Deck 48: Disorders of Musculoskeletal Function: Trauma, Infection, Neoplasms

Question 1

A couple who have three daughters would like to add a son to their family, and they have recently learned that the woman is pregnant. Which of the following phenomena would most likely be associated with the woman's eventual delivery of a healthy son?

A) The production of dihydrotestosterone (DHT) by the embryo and DHT's differentiation into testosterone
B) Development of testes under the influence of the X chromosome
C) Suppression of female reproductive structures by anti-Müllerian hormone (AMH)
D) Atrophy of the Wolffian ducts during embryonic development

Answer 1

Suppression of female reproductive structures by anti-Müllerian hormone (AMH)

Question 2

The nurse knows that if which of the following hormones listed below are not available during embryonic development, a male embryo with an XY chromosomal pattern may develop female external genitalia? Select all that apply.

A) Anti-Müllerian hormone (AMH)
B) Testosterone
C) Dihydrotestosterone (DHT)
D) Acrosome
E) Follicle-stimulating hormone (FSH)

Answer 2

Testosterone
Dihydrotestosterone (DHT)

Question 3

A 68-year-old male has visited his family physician because the size of his scrotum has increased exponentially in recent months. He has subsequently been diagnosed with an inguinal hernia. Which of the following statements best captures the nature of his health problem?

A) Part of his intestine and parietal peritoneum are protruding through the inguinal opening.
B) Rupture of the tunica vaginalis has allowed a part of his small bowel to protrude into the intrascrotal space.
C) Incomplete closure of the inguinal opening during his development has contributed to testicular hypertrophy and hyperplasia.
D) Occlusion of the efferent ductules and epididymis causes massive dilation of the testes.

Answer 3

Part of his intestine and parietal peritoneum are protruding through the inguinal opening.

Question 4

The cremaster muscles work in concert with the pampiniform plexus that surrounds the testicular artery to

A) move the testes into the scrotum.
B) maintain testicular temperature.
C) empty fluid from the seminal vesicles into the genital ducts.
D) move sperm from the ampulla to the penis.

Question 5

A couple has been trying to get pregnant for over 2 years. After infertility testing, the physician has informed the male that he has a low sperm count. The nurse knows which of the following causes of low sperm count may lead to impaired spermatogenesis? Select all that apply.

A) Prolonged fever
B) Wearing tight briefs rather than boxers
C) Undescended testes
D) Swimming in cold-water lakes
E) Vacationing in a tropical location

Question 6

Following ejaculation in a healthy adult, approximately 300 million sperm is present. Which percent of these sperm would be considered normal (mobile and morphologically healthy) and able to fertilize an egg?

A) 95%
B) 75%
C) 55%
D) 45%

Question 7

A nursing student studying obstetrics asks the faculty, "How does the sperm get so much energy to swim up the fallopian tubes?" The instructor responds based on which pathophysiological principle?

A) Usually the ejaculation is so powerful that it propels the sperm far up into the fallopian tubes.
B) Fructose is secreted by the seminal vesicles and provides energy for motility of the sperm.
C) The seminal vesicles secrete fluid for the semen, and they can secrete catecholamines that energize the sperm.
D) Estrogen, which is being secreted when the ova are ripe and ready for penetration, assists by attracting the sperm in the right direction.

Question 8

Sperm follow a prescribed route through the excretory ducts of the male reproductive system. Place the following components of the genital duct system in the order that sperm follow. Use all the options.

A) Efferent ductules
B) Ductus deferens
C) Prostatic urethra
D) Urethra
E) Seminiferous tubules
F) Epididymis

Question 9

An elderly male patient is complaining of dribbling after he urinates and feeling like he never empties his bladder. The nurse suspects the patient may have a problem with

A) kidney stones.
B) an enlarged prostate gland.
C) blood clots clogging the urethra.
D) calcium sediment in the bladder.

Question 10

Which of the following statements best captures an aspect of normal spermatogenesis?

A) Testosterone chemically lyses each primary spermatocyte into two secondary spermatocytes with 23 chromosomes each.
B) Sertoli cells differentiate into spermatids, each of which can contribute half of the chromosomes necessary for reproduction.
C) Spermatogonia adjacent to the tubular wall undergo meiotic division and provide a continuous source of new germinal cells.
D) Each primary spermatocyte undergoes two nuclear divisions yielding four cells with 23 chromosomes each.

