician or AP provider to repeat the examination. - ANSWER-a. Notice if the penis is
straight or curved.
and
d. Ask a physician or AP provider to repeat the examination.
10. A 1-month-old, uncircumcised boy comes to your clinic for a well-baby check-up. How would you
proceed with the genital exam?
a. Elicit the cremasteric reflex.
b. Assess the glans for redness or lesions.
c. Avoid retracting the foreskin.
d. Note any dirt or smegma that has collected under the foreskin. - ANSWER-c. Avoid retracting the
foreskin.
11. You are teaching a 19-year-old how to perform a testicular self-examination. Which of the
following statements is your most appropriate?
a. "A good time to examine your testicles is just before you take a shower."
b. "If you notice an enlarged testicle or a firm lump, call your health care provider."
, c. "The testicle is egg shaped, feels soft, and has a spongy consistency."
d. "Perform testicular self-exam at least once a week." - ANSWER-b. "If you notice an enlarged
testicle or a firm lump, call your health care provider."
12. A 62-year-old man states his doctor told him he has an "inguinal hernia." He asks you to explain
what a hernia is. Your best response is:
a. Tell him not to worry and that most men his age develop hernias.
