Assessment of the Reproductive System NCLEX - Questions, Answers and Rationales When performing an assessment of the external genitalia of an older man,
... [Show More] the nurse observes the scrotum to have smooth skin and to be very pendulous. Which action by the nurse is most appropriate? a. Suggest to the client that he should wear an athletic supporter while awake. b. Ask the client if he has been treated for a sexually transmitted disease. c. Document the observation and continue the assessment. d. Notify the health care provider and facilitate a scrotal ultrasound. Rationale: As the male client ages, the scrotum loses rugae and becomes increasingly pendulous. This is a normal assessment finding. No further action is needed. The nurse is counseling a mother who wants her teenage daughter to have a Pap smear and pelvic examination. Which statement by the nurse is most accurate? a. "If your daughter is over 18, she needs a pelvic examination and Pap smear." b. "A teenager does not need this examination unless she is sexually active." c. "Teach her to have her first examination by the age of 21 at the latest." d. "It is not needed unless you are worried about sexually transmitted diseases." Rationale: A woman needs to have her first pelvic examination with Pap smear by the age of 21, or within 3 years of becoming sexually active. The other statements are not accurate. A young woman is not pregnant but has not had a menstrual period for 5 months. Which factors does the nurse explore as a possible cause of the amenorrhea? a. The client's mother having type 2 diabetes mellitus b. Running 10 to 15 miles/day c. Taking aspirin daily d. Having a diet high in protein Rationale: Excessive exercise, with corresponding loss of body fat, is associated with insufficient estrogen levels for the maintenance of normal ovulatory and menstrual cycles. The other factors are noncontributory. When scheduling an annual pelvic examination and Pap test, the client asks if she should abstain from intercourse before the test. Which is the nurse's best response? a. "Yes. Avoid having intercourse for 24 hours before the test." b. "Yes. Avoid having intercourse for 2 hours before the test." c. "No. Intercourse does not interfere with this test." d. "No. Intercourse can actually enhance the test results." Rationale: The woman should not douche, use vaginal medications or deodorants, or have sexual intercourse for at least 24 hours before the test. Such activities may prevent the accurate evaluation of smears, cultures, and cytologic data. During examination of the male client's external genitalia, the nurse observes a discharge from the urethra when compressing the glans. Which is the nurse's next action? a. Document the observation. b. Ask the client to turn his head and cough. c. Obtain a specimen for culture. d. Test the cremasteric reflex. Rationale: Urethral discharge is not considered normal in a continent client and should be cultured. The other options would not help provide information about the nature of the discharge. A client is in the clinic for an annual examination and questions the need for a pelvic examination and Pap smear because she had a hysterectomy many years ago. Which response by the nurse is most appropriate? a. "Do you still have your cervix?" b. "Are you sexually active?" c. "We can skip it if you like." d. "Let's see what the doctor says." Rationale: Women who still have their cervix after hysterectomy still need a Pap smear according to the guidelines established for other women. Sexual activity is not relevant. Simply stating that it can be skipped does not help the woman protect her health. Asking the provider does not help the nurse further assess the client. A client is scheduled for an ultrasound to evaluate for possible uterine fibroids. Which instruction by the nurse is most appropriate? [Show Less]