Nokea
A client with erectile dysfunction has opted to self-administer a urethral suppository to produce an erection. Which agent would be used?
- A. Sidenafil
- B. Vardenafil
- C. Alprostadil
- D. Papaverine
Correct Answer: C
Rationale: Alprostadil is the drug used for self-administration via a urethral suppository. Sidenafil and vardenafil are examples of phosphodidesterase inhibitors that are taken orally. Papaverine with pheentolamine is used for self-injection into the corpora cavernosa to achieve an erection.
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A client comes to the outpatient clinic for information on a vasectomy. Which instruction should be included by the nurse?
- A. Vasectomies should be considered a permanent means of birth control.
- B. Following surgery, sexual intercourse should be avoided for 3 months.
- C. Postoperative discomfort can be relieved with use of warm bath.
- D. Vasectomy can result in permanent impotence.
Correct Answer: A
Rationale: Although attempts to reverse a vasectomy have proven successful, a vasectomy should be considered a permanent means of birth control. Scar formation and/or sperm leakage can interfere with restoration of reproductive effectiveness. Sexual intercourse can be resumed when it is comfortable to do so, usually in about 1 week. Postoperative discomfort should be controlled with application of cold to reduce swelling or use of mild analgesics. On occasion, clients have complained of impotence, but vasectomies have no effect on erection or ejaculation.
Following morning hygiene of an older adult client, the nurse is unable to replace the retracted foreskin of the penis. Which is the most likely outcome?
- A. Erection of the penis
- B. Unclean gls
- C. Painful swelling
- D. Nuseea and vomiting
Correct Answer: C
Rationale: Paraphimosis results in strangulation of the glans penis from inability to replace the retracted foreskin. The strangulation results in painful swelling of the glans. Erection of the penis in the presence of phimosis can cause pain but is not a result of retracted foreskin. Nausea and vomiting are not indicated with retraction of foreskin.
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.
A clinic nurse is scheduled to see four male clients. Which assessment finding is most important in determining which client has a higher risk for developing testicular cancer?
- A. Previous sexually transmitted infection (STI)
- B. Low sperm count
- C. Cryptorchidism as an infant
- D. Family history of cancer
Correct Answer: C
Rationale: Caucasian men who have had cryptorchidism as an infant, regardless of whether an orchiopexy was performed, are at higher risk, for incidence of testicular cancer. STIs, low sperm count, and family history of general cancer are not indicative of testicular cancer risk.
Which of the following should nurses teach all men, especially those who have had cryptorchidism?
- A. Need for blood tests to measure serum acid phosphatase
- B. Importance of regular monitoring of prostate-specific antigen (PSA) levels
- C. Need to undergo a baseline and follow up lymph node biopsies
- D. How to perform a testicular self-examination
Correct Answer: D
Rationale: The nurses should teach all men, especially those who have had cryptorchidism, to perform testicular self-examination to detect any abnormal mass in the scrotum. The nurse instructs the clients to examine the testicles monthly, preferably when warm, such as in the shower. Having regular PSA levels, lymph node biopsies, and blood tests for measuring serum acid phosphatase are for the clients who are treated for prostate cancer.