A nurse is assessing an older male client for symptoms indicative of benign prostatic hyperplasia (BPH). Which of the following symptoms are commonly associated with BPH? Select all that apply
Painful ejaculation
Urinary hesitancy
Increased urinary frequency
Nocturia
Sudden, severe scrotal pain
Correct Answer : B,C,D
Benign prostatic hyperplasia (BPH) is a nonmalignant enlargement of the prostate gland that typically occurs in aging males due to increased dihydrotestosterone (DHT) stimulation of prostatic tissue. It leads to urethral compression and bladder outlet obstruction. Common symptoms include urinary frequency, nocturia, and hesitancy. A normal prostate volume is 20–30 mL in younger men and may increase to >40 mL with BPH. Normal post-void residual urine is <50 mL in younger men and <100 mL in men >65 years.
Rationale for correct answers
B. Urinary hesitancy is a classic obstructive symptom of BPH, resulting from increased resistance to urine flow due to compression of the prostatic urethra.
C. Increased urinary frequency, especially during the day, is a common irritative symptom due to incomplete bladder emptying and detrusor overactivity secondary to obstruction.
D. Nocturia, or waking multiple times at night to urinate, is a frequent symptom of BPH caused by reduced bladder capacity and residual urine volume.
Rationale for incorrect answers
A. Painful ejaculation is not a typical symptom of BPH. It is more commonly associated with prostatitis or other inflammatory or infectious conditions of the prostate or seminal vesicles.
E. Sudden, severe scrotal pain is characteristic of testicular torsion or epididymitis, not BPH. BPH does not cause acute scrotal symptoms.
Take home points
- BPH typically presents with lower urinary tract symptoms, both obstructive and irritative.
- BPH does not cause acute pain or symptoms related to ejaculation.
- Normal prostate volume increases with age but should not impair quality of life.
- Distinguishing BPH from prostatitis and malignancy requires careful symptom evaluation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","D","E"]
Explanation
Sertoli cell function is central to spermatogenesis and testicular immune privilege. Located within seminiferous tubules, Sertoli cells regulate the development and protection of germ cells, form the blood-testis barrier, and secrete regulatory proteins. They produce inhibin, which inhibits follicle-stimulating hormone (FSH), and express androgen-binding protein to maintain high testosterone concentration locally. Serum FSH normal range is A.5–1B.4 mIU/mL in males, and inhibin B normally ranges between 80–400 pg/mL. Sertoli cells do not produce testosterone; Leydig cells do.
Rationale for correct answers
B. Sertoli cells form the blood-testis barrier using tight junctions. This barrier prevents autoimmune reactions by isolating developing sperm from systemic circulation and shields them from harmful substances.
D. Sertoli cells provide metabolic support, secrete nutrients, and phagocytose residual cytoplasm from developing spermatids. They also maintain a controlled environment for germ cell differentiation.
E. Sertoli cells secrete inhibin B in response to FSH stimulation. Inhibin provides negative feedback to the anterior pituitary to regulate FSH secretion and thus maintain spermatogenic homeostasis.
Rationale for incorrect answers
A. Testosterone is not secreted by Sertoli cells. It is synthesized by Leydig cells located in the interstitial tissue of the testes in response to luteinizing hormone (LH). Normal serum testosterone in males is 300–1,000 ng/dL.
C. Sertoli cells do not produce spermatozoa. They facilitate and support spermatogenesis, but spermatozoa are derived from spermatogonia through mitotic and meiotic divisions involving primary and secondary spermatocytes and spermatids.
Take home points
- Sertoli cells form the blood-testis barrier via tight junctions.
- They secrete inhibin, which negatively regulates FSH release.
- They nourish and support germ cell maturation but do not form sperm.
- Testosterone is produced by Leydig cells, not Sertoli cells.
Correct Answer is ["A","C","E"]
Explanation
Penile anatomy includes specialized erectile tissues, vascular structures, and sensory regions that function in urination, copulation, and ejaculation. The penis is composed of two corpora cavernosa and one corpus spongiosum, all enveloped in dense connective tissue. The glans penis, an extension of the corpus spongiosum, houses numerous sensory receptors. Normal penile erection involves vasodilation and blood filling of erectile tissues, with typical penile length in erect state ranging from 1B.9 to 1E.5 cm and penile arterial systolic velocity >30 cm/s indicating normal erectile function.
Rationale for correct answers
A. The corpora cavernosa are paired cylindrical erectile tissues located dorsolaterally in the penis. They are primarily responsible for penile rigidity during erection by engorging with blood via deep penile arteries.
C. The glans penis is the bulbous distal end of the penis, formed by the expansion of the corpus spongiosum. It is richly innervated and plays a key role in tactile sensation and sexual stimulation.
E. The corpus spongiosum is a single midline erectile structure surrounding the urethra. It prevents urethral compression during erection and expands distally to form the glans penis, contributing to both structure and function.
Rationale for incorrect answers
B. The rete testis is not a penile structure. It is a network of interconnecting tubules located in the mediastinum testis, responsible for collecting sperm from seminiferous tubules and transporting it to the epididymis. It has no structural or functional association with the penis.
D. The corpus luteum is a temporary endocrine structure formed from the ruptured ovarian follicle after ovulation in females. It secretes progesterone and estrogen. It is exclusive to the female reproductive system and unrelated to male genital anatomy.
Take home points
- The penis consists of corpora cavernosa, corpus spongiosum, and glans penis.
- Rete testis is located within the testes, not the penis.
- Corpus luteum is a female ovarian structure, not present in males.
- Erectile tissues are essential for penile rigidity and reproductive function.
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