Nokea
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.
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A hydrocele is suspected in a client with scrotal edema. Which assessment technique would the nurse anticipate to be done first?
- A. Transillumination of the scrotum
- B. Palpate for presence of testicle
- C. Examine for soft tissue swelling
- D. Assess for collection of blood in the scrotum
Correct Answer: A
Rationale: Transillumination, shining a light through the scrotum, will determine if the swelling in the scrotum is caused by serous fluid versus a solid mass. Palpation for testicle is not indicated with a hydrocele. Soft-tissue swelling and/or collection of blood in the scrotum is not indicated with hydrocele.
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 prostatitis presents with low back pain, dysuria, and unusual sensation following ejaculation. Which treatment(s) does the nurse anticipate being prescribed? Select all that apply.
- A. Analgesics
- B. Sitz bath
- C. Antibiotics
- D. Abstinence
- E. Treatment of sexual partner
Correct Answer: A,B,C,E
Rationale: Prostatitis is an inflammation of the prostate gland that is most often caused by microorganisms. Treatment consists of up to 30 days of antibiotic therapy, mild analgesics, and sitz bath. Sexual partners also need to be treated. Regular drainage of the prostate gland through masturbation or intercourse can be helpful in decreasing the inflammation and discomfort.
Which nursing assessment finding is most significant in determining the plan of care in a client with erectile dysfunction?
- A. Age
- B. Medication use
- C. Sexual history
- D. Undescended testicle
Correct Answer: B
Rationale: Certain medications such as antihypertensive drugs, antidepressants, narcotics, etc. can cause sexual dysfunction in men. Impotence is not a normal part of aging. Undescended testicle is not indicative of ED. Sexual history is not indicative of ED.
The nurse is caring for a client with benign prostatic hyperplasia (BPH). Which assessment finding provides the best indication of urinary retention?
- A. Frequency
- B. Urgency
- C. Hesitancy
- D. Dribbling
Correct Answer: A
Rationale: As residual urine accumulates, the client has an urge to void more often. Urgency, hesitancy, and dribbling are all urinary symptoms associated with BPH but not specific to urinary retention.