Nokea
A client came to the clinic with erectile dysfunction. What are some possible causes of this condition that the nurse could discuss with the client during history taking?
- A. Recent prostatectomy
- B. Long-term hypertension
- C. Diabetes mellitus
- D. Hour-long exercise sessions
- E. Consumption of beer each night
Correct Answer: A,B,C,E
Rationale: Organic erectile dysfunction can be caused by surgical procedures, hypertension and its treatment, diabetes mellitus, and alcohol consumption. There is no evidence that exercise is related to this problem.
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The nurse is administering finasteride (Proscar) and doxazosin (Cardura) to a 67-year-old client with benign prostatic hyperplasia. What precautions are related to the side effects of these medications?
- A. Assessing for blood pressure changes when lying, sitting, and arising from the bed
- B. Immediately reporting any change in the alanine aminotransferase laboratory test
- C. Teaching the client about the possibility of increased libido with these medications
- D. Taking the clients pulse rate for a minute in anticipation of bradycardia
- E. Asking the client to report any weakness, light-headedness, or dizziness
Correct Answer: A,B,E
Rationale: Both the 5-alpha-reductase inhibitor (5-ARI) and the alpha-selective blocking agents can cause orthostatic hypotension. The 5-ARI agent (Proscar) can cause a decreased libido rather than an increased sexual drive. The alpha-blocking drug (Cardura) can cause tachycardia rather than bradycardia.
The nurse is teaching an uncircumcised 65-year-old client about self-management of a urinary catheter in preparation for discharge to his home. What statement indicates a lack of understanding by the client?
- A. I only have to wash the outside of the catheter once a week.
- B. I should take extra time to clean the catheter site by pushing the foreskin back.
- C. The drainage bag needs to be changed at least once a week and as needed.
- D. I should pour a solution of vinegar and water through the tubing and bag.
Correct Answer: A
Rationale: The first few inches of the catheter must be washed daily starting at the penis and washing outward with soap and water. The other options are correct for self-management of a urinary catheter in the home setting.
A 55-year-old male client is admitted to the emergency department with symptoms of a myocardial infarction. Which question by the nurse is the most appropriate before administering nitroglycerin?
- A. On a scale from 0 to 10, what is the rating of your chest pain?
- B. Are you allergic to any food or medications?
- C. Have you taken any drugs like Viagra recently?
- D. Are you light headed or dizzy right now?
Correct Answer: C
Rationale: Phosphodiesterase-5 inhibitors such as sildenafil (Viagra) relax smooth muscles to increase blood flow to the penis for treatment of erectile dysfunction. In combination with nitroglycerin, there can be extreme hypotension with reduction of blood flow to vital organs. The other questions are appropriate but not the highest priority before administering nitroglycerin.
A client is interested in learning about the risk factors for prostate cancer. Which factors does the nurse include in the teaching?
- A. Family history of prostate cancer
- B. Smoking
- C. Obesity
- D. Advanced age
- E. Eating too much red meat
- F. Race
Correct Answer: A,D,E,F
Rationale: Advanced family history of prostate cancer, age, a diet high in animal fat, and race are all risk factors for prostate cancer. Smoking and obesity are not known risk factors.
A 34-year-old client comes to the clinic with concerns about an enlarged left testicle and heaviness in his lower abdomen. Which diagnostic test would the nurse expect to be ordered to confirm testicular cancer?
- A. Alpha-fetoprotein (AFP)
- B. Prostate-specific antigen (PSA)
- C. Prostate acid phosphatase (PAP)
- D. C-reactive protein (CRP)
Correct Answer: A
Rationale: AFP is a glycoprotein that is elevated in testicular cancer. PSA and PAP testing is used in the screening of prostate cancer. CRP is diagnostic for inflammatory conditions.