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The nurse is assessing a 22-year-old male patient at the health clinic with symptoms of erectile dysfunction. When assessing for possible etological factors, which of the following questions should the nurse ask first?
- A. Are you using any recreational drugs or drinking more than 3 drinks of alcohol per day?
- B. Have you been experiencing an unusual amount of anxiety or stress?
- C. Do you have any history of an erection that lasted for 6 hours or more?
- D. Do you have any persistent cardiovascular or peripheral vascular disease?
Correct Answer: A
Rationale: A common etiological factor for erectile dysfunction (ED) in younger men is use of recreational drugs or alcohol. Stress, priapism, and cardiovascular illness also contribute to ED, but they are not common etiologic factors in younger men.
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The nurse is assessing a 53-year-old man who has been having increasing problems with erectile dysfunction (ED) for several years and is interested in using sildenafil. Which of the following actions should the nurse take first?
- A. Ask the patient about any prescription drugs he is taking.
- B. Tell the patient that sildenafil does not always work for ED.
- C. Discuss the common adverse effects of erecogenic drugs.
- D. Assure the patient that ED is commonly associated with aging.
Correct Answer: A
Rationale: Because some medications can cause ED and patients using nitrates should not take sildenafil, the nurse should first assess for prescription drug use. The nurse may want to teach the patient about realistic expectations and adverse effects of sildenafil therapy, but this should not be the first action. Although ED does increase with aging, it may be secondary to medication use or cardiovascular disease in a 53-year-old.
The nurse is conducting a focused health history for a patient with possible testicular cancer. Which of the following topics should the nurse include in the assessment?
- A. Sexually transmitted infections (STIS)
- B. Testicular trauma
- C. Testicular torsion
- D. Undescended testicles
Correct Answer: D
Rationale: Cryptorchidism is a risk factor for testicular cancer if it is not corrected before puberty. STIs, testicular torsion, and testicular trauma are risk factors for other testicular conditions but not for testicular cancer.
The nurse is caring for a patient following a radical retropubic prostatectomy for prostate cancer and is incontinent of urine. Which of the following information should the nurse include in the teaching plan?
- A. Restrict oral fluid intake.
- B. Pelvic floor muscle exercises
- C. Use belladonna and opium suppositories.
- D. Perform intermittent self-catheterization
Correct Answer: B
Rationale: Pelvic floor muscle training (Kegel) exercises are recommended to strengthen the pelvic floor muscles and improve urinary control. Belladonna and opium suppositories are used to reduce bladder spasms after surgery. Intermittent self-catheterization may be taught before surgery if the patient has urinary retention, but it will not be useful in reducing incontinence after surgery. The patient should have a daily oral intake of 2-3 L.
The nurse is caring for a patient who has benign prostatic hyperplasia (BPH) with mild obstruction and tells the nurse, 'My symptoms have gotten a lot worse this week.' Which of the following responses by the nurse is best?
- A. I will talk to the health care provider about ordering a prostate specific antigen (PSA) test.
- B. Have you been taking any over-the-counter (OTC) medications recently?
- C. Have you talked to the doctor about surgical procedures such as transurethral resection of the prostate (TURP)?
- D. The prostate gland changes slightly in size from day to day, and this may be making your symptoms worse
Correct Answer: B
Rationale: Because the patient's increase in symptoms has occurred abruptly, the nurse should ask about OTC medications (such as decongestants and anticholinergics) that might cause contraction of the smooth muscle in the prostate and worsen obstruction. The prostate gland does not vary in size from day to day. A TURP may be needed, but more assessment about possible reasons for the sudden symptom change is a more appropriate first response by the nurse. PSA testing is done to differentiate BPH from prostatic cancer.
The nurse is assessing a patient with benign prostatic hyperplasia (BPH). Which of the following symptoms should the nurse assess to determine the severity of the BPH?
- A. Blood in the urine
- B. Lower back or hip pain
- C. Erectile dysfunction (ED)
- D. Strength of the urinary stream
Correct Answer: D
Rationale: The American Urological Association (AUA) Symptom Index (used in Canada) for a patient with BPH asks questions about the force and frequency of urination, nocturia, etc. Blood in the urine, ED, and back or hip pain are not typical symptoms of BPH.