Nokea
The client with benign prostatic hyperplasia (BPH) is considering use of medication in the management of symptoms. The nurse explains that which drug reduces the size of the prostate without lowering circulating levels of testosterone?
- A. Finasteride (Proscar)
- B. Tamsulosin (Flomax)
- C. Terazosin (Hytrin)
- D. Oxybutynin chloride (Ditropan)
Correct Answer: A
Rationale: Finasteride (Proscar) inhibits the conversion of testosterone, depriving the gland of dihydrotestosterone (more potent type of testosterone), which stimulates prostatic growth. Tamsulosin (Flomax) and terazosin (Hytrin) work by reducing the tone of smooth muscle in the bladder neck and prostate gland but have little effect on reducing prostate size. Oxybutynin chloride (Ditropan) is an antimuscarinic, antispasmodic drug used for treatment of overactive bladder.
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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.
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 with erectile dysfunction has opted to self-administer a urethral suppository to produce an erection. Which agent would be used?
- A. Sidenafil
- B. Vardenafil
- C. Alprostadil
- D. Papaverine
Correct Answer: C
Rationale: Alprostadil is the drug used for self-administration via a urethral suppository. Sidenafil and vardenafil are examples of phosphodidesterase inhibitors that are taken orally. Papaverine with pheentolamine is used for self-injection into the corpora cavernosa to achieve an erection.
Which recommendation would a nurse advocate during infancy and childhood to help reduce potential adult complications such as orchitis?
- A. Ensure immunizations against infectious diseases such as mumps.
- B. Engage in activities and exercises that minimize heavy lifting.
- C. Encourage the consumption of foods that are rich in fat and starch.
- D. Urge the limited intake of foods and fluids containing caffeine.
Correct Answer: A
Rationale: Nurses should advocate for infant and childhood immunizations against infectious diseases such as mumps to reduce potential adult complications such as orchitis. Minimizing activities involving heavy lifting or urging limited intake of caffeine have no effect on the potential for adult complications such as orchitis. The nurse should encourage foods that are low in fat and starch; however, this also would have no effect on the potential for orchitis.
A client is scheduled for a pump-type implanted penile prosthesis. Which client statement to the nurse would indicate the need for additional teaching?
- A. The reservoir is filled with saline solution.
- B. The penis will appear longer than usual.
- C. Surgery is required for placing the implant.
- D. The implant is pumped when sexual activity is desired.
Correct Answer: B
Rationale: When a pump-type implant is used, the erect penis tends to be shorter than usual because the saline filled cylinders do not fill the glans portion of the penis. This procedure is performed via surgical approach. The implant is pumped causing filling and erection when sexual activity is desired.