Nokea
The nurse is providing discharge teaching to a client following a vasectomy. Which is the most important instruction to provide?
- A. Wear a scrotal support until swelling is resolved.
- B. Use a Tylenol as needed for discomfort.
- C. Use another form of birth control until further notice.
- D. Take a day or two to rest and recuperate from the procedure.
Correct Answer: C
Rationale: It may take up to 10 ejaculations to clear sperm and prevent impregnation. The client should be instructed to use another form of reliable birth control until a sperm count proves sterility has occurred. Use of Tylenol, scrotal support, and rest are all helpful during the initial recovery period.
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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.
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.
A client who comes to the clinic complaining of perineal pain, dysuria, and fever is diagnosed with prostatitis. The nurse understands that which of the following organisms would be the most likely cause?
- A. Staphylococcus
- B. Sreptococcus
- C. Escherichia coli
- D. Paramyxovirus
Correct Answer: C
Rationale: Prostatitis is an inflammation of the prostate gland and is most often caused by microorganisms that reach the prostate by way of the urethra. Escherichia coli and microbes that cause sexually transmitted infections often are responsible. Staphylococcus and Sreptococcus are not typically a cause of prostatitis. Paramyxovirus is the cause of mumps.
Which pharmacologic agent poses the greatest risk for urinary retention in a client with benign prostatic hyperplasia (BPH)?
- A. Muscle relaxers
- B. Antihypertensives
- C. Nitrates
- D. Antihistamines
Correct Answer: D
Rationale: Antihistamines and over-the-counter cold medications should be avoided in clients with BPH due to the increase in urinary retention properties. Muscle relaxers are commonly prescribed for treatment of urinary retention. Nitrates and antihypertensive medications do not cause significant risk in the management of BPH.
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.