Nokea
A 57-year-old male comes to the clinic complaining that when he has an erection his penis curves and becomes painful. The patients diagnosis is identified as severe Peyronies disease. The nurse should be aware of what likely treatment modality?
- A. Physical therapy
- B. Treatment with PDE-5 inhibitors
- C. Intracapsular hydrocortisone injections
- D. Surgery
Correct Answer: D
Rationale: Severe Peyronies disease, characterized by painful penile curvature from fibrous plaques, often requires surgical removal of plaques. Physical therapy, PDE-5 inhibitors, or hydrocortisone injections are not effective treatments.
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An uncircumcised 78-year-old male has presented at the clinic complaining that he cannot retract his foreskin over his glans. On examination, it is noted that the foreskin is very constricted. The nurse should recognize the presence of what health problem?
- A. Bowens disease
- B. Peyronies disease
- C. Phimosis
- D. Priapism
Correct Answer: C
Rationale: Phimosis is a condition where a tight foreskin cannot be retracted over the glans, common in uncircumcised older males due to scarring or poor hygiene. Bowens disease is a penile carcinoma in situ, Peyronies disease involves penile curvature from fibrous plaques, and priapism is a persistent erection, none of which fit the description.
A patient has just been diagnosed with prostate cancer and is scheduled for brachytherapy next week. The patient and his wife are unsure of having the procedure because their daughter is 3 months pregnant. What is the most appropriate teaching the nurse should provide to this family?
- A. The patient should not be in contact with the baby after delivery.
- B. The patients treatment poses no risk to his daughter or her infant.
- C. The patients brachytherapy may be contraindicated for safety reasons.
- D. The patient should avoid close contact with his daughter for 2 months.
Correct Answer: D
Rationale: Brachytherapy involves radioactive seeds emitting low-level radiation, requiring the patient to avoid close contact with pregnant women and infants for about 2 months to minimize exposure risk. The treatment is not contraindicated, and complete isolation from the baby post-delivery is unnecessary.
A patient who is postoperative day 12 and recovering at home following a laparoscopic prostatectomy has reported that he is experiencing occasional dribbling of urine. How should the nurse best respond to this patients concern?
- A. Inform the patient that urinary control is likely to return gradually.
- B. Arrange for the patient to be assessed by his urologist.
- C. Facilitate the insertion of an indwelling urinary catheter by the home care nurse.
- D. Teach the patient to perform intermittent self-catheterization.
Correct Answer: A
Rationale: Urinary incontinence post-prostatectomy is common and typically resolves gradually within months to a year. Reassuring the patient about this normal recovery process is appropriate. Urologist referral, catheterization, or self-catheterization are not indicated at this stage.
A patient has presented at the clinic with symptoms of benign prostatic hyperplasia. What diagnostic findings would suggest that this patient has chronic urinary retention?
- A. Hypertension
- B. Peripheral edema
- C. Tachycardia and other dysrhythmias
- D. Increased blood urea nitrogen (BUN)
Correct Answer: D
Rationale: Chronic urinary retention from benign prostatic hyperplasia can lead to azotemia, evidenced by increased BUN due to impaired renal clearance. Hypertension, edema, or tachycardia are not directly associated with this condition.
A 76-year-old with a diagnosis of penile cancer has been admitted to the medical floor. Because the incidence of penile cancer is so low, the staff educator has been asked to teach about penile cancer. What risk factors should the educator cite in this presentation? Select all that apply.
- A. Phimosis
- B. Priapism
- C. Herpes simplex infection
- D. Increasing age
- E. Lack of circumcision
Correct Answer: A,D,E
Rationale: Risk factors for penile cancer include phimosis, increasing age (most cases in men over 65), and lack of circumcision, which can lead to poor hygiene and HPV exposure. Priapism and herpes simplex are not established risk factors.