Nokea
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.
You may also like to solve these questions
The nurse is preparing a teaching plan for a patient who has an enlarged prostate detected by digital rectal examination (DRE) and an elevated prostate specific antigen (PSA) level. Which of the following procedures should the nurse include in the teaching plan?
- A. Cystourethroscopy
- B. Uroflowmetry studies
- C. Magnetic resonance imaging (MRI)
- D. Transrectal ultrasonography (TRUS)
Correct Answer: D
Rationale: In a patient with an abnormal DRE and elevated PSA, transrectal ultrasound is used to visualize the prostate for biopsy. Uroflowmetry studies help determine the extent of urine blockage and treatment, but there is no indication that this is a problem for this patient. Cystoscopy may be used before prostatectomy, but will not be done until after the TRUS and biopsy. MRI is used to determine whether prostatic cancer has metastasized but would not be ordered at this stage of the diagnostic process.
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.
The nurse is caring for a patient with erectile dyfunction (ED) following treatment for benign prostatic hyperplasia (BPH). He shares with the nurse that he is seeking treatment as his wife 'is losing patience with the situation.' Which of the following nursing diagnoses is best for the patient?
- A. Ineffective role performance related to alteration in body image
- B. Anxiety related to threat to current status (inability to have sexual intercourse)
- C. Situational low self-esteem related to alteration in body image
- D. Ineffective sexuality pattern related to skill deficit about alternatives related to sexuality
Correct Answer: A
Rationale: The patient's statement indicates that the relationship with his wife is his primary concern. Although anxiety, low self-esteem, and ineffective sexuality patterns also may be concerns, the patient information suggests that addressing the role performance problem will lead to the best outcome for this patient.
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 admitting a patient with benign prostatic hyperplasia (BPH) who has urinary retention and new onset elevations in blood urea nitrogen (BUN) and creatinine. Which of the following prescribed therapies should the nurse implement first?
- A. Schedule an abdominal computed tomography (CT) scan
- B. Insert a urinary retention catheter.
- C. Draw blood for a complete blood count.
- D. Infuse normal saline at 50 mL/hour.
Correct Answer: B
Rationale: The patient data indicate that the patient may have acute renal failure caused by the BPH. The initial therapy will be to insert a catheter. The other actions also are appropriate, but they can be implemented after the acute urinary retention is resolved.