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The nurse is obtaining a medication history from a client who is reporting erectile dysfunction. Which medication would the nurse identify as being least likely to contribute to the client's condition?
- A. Spironolactone
- B. Cimetidine
- C. Ibprofen
- D. Methyldopa
Correct Answer: C
Rationale: Certain medications, such as antihypertensive agents (e.g., methyldopa and spironolactone), antidepressants, narcotics, and cimetidine cause sexual dysfunction in men. Ibprofen is not associated with causing erectile dysfunction. Cimetidine is a histamine-receptor antagonist used for gastric ulcers.
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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 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.
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.
A client with erectile dysfunction who had a penile implant inserted has been taught how to identify malfunction of the device. Which characteristic named by the client, indicative of malfunction, would show the nurse that the client has understood the teaching?
- A. Erosion of penile or urethral tissue
- B. Underinflation or bulging of the cylinders during inflation
- C. Erosion of scrotal, bowel, or bladder tissue
- D. Migration of the cylinders, pump, or reservoir from their intended location
Correct Answer: B
Rationale: Malfunction of the device is characterized by the underinflation, bulging of the cylinders during inflation, and a loss of fluid from the implant. Erosion of penile or urethral tissue occurs due to a midsized implant, pressure, or friction of the implanted cylinders. Erosion of scrotal, bowel, or bladder tissue occurs if an implant with a fluid reservoir is used. Migration of the cylinders, pump, or reservoir from their intended location is accompanied by pain, tenderness, and dysfunction of components that are part of the device.
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.