Question 11

A student asks the instructor what are the parameters of infertility. The instructor responds, "Infertility is defined as"

A) 100 million of sperm in ejaculate.
B) 50% of sperm has good motility.
C) morphology that appears normal.
D) 10 million/mL sperm available in seminal fluid.

Question 12

A 40-year-old male client with multiple health problems has been diagnosed with a testosterone deficiency. The nurse knows that which of the following assessment findings would correlate with a testosterone deficiency? Select all that apply.

A) A high-pitched voice
B) Long-lasting chronic hip dysplasia
C) Complaints of multiple upper respiratory infections
D) A low muscle mass in proportion to his total body weight
E) Hot flashes and diaphoresis

Question 13

A 31-year-old male has been referred to a fertility clinic following a count of 2 million sperm/mL on seminal fluid analysis. Which of the following hormone levels would a clinician want to examine in an effort to ascertain the cause of the client's low sperm count? Select all that apply.

A) Luteinizing hormone (LH)
B) Adrenocorticotropic hormone (ACTH)
C) Follicle-stimulating hormone (FSH)
D) Cortisol
E) Somatostatin
F) Gonadotropin-releasing hormone (GnRH)

Question 14

A 39-year-old male client has been recently diagnosed with primary hypogonadism. Which of the following lab results would be most indicative of this diagnosis?

A) Normal levels of free testosterone; low levels of total testosterone
B) Low free testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) levels
C) Low levels of gonadotropin-releasing hormone (GnRH)
D) Low testosterone levels; high levels of LH and FSH

Question 15

Which of the following statements best captures an aspect of the neural control of sexual function?

A) The sensory system contained in the testes communicates with the spinal cord by way of afferent pathways.
B) Perineal stimulation transmits signals to the thalamus and hypothalamus.
C) The spinal cord plays a central role, with the limbic system and cerebral cortex also contributing.
D) Sympathetic stimulation causes the shunting of blood resulting in erection, while parasympathetic stimulation results in detumescence.

Question 16

A 24-year-old male patient with a complete transection of the spinal cord asks, "Will I be able to father children in the future?" The nurse responds,

A) "Probably not since your spinal cord has been completely severed."
B) "An urologist may be able to insert a needle into your testes and withdraw some sperm."
C) "With proper stimulation of your genitals, you may be able to produce an erection and ejaculation."
D) "It takes sympathetic innervation to produce an erection and ejaculation which is loss with your type of injury."

Question 17

A 71-year-old man has visited his family physician for a checkup, during which the physician has initiated a discussion about the client's sexual function. Which of the following phenomena would the physician most likely consider pathological rather than age-related changes?

A) The presence of an enlarging prostate gland
B) A decrease in the size and firmness of the client's testes
C) Cessation of androgen production
D) A decrease in the force of the man's ejaculation

Question 18

If a male has a history of impaired blood flow in his vascular system, he may be prone to develop

A) premature ejaculation.
B) erectile dysfunction.
C) penile engorgement.
D) vascular clots in pudendal arteries.

Question 19

A 68-year-old man has revealed to his care provider that he is distraught over his increasingly frequent inability to maintain an erection. Which of the following teaching points is most warranted?

A) "Above the age of 65, erectile dysfunction is largely inevitable and untreatable."
B) "With lifestyle modifications like exercise, weight loss, and quitting smoking, you can most likely correct this and prevent it in the future."
C) "While this problem is often a part of the aging process, it might be a result of some of the medications that you take."
D) "Most often this problem is transient and will resolve with time."

Question 20

A 21-year-old college football player has acknowledged to a nurse at a campus clinic that he has been injecting androgens in an effort to increase the size of his musculature and enhance his on-field performance. Which of the following teaching points should the nurse include in a conversation with the player?

A) "You run a real risk of developing acne and developing breasts by doing this."
B) "You will indeed be able to increase your muscles, but they will rebound by shrinking smaller than they ever were within a few months."
C) "Most of the people who do this cause themselves to be permanently sterile."
D) "A reduction in the size of your penis and the production of mutated sperm can be an effect of steroid use."