(Osborn Chapter) 48 Learning Outcomes Number and Title

[Osborn chapter] 48
Learning Outcomes Number and Title

Learning Outcome 1
Describe the structures and function of the male and female
reproductive systems.
Learning Outcome 2
Identify pertinent subjective and objective data related to the
reproductive systems and information about sexual function
that should be obtained.
Learning Outcome 3
Identify risk factors for reproductive system disorders.
Learning Outcome 4
Differentiate normal from abnormal findings obtained from the
physical assessment for males and females.
Learning Outcome 5
Describe age-related changes in the male and female
reproductive systems.
Learning Outcome 6
Discuss the implications for health promotion related to the
reproductive systems of females and males.
Osborn, et al., Test Item File for Medical-Surgical Nursing: Preparation for Practice
Copyright 2010 by Pearson Education, Inc.
1. The nurse is instructing a client about the timing of ovulation during the
menstrual cycle. While reviewing the laboratory analysis of the clients hormones,
the nurse would examine for increases in which of following levels?
1.
2.
3.
4.
Luteinizing hormone
Progesterone
Estrogen
Gonadotropin-releasing hormone
Correct Answer: Luteinizing hormone

Rationale: When the luteinizing hormone peaks, ovulation occurs. Increases in the progesterone
level would occur after ovulation. Estrogen levels will peak prior to the luteinizing hormone
release, which is necessary for ovulation. The gonadotropin-releasing hormone stimulates the
anterior pituitary to release the follicle-stimulating hormone, which occurs prior to ovulation.
Cognitive Level: Analysis
Nursing Process: Planning
Client Need: Health Promotion and Maintenance
LO: 1
2. A client with a menstrual cycle of 28 days asks about the timing of ovulation. The nurse would
respond by stating that ovulation would most likely occur on day:
1. 14 to 16.
2. 12 to 14.
3. 10 to 12.
4. 20 to 22.
Correct Answer: 14 to 16.
Rationale: Ovulation will occur at midcycle. Because there are 28 days in the clients menstrual
cycle, ovulation would occur on day 14 to. The other answers are not considered midcycle for
the client.
Cognitive Level: Application
Nursing Process Implementation
Client Need: Physiological Integrity
LO: 1
3. A client is having a routine prostate examination. An important question that the

nurse would ask at this time is:
1.
2.
3.
4.
Do you have difficulty with urination?

Do you experience constipation?
Do you have polyuria in the morning?
Do you take laxatives or stool softeners?
Correct Answer: Do you have difficulty with urination?

Rationale: When the prostate is enlarged, it disrupts urinary flow and causes several urinary
symptoms. Experiencing constipation is not associated with the prostate gland. Polyuria in the
morning does not indicate any signs of prostate disease. Taking laxatives or stool softeners does
not affect the function of the prostate.
Nursing Process: Assessment
LO: 1
4. During the assessment of the medication history for a client with an enlarged prostate, the
nurse would inquire about the use of:
1. Saw palmetto.
2. Fish oil.
3. Ginko.
4. Green tea.
Correct Answer: Saw palmetto.
Rationale: Saw palmetto is the herbal supplement used to treat clients with an enlarged prostate
gland. The other herbal remedies are not indicated for clients with prostate enlargement.
LO: 2
5. During a physical examination, a male client reports discharge from the urinary
meatus. The discharge is not visible to the nurse. The nurse would first instruct the
client to:
1.
2.
3.
4.
Strip the penis to bring discharge to the meatus for culture.

Return to the clinic when the discharge occurs.
Go to the emergency department for further testing.
Continue to watch for other signs of sexually transmitted diseases.
Correct Answer: Strip the penis to bring discharge to the meatus for culture.
Rationale: The client should strip the penis to bring discharge to the meatus so that testing can be
performed. Returning to the clinic when the discharge occurs is appropriate, but the initial action
would be to attempt to obtain a culture of the fluid. Going to the emergency department is
unnecessary because the client can be treated and further tested during the time of the
examination. Watching for other signs of sexually transmitted diseases is premature because the
nurse does not know if the discharge is related to a sexually transmitted disease.
Nursing Process: Implementation
LO: 2
6. The nurse is assisting the health care provider with a routine prostate
examination. The nurse would position the client:
Select all that apply.

1.
2.
3.
4.
5.
Leaning over the examination table.

