Nokea
A client with erectile dysfunction who had a penile implant inserted has been taught how to identify malfunction of the device. Which characteristic named by the client, indicative of malfunction, would show the nurse that the client has understood the teaching?
- A. Erosion of penile or urethral tissue
- B. Underinflation or bulging of the cylinders during inflation
- C. Erosion of scrotal, bowel, or bladder tissue
- D. Migration of the cylinders, pump, or reservoir from their intended location
Correct Answer: B
Rationale: Malfunction of the device is characterized by the underinflation, bulging of the cylinders during inflation, and a loss of fluid from the implant. Erosion of penile or urethral tissue occurs due to a midsized implant, pressure, or friction of the implanted cylinders. Erosion of scrotal, bowel, or bladder tissue occurs if an implant with a fluid reservoir is used. Migration of the cylinders, pump, or reservoir from their intended location is accompanied by pain, tenderness, and dysfunction of components that are part of the device.
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Which pharmacologic agent poses the greatest risk for urinary retention in a client with benign prostatic hyperplasia (BPH)?
- A. Muscle relaxers
- B. Antihypertensives
- C. Nitrates
- D. Antihistamines
Correct Answer: D
Rationale: Antihistamines and over-the-counter cold medications should be avoided in clients with BPH due to the increase in urinary retention properties. Muscle relaxers are commonly prescribed for treatment of urinary retention. Nitrates and antihypertensive medications do not cause significant risk in the management of BPH.
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.
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.
Which nursing assessment finding is most significant in determining the plan of care in a client with erectile dysfunction?
- A. Age
- B. Medication use
- C. Sexual history
- D. Undescended testicle
Correct Answer: B
Rationale: Certain medications such as antihypertensive drugs, antidepressants, narcotics, etc. can cause sexual dysfunction in men. Impotence is not a normal part of aging. Undescended testicle is not indicative of ED. Sexual history is not indicative of ED.
The nurse is caring for a client with benign prostatic hyperplasia (BPH). Which assessment finding provides the best indication of urinary retention?
- A. Frequency
- B. Urgency
- C. Hesitancy
- D. Dribbling
Correct Answer: A
Rationale: As residual urine accumulates, the client has an urge to void more often. Urgency, hesitancy, and dribbling are all urinary symptoms associated with BPH but not specific to urinary retention.