Nokea
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.
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After examination, a client is found to have a prostatic nodule and is scheduled for prostatic-specific antigen (PSA) testing. When the nurse is reviewing the results, which of the following would indicate that the nodule is malignant?
- A. 4 ng/mL.
- B. 7 ng/mL.
- C. 4 ng/mL.
- D. 12 ng/mL.
Correct Answer: D
Rationale: After a prostatic nodule is detected, prostate-specific antigen testing may be done. A PSA greater than 4 ng/mL is the basis for performing more definitive diagnostic procedures, and a PSA greater than 10 ng/mL indicates a prostatic malignancy. A PSA greater than 80 ng/mL indicates advanced metastatic disease.
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.
The nurse is providing discharge teaching to a client following a vasectomy. Which is the most important instruction to provide?
- A. Wear a scrotal support until swelling is resolved.
- B. Use a Tylenol as needed for discomfort.
- C. Use another form of birth control until further notice.
- D. Take a day or two to rest and recuperate from the procedure.
Correct Answer: C
Rationale: It may take up to 10 ejaculations to clear sperm and prevent impregnation. The client should be instructed to use another form of reliable birth control until a sperm count proves sterility has occurred. Use of Tylenol, scrotal support, and rest are all helpful during the initial recovery period.
The nurse is reviewing a client's medication and health history. Which assessment finding would cause the nurse to question the client's new prescription for the phosphodiesterase inhibitor sidenafil?
- A. Use of nitrates
- B. History of hypertension
- C. Type 2 diabetes
- D. Use of diuretics
Correct Answer: A
Rationale: PDE5 inhibitors facilitate penile erection by producing smooth muscle relaxation in the corpora cavernosa via vasodilation of the blood vessels. If a client is using nitrates (which also exhibit vasodilation) hypotension is likely to occur. History of hypertension and diabetes does not interfere with the administration of PDE5 inhibitors. Use of diuretics is not significant.
A client is diagnosed with prostatitis. Which is the most important teaching point for the management of this disorder?
- A. Avoid tub baths.
- B. Avoid sexual activity.
- C. Limit fluid intake.
- D. Avoid prolonged sitting.
Correct Answer: D
Rationale: Prolonged sitting can aggravate the condition of prostatitis and should be avoided. Warm tub baths and/or sitz baths can provide comfort. Increasing fluid intake can also flush the urethra of microorganisms and decrease risk of bacterial infection. Regularly draining the prostate gland through masturbation or intercourse can be helpful.