On the left side with right knee drawn up.
On the edge of the table with the rectum exposed.
On the right side with both knees flexed.
Standing in the most comfortable position.
Correct Answer:
1. Leaning over the examination table.
2. On the left side with right knee drawn up.
Rationale: Leaning over the examination table. This is a correct anatomical position for a
routine prostate examination. On the left side with right knee drawn up. This is a correct
anatomical position for a routine prostate examination. On the edge of the table with the
rectum exposed. This is not the recommended position to facilitate examination of the prostate.
On the right side with both knees flexed. This is not the recommended position to facilitate
examination of the prostate. Standing in the most comfortable position. This is not the
recommended position to facilitate examination of the prostate.
LO: 2
7. A male client states that he is having problems with impotence. Which of the
following diseases should the nurse question as part of the clients past medical
history?

1.
2.
3.
4.
5.
Hypertension
Diabetes
Alcoholism
Herpes
HIV
Correct Answer:
1. Hypertension
2. Diabetes
3. Alcoholism
Rationale: Hypertension. Hypertension clients may be taking antihypertensive medication,
which may affect the erection of male clients. Diabetes. Diabetes will impair the circulation to
the penis, thus creating difficulty with obtaining an erection. Alcoholism. Alcoholism has been
shown to affect the ability for the male client to achieve an erection. Herpes. Herpes will not
impair the male clients ability to achieve an erection. HIV. HIV will not impair the male clients
ability to achieve an erection.
Cognitive Level: Analysis
LO: 3
8. During a routine physical examination, a nurse instructs a client about safe sex
practices. Which of the following should the nurse include in her teaching?

1.
2.
3.
4.
5.
Sexually active individuals should be tested for HIV.

Condoms provide a means of safer sex.
Limit sexual partners.
Use lubricants such as oils and creams during sex.
Oral sex will prevent sexually transmitted diseases.
Correct Answer:
1. Sexually active individuals should be tested for HIV.
2. Condoms provide a means of safer sex.
3. Limit sexual partners.
Rationale: Sexually active individuals should be tested for HIV. All sexually active individuals
should get tested for HIV. The reason HIV has become so widespread is because individuals do
not know they have the disease. Condoms provide a means of safer sex. Condoms do provide a
means of safer sex, but they do not guarantee safe sex. Limit sexual partners. Limiting sex
partners is correct, but optimally clients should have a monogamous partner. Use lubricants
such as oils and creams during sex. Individuals should not use oils and creams; a better choice
is to use water-soluble lubricants such as KY jelly. Oral sex will prevent sexually transmitted
diseases. Oral sex is not safe for the transmission of sexually transmitted diseases.
LO: 3
9. While obtaining a social history on a male client regarding his patterns of alcohol
use, the nurse becomes suspicious of a problem with drinking. The nurse continues
assessing the client using the CAGE questionnaire. The nurse would ask, Have you
ever:

1.
2.
3.
4.
5.
Felt the need to cut down on drinking?

Felt annoyed by criticism of your drinking?
Felt guilty about drinking?
Taken a drink first thing in the morning?
Felt the desire to stop drinking?
Correct Answer:
1. Felt the need to cut down on drinking?
2. Felt annoyed by criticism of your drinking?
3. Felt guilty about drinking?
4. Taken a drink first thing in the morning?
Rationale: Felt the need to cut down on drinking? This question is one of the
first four answers because these are considered part of the CAGE questionnaire,
which stands for cutting down, annoyance if criticized, guilty feelings, eye-openers.
These screening questions are used to help identify alcohol abuse. Felt annoyed
by criticism of your drinking? This question is one of the first four answers
because these are considered part of the CAGE questionnaire, which stands for
cutting down, annoyance if criticized, guilty feelings, eye-openers. These screening
questions are used to help identify alcohol abuse. Felt guilty about drinking?
This question is one of the first four answers because these are considered part of
the CAGE questionnaire, which stands for cutting down, annoyance if criticized,
guilty feelings, eye-openers. These screening questions are used to help identify
alcohol abuse. Taken a drink first thing in the morning? This question is one
of the first four answers because these are considered part of the CAGE
questionnaire, which stands for cutting down, annoyance if criticized, guilty feelings,
eye-openers. These screening questions are used to help identify alcohol abuse.
Felt the desire to stop drinking? This question is not part of the CAGE
questionnaire.

