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A patient who is scheduled for an open prostatectomy is concerned about the potential effects of the surgery on his sexual function. What aspect of prostate surgery should inform the nurses response?
- A. Erectile dysfunction is common after prostatectomy as a result of hormonal changes.
- B. All prostatectomies carry a risk of nerve damage and consequent erectile dysfunction.
- C. Erectile dysfunction after prostatectomy is expected, but normally resolves within several months.
- D. Modern surgical techniques have eliminated the risk of erectile dysfunction following prostatectomy.
Correct Answer: B
Rationale: Prostatectomies risk damaging pudendal nerves, leading to permanent erectile dysfunction in some cases. Hormonal changes are not the cause, resolution is not guaranteed, and modern techniques reduce but do not eliminate the risk.
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A patient has just been diagnosed with prostate cancer and is scheduled for brachytherapy next week. The patient and his wife are unsure of having the procedure because their daughter is 3 months pregnant. What is the most appropriate teaching the nurse should provide to this family?
- A. The patient should not be in contact with the baby after delivery.
- B. The patients treatment poses no risk to his daughter or her infant.
- C. The patients brachytherapy may be contraindicated for safety reasons.
- D. The patient should avoid close contact with his daughter for 2 months.
Correct Answer: D
Rationale: Brachytherapy involves radioactive seeds emitting low-level radiation, requiring the patient to avoid close contact with pregnant women and infants for about 2 months to minimize exposure risk. The treatment is not contraindicated, and complete isolation from the baby post-delivery is unnecessary.
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 75-year-old male patient is being treated for phimosis. When planning this patients care, what health promotion activity is most directly related to the etiology of the patients health problem?
- A. Teaching the patient about safer sexual practices
- B. Teaching the patient about the importance of hygiene
- C. Teaching the patient about the safe use of PDE-5 inhibitors
- D. Teaching the patient to perform testicular self-examination
Correct Answer: B
Rationale: Poor hygiene is a key contributor to phimosis, as smegma accumulation can cause foreskin scarring. Teaching proper genital hygiene directly addresses this etiology, unlike sexual practices, PDE-5 inhibitors, or testicular self-examination.
A nurse is planning the postoperative care of a patient who is scheduled for radical prostatectomy. What intraoperative position will place the patient at particular risk for the development of deep vein thrombosis postoperatively?
- A. Fowlers position
- B. Prone position
- C. Supine position
- D. Lithotomy position
Correct Answer: D
Rationale: The lithotomy position, used during prostatectomy, elevates the legs, potentially impairing venous return and increasing the risk of deep vein thrombosis. Compression stockings are critical for prevention. Fowlers, prone, and supine positions do not pose the same risk.
A physician explains to the patient that he has an inflammation of the Cowper glands. Where are the Cowper glands located?
- A. Within the epididymis
- B. Below the prostate, within the posterior aspect of the urethra
- C. On the inner epithelium lining the scrotum, lateral to the testes
- D. Medial to the vas deferens
Correct Answer: B
Rationale: Cowper glands (bulbourethral glands) are located below the prostate within the posterior urethra, secreting lubricating fluid during ejaculation. They are not in the epididymis, scrotal lining, or near the vas deferens.