The nurse is assessing an older-adult male patient and the patient says that he does not respond to sexual stimulation the way he did when he was younger. Which of the following responses to the patient's comment is best?
- A. Many men need more sexual stimulation with aging.
- B. Interest in sex frequently decreases as men get older.
- C. Erectile dysfunction is a common problem with older men.
- D. Tell me more about how your sexual response has changed.
Correct Answer: D
Rationale: The initial response by the nurse should be further assessment of the problem. The other statements by the nurse are accurate but might not respond to the patient's concerns.
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The nurse is preparing a patient for colposcopy with a cervical biopsy. Which of the following information should the nurse explain to the patient about the procedure?
- A. It involves dilation of the cervix and biopsy of the tissue lining the uterus.
- B. It will take place in a same-day-surgery centre so that local anesthesia can be used.
- C. It requires that the patient have nothing to eat or drink for 6 hours before the procedure.
- D. It is similar to a speculum examination of the cervix and should result in little or no pain.
Correct Answer: D
Rationale: Colposcopy involves visualization of the cervix with a binocular microscope and is similar to a speculum examination. A cervical biopsy may cause a minimal amount of pain.
A patient calls the clinic because of an unusually heavy menstrual flow. She tells the nurse that she has saturated two tampons in the past 2 hours. Which of the following amounts of blood loss should the nurse estimate from the patient's information?
- A. 10-20 mL
- B. 20-30 mL
- C. 30-40 mL
- D. 40-60 mL
Correct Answer: D
Rationale: The average tampon absorbs 20-30 mL. Since the patient saturated two tampons in 2 hours, the estimated blood loss is 40-60 mL.
The nurse is assessing a patient in the Sexual Health Clinic who has a positive Venereal Disease Research Laboratory (VDRL) test, but no chancre is noted. The nurse should plan to send the specimens for which of the following tests?
- A. Gram stain
- B. Cytological studies
- C. Rapid plasma reagin (RPR) agglutination
- D. Fluorescent treponemal antibody absorption (FTA-ABS)
Correct Answer: D
Rationale: Since false positives are common with VDRL and RPR testing, FTA-ABS testing is recommended to confirm a diagnosis of syphilis. Gram staining is used for other sexually transmitted infections (STIs) such as gonorrhea and chlamydia, and cytological studies are used to detect abnormal cells (such as neoplastic cells).
Which of the following questions should the nurse ask when assessing a patient who has a history of benign prostatic hyperplasia (BPH)?
- A. Have you noticed any unusual discharge from your penis?
- B. Has there been any change in your sex life in the last year?
- C. Do you find it hard to initiate your urinary stream?
- D. Have you been experiencing any difficulty in achieving an erection?
Correct Answer: C
Rationale: Enlargement of the prostate blocks the urethra, leading to urinary changes. Benign prostatic hyperplasia is a common problem of older men. It can alter normal urination, causing retention and difficulty in initiating the urinary stream. The other questions address possible problems with infection or sexual difficulties but would not be helpful in determining whether there were functional changes caused by BPH.
The nurse is performing a physical assessment on a male patient and obtains this information. Which of the following findings is most important to report to the health care provider?
- A. One testis hangs lower than the other
- B. Inguinal lymph nodes are nonpalpable
- C. Genital hair distribution is diamond shaped
- D. Clear penile discharge is present at the meatus
Correct Answer: D
Rationale: Clear penile discharge may be indicative of a sexually transmitted infection (STI). The other findings are normal and do not need to be reported.
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