Client Need: Psychosocial Integrity
LO: 3
10. A client is having a breast examination and is asked by the nurse to position her
arms at her side and then press her hands to her hips. The client asks why she has
to perform so many different positions for the examination. The nurse would
respond by stating that several positions:
1.
2.
3.
4.
Pull ligaments, causing dimpling if a tumor is present.

Help test motor strength.
Help to determine state of balance.
Provide a neurological assessment along with the breast examination.
Correct Answer: Pull ligaments, causing dimpling if a tumor is present.

Rationale: Several maneuvers will move the breast and pull the suspensory ligaments in such a
way that a tumor would cause dimpling or a bulge. Testing motor strength or state of balance is
not done during a breast examination and is not the reason for the clients maneuvering.
Neurological assessments are not the reason for maneuvering the extremities during a breast
examination.
LO: 4
11. During a routine breast examination of a client, the nurse notes a small amount
of nipple discharge. The nurse would:
1.
2.
3.
4.
5.
Collect a specimen on slide.

Document the finding.
Ask the client if this has occurred before.
Send the specimen to the lab.
Tell the client she may have cancer.
Correct Answer:
1. Collect a specimen on slide.
2. Document the finding.
3. Ask the client if this has occurred before.
4. Send the specimen to the lab.
Rationale: Collect a specimen on slide. The drainage should be collected on a specimen slide.
Document the finding. The nurse would document the finding so that future comparisons can be
made if the drainage would continue. Ask the client if this has occurred before. The nurse
would question if this has occurred before and when the drainage began. Send the specimen to
the lab. The nipple drainage would be sent to the lab for analysis. Tell the client she may have
cancer. Telling the client she has cancer is inappropriate; discharge does not always indicate a
sign of cancer.
LO: 4
12. During a routine pelvic examination the nurse instructs the client to bear down.
The nurse understands that the reason for this is to assess for:

1.
2.
3.
4.
5.
Cystoceles.
Rectoceles.
Prolapsed uterus.
Ovarian cysts.
Vaginal tumors.
Correct Answer:
1. Cystoceles.
2. Rectoceles.
3. Prolapsed uterus.
Rationale: Cystoceles. Cystoceles, or relaxation of the anterior vagina wall under the urinary
bladder, is assessed by asking the client to bear down so that the health care provider can
determine the presence of the structures through the vagina. Rectoceles. Rectoceles, or
relaxation of the posterior vaginal wall over the rectum, is assessed by asking the client to bear
down so that the health care provider can determine the presence of the structures through the
vagina. Prolapsed uterus. Prolapsed uterus, or the protrusion of the uterus into the vaginal wall,
is assessed by asking the client to bear down so that the health care provider can determine the
presence of the structures through the vagina. Ovarian cysts. Ovarian cysts are palpated
manually and the client does not have to bear down to determine their presence. Vaginal tumors.
Vaginal tumors may be detected by visual inspection of the pelvis thorough a speculum device.
LO: 4
13. The nurse is instructing a female client about sexual functioning changes that may result
from the aging process. Which of the following nursing diagnoses would the nurse incorporate in
the plan of care for this client regarding sexual intercourse?
1. Alteration in Comfort
2. Impaired Skin Integrity
3. Impaired Physical Mobility
4. Risk for Infection
5. Risk for Injury
Correct Answer:
1. Alteration in Comfort
2. Impaired Skin Integrity
3. Impaired Physical Mobility
4. Risk for Infection
Rationale:
Rationale: Alteration in Comfort. Intercourse may be painful because of the estrogen loss and
drying of the vaginal mucosa. Impaired Skin Integrity. Impaired skin integrity may result
because of the thinning of the vaginal mucosa and loss of adipose tissue. Impaired Physical
Mobility. The elderly population may have impaired mobility, which will decrease the libido of
the client. Risk for Infection. With intercourse, the vaginal tissue may tear and could result in
infection of the disrupted tissue. Risk for Injury. The client is not at risk for injury during sexual
intercourse.
LO: 5
14. A female client is experiencing hot flashes. The client asks the nurse how long
will these last. The nurse would respond by stating that hot flashes:
1.
2.
3.
4.
May last up to 5 years.

Usually occur once a month.
Will occur for 2 years.
Will not occur after the first year.
Correct Answer: May last up to 5 years.

