Nokea
A 55-year-old man presents at the clinic complaining of erectile dysfunction. The patient has a history of diabetes. The physician orders tadalafil (Cialis) to be taken 1 hour before sexual intercourse. The nurse reviews the patients history prior to instructing the patient on the use of this medication. What disorder will contraindicate the use of tadalafil (Cialis)?
- A. Cataracts
- B. Retinopathy
- C. Hypotension
- D. Diabetic nephropathy
Correct Answer: C
Rationale: Tadalafil is contraindicated in patients with hypotension due to the risk of severe blood pressure drops, especially with nitrates. Cataracts, retinopathy, and nephropathy do not typically contraindicate its use, though retinopathy requires caution.
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A nurse is caring for a 33-year-old male who has come to the clinic for a physical examination. He states that he has not had a routine physical in 5 years. During the examination, the physician finds that digital rectal examination (DRE) reveals stoney hardening in the posterior lobe of the prostate gland that is not mobile. The nurse recognizes that the observation typically indicates what?
- A. A normal finding
- B. A sign of early prostate cancer
- C. Evidence of a more advanced lesion
- D. Metastatic disease
Correct Answer: C
Rationale: A stony hard, fixed lesion in the prostate on DRE suggests a more advanced prostate cancer, as early lesions are typically nodular. This is not a normal finding or indicative of metastatic disease without further evidence.
A nurse is assessing a patient who presented to the ED with priapism. The student nurse is aware that this condition is classified as a urologic emergency because of the potential for what?
- A. Urinary tract infection
- B. Chronic pain
- C. Permanent vascular damage
- D. Future erectile dysfunction
Correct Answer: C
Rationale: Priapism, particularly the ischemic type, is a urologic emergency due to the risk of permanent vascular damage from prolonged lack of blood flow, which can lead to tissue necrosis. It is not directly linked to UTIs, chronic pain, or future erectile dysfunction as primary concerns.
A public health nurse is teaching a health class for the male students at the local high school. The nurse is teaching the boys to perform monthly testicular self-examinations. What point would be appropriate to emphasize?
- A. Testicular cancer is a highly curable type of cancer.
- B. Testicular cancer is very difficult to diagnose.
- C. Testicular cancer is the number one cause of cancer deaths in males.
- D. Testicular cancer is more common in older men.
Correct Answer: A
Rationale: Testicular cancer is highly curable, especially with early detection through monthly self-examinations, which facilitate timely treatment. It is not difficult to diagnose, not the leading cause of cancer deaths, and is more common in younger men.
A patient has experienced occasional urinary incontinence in the weeks since his prostatectomy. In order to promote continence, the nurse should encourage which of the following?
- A. Pelvic floor exercises
- B. Intermittent urinary catheterization
- C. Reduced physical activity
- D. Active range of motion exercises
Correct Answer: A
Rationale: Pelvic floor exercises strengthen muscles supporting the bladder, aiding continence post-prostatectomy. Catheterization is unnecessary and risky, and physical activity levels do not directly impact continence.
A patient has been diagnosed with erectile dysfunction; the cause has been determined to be psychogenic. The patients interdisciplinary plan of care should prioritize which of the following interventions?
- A. Penile implant
- B. PDE-5 inhibitors
- C. Physical therapy
- D. Psychotherapy
Correct Answer: D
Rationale: Psychogenic erectile dysfunction, stemming from psychological factors, is best addressed with psychotherapy to explore underlying issues. Penile implants and PDE-5 inhibitors are for organic causes, and physical therapy is ineffective.