Nokea
A client is scheduled for a pump-type implanted penile prosthesis. Which client statement to the nurse would indicate the need for additional teaching?
- A. The reservoir is filled with saline solution.
- B. The penis will appear longer than usual.
- C. Surgery is required for placing the implant.
- D. The implant is pumped when sexual activity is desired.
Correct Answer: B
Rationale: When a pump-type implant is used, the erect penis tends to be shorter than usual because the saline filled cylinders do not fill the glans portion of the penis. This procedure is performed via surgical approach. The implant is pumped causing filling and erection when sexual activity is desired.
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A young client is admitted with torsion of the spermatic cord. Which is the appropriate action to be taken by the nurse?
- A. Elevate the scrotum.
- B. Keep the client NPO.
- C. Monitor vital signs for cardiac changes.
- D. Avoid the use of analgesics.
Correct Answer: B
Rationale: With torsion of the spermatic cord, immediate surgery is necessary to prevent atrophy of the cord and preserve fertility. The client should be placed on NPO state in preparation for surgery. Elevating the scrotum intensifies the pain by increasing the degree of twist. Analgesics are prescribed preoperatively to control pain. Cardiac changes are not indicated unless client history warrants assessment.
The nurse is providing discharge teaching to a client following a vasectomy. Which is the most important instruction to provide?
- A. Wear a scrotal support until swelling is resolved.
- B. Use a Tylenol as needed for discomfort.
- C. Use another form of birth control until further notice.
- D. Take a day or two to rest and recuperate from the procedure.
Correct Answer: C
Rationale: It may take up to 10 ejaculations to clear sperm and prevent impregnation. The client should be instructed to use another form of reliable birth control until a sperm count proves sterility has occurred. Use of Tylenol, scrotal support, and rest are all helpful during the initial recovery period.
A hydrocele is suspected in a client with scrotal edema. Which assessment technique would the nurse anticipate to be done first?
- A. Transillumination of the scrotum
- B. Palpate for presence of testicle
- C. Examine for soft tissue swelling
- D. Assess for collection of blood in the scrotum
Correct Answer: A
Rationale: Transillumination, shining a light through the scrotum, will determine if the swelling in the scrotum is caused by serous fluid versus a solid mass. Palpation for testicle is not indicated with a hydrocele. Soft-tissue swelling and/or collection of blood in the scrotum is not indicated with hydrocele.
After examination, a client is found to have a prostatic nodule and is scheduled for prostatic-specific antigen (PSA) testing. When the nurse is reviewing the results, which of the following would indicate that the nodule is malignant?
- A. 4 ng/mL.
- B. 7 ng/mL.
- C. 4 ng/mL.
- D. 12 ng/mL.
Correct Answer: D
Rationale: After a prostatic nodule is detected, prostate-specific antigen testing may be done. A PSA greater than 4 ng/mL is the basis for performing more definitive diagnostic procedures, and a PSA greater than 10 ng/mL indicates a prostatic malignancy. A PSA greater than 80 ng/mL indicates advanced metastatic disease.
The nurse is reviewing a client's medication and health history. Which assessment finding would cause the nurse to question the client's new prescription for the phosphodiesterase inhibitor sidenafil?
- A. Use of nitrates
- B. History of hypertension
- C. Type 2 diabetes
- D. Use of diuretics
Correct Answer: A
Rationale: PDE5 inhibitors facilitate penile erection by producing smooth muscle relaxation in the corpora cavernosa via vasodilation of the blood vessels. If a client is using nitrates (which also exhibit vasodilation) hypotension is likely to occur. History of hypertension and diabetes does not interfere with the administration of PDE5 inhibitors. Use of diuretics is not significant.