Nokea
A patient confides to the nurse that he cannot engage in sexual activity. The patient is 27 years old and has no apparent history of chronic illness that would contribute to erectile dysfunction. What does the nurse know will be ordered for this patient to assess his sexual functioning?
- A. Sperm count
- B. Ejaculation capacity tests
- C. Engorgement tests
- D. Nocturnal penile tumescence tests
Correct Answer: D
Rationale: Nocturnal penile tumescence tests assess erectile function during sleep, helping differentiate psychogenic from organic causes of erectile dysfunction in a young, healthy patient. Sperm count, ejaculation capacity, or engorgement tests are not relevant.
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A man tells the nurse that his father died of prostate cancer and he is concerned about his own risk of developing the disease, having heard that prostate cancer has a genetic link. What aspect of the pathophysiology of prostate cancer would underlie the nurses response?
- A. A number of studies have identified an association of BRCA-2 mutation with an increased risk of prostate cancer.
- B. HNPCC is a mutation of two genes that causes prostate cancer in men and it is autosomal dominant.
- C. Studies have shown that the presence of the TP53 gene strongly influences the incidence of prostate cancer.
- D. Recent research has demonstrated that prostate cancer is the result of lifestyle factors and that genetics are unrelated.
Correct Answer: A
Rationale: BRCA-2 mutations are associated with an increased risk of prostate cancer, particularly in men with a family history. HNPCC relates to colon cancer, TP53 is linked to breast cancer, and genetics, not just lifestyle, contribute to prostate cancer risk.
To decrease glandular cellular activity and prostate size, an 83-year-old patient has been prescribed finasteride (Proscar). When performing patient education with this patient, the nurse should be sure to tell the patient what?
- A. Report the planned use of dietary supplements to the physician.
- B. Decrease the intake of fluids to prevent urinary retention.
- C. Abstain from sexual activity for 2 weeks following the initiation of treatment.
- D. Anticipate a temporary worsening of urinary retention before symptoms subside.
Correct Answer: A
Rationale: Finasteride can interact with certain herbal supplements, so reporting their use to the physician is crucial to avoid adverse effects. Fluid intake should remain normal, sexual abstinence is unnecessary, and worsening urinary retention is not expected.
A 22-year-old male is being discharged home after surgery for testicular cancer. The patient is scheduled to begin chemotherapy in 2 weeks. The patient tells the nurse that he doesnt think he can take weeks or months of chemotherapy, stating that he has researched the adverse effects online. What is the most appropriate nursing action for this patient at this time?
- A. Provide empathy and encouragement in an effort to foster a positive outlook.
- B. Tell the patient it is his decision whether to accept or reject chemotherapy.
- C. Report the patients statement to members of his support system.
- D. Refer the patient to social work.
Correct Answer: A
Rationale: Empathy and encouragement help address the patient's fears and promote a positive attitude toward chemotherapy, which is critical for adherence. Informing support systems breaches confidentiality, and social work referral or emphasizing patient choice are less immediate.
A 55-year-old man presents at the clinic complaining of erectile dysfunction. The patient has a history of diabetes. The physician orders tadalafil (Cialis) to be taken 1 hour before sexual intercourse. The nurse reviews the patients history prior to instructing the patient on the use of this medication. What disorder will contraindicate the use of tadalafil (Cialis)?
- A. Cataracts
- B. Retinopathy
- C. Hypotension
- D. Diabetic nephropathy
Correct Answer: C
Rationale: Tadalafil is contraindicated in patients with hypotension due to the risk of severe blood pressure drops, especially with nitrates. Cataracts, retinopathy, and nephropathy do not typically contraindicate its use, though retinopathy requires caution.
A clinic nurse is providing preprocedure education for a man who will undergo a vasectomy. Which of the following measures will enhance healing and comfort? Select all that apply.
- A. Abstaining from sexual intercourse for at least 14 days postprocedure
- B. Wearing a scrotal support garment
- C. Using sitz baths
- D. Applying a heating pad intermittently
- E. Staying on bed rest for 48 to 72 hours postprocedure
Correct Answer: B,C
Rationale: Scrotal support reduces swelling and discomfort, and sitz baths promote healing post-vasectomy. Ice, not heat, is recommended, sexual activity can resume in about 7 days, and prolonged bed rest is unnecessary.