Rationale: Hot flashes are unpredictable and may last up to 5 years, especially if the client is not
taking hormone replacement therapy.
LO: 5
15. Which of the following nursing diagnoses would the nurse include in the plan of
care with an older client experiencing urinary incontinence?

1.
2.
3.
4.
5.
Risk for Social Isolation

Anxiety
Altered Comfort; pain
Activity Intolerance
Risk for Injury
Correct Answer:
1. Risk for Social Isolation
2. Anxiety
Rationale: Risk for Social Isolation. The client with urinary incontinence may experience social
isolation because of the embarrassment of the episodes and the potential odor for the client.
Anxiety. The client with urinary incontinence may experience anxiety because of the frequency
of incontinence episodes. The client may wear a protective undergarment to avoid having to
quickly empty the bladder or to control the incontinence episode. Altered Comfort; pain.
Urinary incontinence is not associated with pain. Activity Intolerance. Urinary incontinence
will not impair the clients ability to perform activities of daily living. Risk for Injury. Risk for
injury is incorrect because the client is not prone to injury with episodes of incontinence.
Client Need: Psychosocial Integrity
LO: 5
16. A young adult male asks the nurse about the frequency of performing selftesticular exams. The nurse would respond by stating that testicular self-exams:
1.
2.
3.
4.
Have shown to cause more harm than benefit.

Are unnecessary for the clients age.
Should be performed once a month.
Are very beneficial the more they are performed.
Correct Answer: Have shown to cause more harm than benefit.

Rationale: Testicular self-exams have been shown to cause more harm than benefit, according to
the United States Preventative Service task Force (USPSTF). The guidelines of the USPSTF
state that routine exams should not be performed. The guidelines do not indicate that selftesticular exams are beneficial the more they are performed.
LO: 6
17. A 20-year-old female asks the nurse when she should begin having pelvic
examinations. The nurse would respond by asking:
1.
2.
3.
4.
Are you sexually active?

Are you on any medications?
Do you have a boyfriend?
Are you pregnant?
Correct Answer: Are you sexually active?

Rationale: The United States Preventive Task Force (USPSTF) recommends that sexually active
females have pelvic examinations when they are sexually active. Asking about medications is too
broad of a question and does not give the nurse information on the clients sexual practices.
Having a boyfriend does not always indicate that the client is sexually active. Pregnancy is a
reason for a pelvic examination, but the nurse should not assume that the client may be pregnant.
LO: 6
18. A female client states the she has a strong family history of ovarian cancer. The
nurse recommends screening for this disease by obtaining a(n):

1. Transvaginal ultrasound.
2. Serum-CA-125 level.
3. Record of menstrual cycles.
4. Abdominal x-ray.
5. CT scan.
Correct Answer:
1. Transvaginal ultrasound.
2. Serum-CA-125 level.
Rationale: Transvaginal ultrasound. Transvaginal ultrasound is a recommended practice for
females with strong family histories of ovarian cancer, according to the American Cancer
Society. Serum-CA-125 level. Obtaining serum CA-125 levels is a recommended practice for
females with strong family histories of ovarian cancer, according to the American Cancer
Society. Record of menstrual cycles. Obtaining records of menstrual cycles is not a
recommended screening practice for ovarian cancer. Abdominal x-ray. Abdominal x-rays are
not a recommended screening practice for ovarian cancer. CT scan. CT scans are not a
recommended screening practice for ovarian cancer.
LO: 6

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[Osborn chapter] 48

Learning Outcomes Number and Title

Correct Answer: Luteinizing hormone

3. A client is having a routine prostate examination. An important question that the

Do you have difficulty with urination?

Correct Answer: Do you have difficulty with urination?

Strip the penis to bring discharge to the meatus for culture.

Select all that apply.

Leaning over the examination table.

Select all that apply.

Select all that apply.

Sexually active individuals should be tested for HIV.

Select all that apply.

Felt the need to cut down on drinking?

Cognitive Level: Application

Pull ligaments, causing dimpling if a tumor is present.

Correct Answer: Pull ligaments, causing dimpling if a tumor is present.

Collect a specimen on slide.

Select all that apply.

May last up to 5 years.

Correct Answer: May last up to 5 years.

Select all that apply.

Risk for Social Isolation

Have shown to cause more harm than benefit.

Correct Answer: Have shown to cause more harm than benefit.

Are you sexually active?

Correct Answer: Are you sexually active?

Select all that apply.

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