Nokea
A man comes to the clinic complaining that he is having difficulty obtaining an erection. When reviewing the patients history, what might the nurse note that contributes to erectile dysfunction?
- A. The patient has been treated for a UTI twice in the past year.
- B. The patient has a history of hypertension.
- C. The patient is 66 years old.
- D. The patient leads a sedentary lifestyle.
Correct Answer: B
Rationale: Hypertension, a vascular condition, is a major cause of erectile dysfunction in men over 50, impairing penile blood flow. Recent UTIs, age alone, or sedentary lifestyle are less direct contributors.
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A patient presents to the emergency department with paraphimosis. The physician is able to compress the glans and manually reduce the edema. Once the inflammation and edema subside, what is usually indicated?
- A. Needle aspiration of the corpus cavernosum
- B. Circumcision
- C. Abstinence from sexual activity for 6 weeks
- D. Administration of vardenafil
Correct Answer: B
Rationale: Paraphimosis, where the foreskin is trapped behind the glans, often recurs, making circumcision the usual treatment after edema subsides to prevent future episodes. Aspiration is for priapism, abstinence is unnecessary, and vardenafil is irrelevant.
A nurse is performing an admission assessment on a 40-year-old man who has been admitted for outpatient surgery on his right knee. While taking the patients family history, he states, My father died of prostate cancer at age 48. The nurse should instruct him on which of the following health promotion activities?
- A. The patient will need PSA levels drawn starting at age 55.
- B. The patient should have testing for presence of the CDH1 and STK11 genes.
- C. The patient should have PSA levels drawn regularly.
- D. The patient should limit alcohol use due to the risk of malignancy.
Correct Answer: C
Rationale: A family history of prostate cancer at age 48 warrants regular PSA screening starting earlier than age 55, typically around age 40-45, to monitor for early signs. CDH1/STK11 genes are not linked to prostate cancer, and alcohol limitation is less specific.
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 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.
A nurse is caring for a 33-year-old male who has come to the clinic for a physical examination. He states that he has not had a routine physical in 5 years. During the examination, the physician finds that digital rectal examination (DRE) reveals stoney hardening in the posterior lobe of the prostate gland that is not mobile. The nurse recognizes that the observation typically indicates what?
- A. A normal finding
- B. A sign of early prostate cancer
- C. Evidence of a more advanced lesion
- D. Metastatic disease
Correct Answer: C
Rationale: A stony hard, fixed lesion in the prostate on DRE suggests a more advanced prostate cancer, as early lesions are typically nodular. This is not a normal finding or indicative of metastatic disease without further evidence.