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Reproductive 4 – Flashcards

Patricia Smith

7 July 2022

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question

Which sexually transmitted infection (STI) would warrant a cesarean delivery? 1 Genital warts 2 Syphilis 3 Gonorrhea 4 Active herpes

answer

4 Active herpes

question

The health care provider advises expedited partner therapy (EPT) to a patient with a sexually transmitted infection (STI). What should the nurse explain to this patient about EPT? 1 The patient should cut off all ties with the partner because the patient will become reinfected. 2 Prescription or medications can be given to the patient's partner; no examination is required. 3 The partner of the concerned patient will be examined and will be advised if treatment is needed. 4 The partner of the patient will be given a vaccine to prevent transmission of the sexually transmitted infection.

answer

2 Prescription or medications can be given to the patient's partner; no examination is required. EPT enables the health care provider to give a prescription or medication to the patient's partner without examining the partner. EPT has been found to be useful in ensuring partner treatment among men and reducing repeat infections among women. It is a safe, effective tool for treating STIs. It is not necessary to cut off ties with the partner. The partner is not examined. There are no preventive vaccines for STIs (except for Gardasil, which protects against HPV only). Text Reference - p. 1272

question

A patient with neurosyphilis is being discharged after treatment. What follow-up care should the nurse advise for the patient? Select all that apply. 1 Periodic serologic testing 2 Clinical evaluation at six-month intervals 3 Periodic cerebrospinal fluid examinations for at least three years 4 Continued use of oral acyclovir 5 Viral cultures of active lesions

answer

1 Periodic serologic testing 2 Clinical evaluation at six-month intervals 3 Periodic cerebrospinal fluid examinations for at least three years

question

A patient comes to the clinic complaining of difficulty urinating, flu-like symptoms, genital tingling, and blister-like vesicles on the upper thigh and vagina for the first time. Which medication does the nurse anticipate the primary health care provider will prescribe? 1 Acyclovir 2 Ceftriaxone 3 Azithromycin 4 Penicillin G

answer

1 Acyclovir

question

Which diagnostic test is used to screen a patient for syphilis? 1 Rapid plasma region test 2 Human papillomavirus DNA tests 3 Treponema pallidum particle agglutination test 4 Fluorescent treponemal antibody absorption test

answer

Correct1 Rapid plasma region test

question

A patient suspected of neurosyphilis underwent cerebrospinal fluid (CSF) analysis. What changes in the CSF indicate neurosyphilis? Select all that apply. 1 Increased sugar levels 2 Increased white blood cell count 3 Increased total proteins 4 A positive treponemal antibody test 5 Increased creatinine levels

answer

2 Increased white blood cell count 3 Increased total proteins 4 A positive treponemal antibody test

question

A nurse is collecting data from a patient with a suspected sexually transmitted infection (STI). What questions about lifestyle patterns should a nurse include to assess high risk behavior? Select all that apply. 1 Illicit use of intravenous drugs 2 Method of contraception used 3 Sexual preference 4 Diet and exercise regimen 5 Number of sexual partners 6 Smoking and alcohol consumption

answer

1 Illicit use of intravenous drugs 2 Method of contraception used 3 Sexual preference 5 Number of sexual partners

question

Factors that contribute to incidents of sexually transmitted infection (STI) include which of the following? Select all that apply. 1 Monogamous relationship 2 Multiple sex partners 3 Alternative lifestyles 4 Use of oral contraceptives 5 Alcohol and substance usage 6 Use of barrier methods of birth control

answer

2 Multiple sex partners 3 Alternative lifestyles 4 Use of oral contraceptives 5 Alcohol and substance usage

question

What should teaching for patients with a sexually transmitted infection (STI) include? Select all that apply. 1 Treatment of sexual partners 2 Douching may help to provide relief of itching 3 Cotton undergarments are preferred over synthetic materials 4 Sexual abstinence is indicated during the communicable phase of the disease 5 Condoms should be used during, as well as after, treatment during sexual activity

answer

1 Treatment of sexual partners 3 Cotton undergarments are preferred over synthetic materials 4 Sexual abstinence is indicated during the communicable phase of the disease 5 Condoms should be used during, as well as after, treatment during sexual activity Teaching for patients with an STI should include the treatment of all sexual partners. Cotton undergarments are more comfortable, sexual abstinence is needed during the communicable phase of the infection to prevent spread, and condoms should be used for sexual activity during and after treatment to prevent spread and reinfection. Douching may spread the infection or alter the local immune responses, and therefore is contraindicated in patients with STIs. Text Reference - p. 1272

question

A patient suspected of having syphilis tests positive on the Venereal Disease Research Laboratory (VDRL) test. Which other diseases can give false-positive results when testing for syphilis? Select all that apply. 1 Hepatitis 2 Hyperlipidemia 3 Infectious mononucleosis 4 Systemic lupus erythematosus 5 Type 2 diabetes mellitus

answer

1 Hepatitis 3 Infectious mononucleosis 4 Systemic lupus erythematosus

question

When performing a physical examination of a patient with herpes simplex virus (HSV) type 1, which body parts would the nurse find to be affected? Select all that apply. 1 Gingiva 2 Upper respiratory tract 3 Central nervous system 4 Genital tract 5 Perineum

answer

1 Gingiva 2 Upper respiratory tract 3 Central nervous system Two strains of HSV cause infection. In general, HSV type 1 causes infection above the waist, involving the gingivae, the dermis, the upper respiratory tract, and the central nervous system. HSV type 2 most frequently infects the genital tract and the perineum (that is, locations below the waist). However, either strain can cause infection in the mouth or the genitalia. Text Reference - p. 1268

question

A patient is on intravenous acyclovir for management of genital herpes-related pneumonitis. For which symptoms should the nurse look in this patient? Select all that apply. 1 Disorientation 2 Loss of sense of taste 3 Elevated creatinine levels 4 Decreased urinary output 5 Peripheral edema, especially in the feet

answer

3 Elevated creatinine levels 4 Decreased urinary output 5 Peripheral edema, especially in the feet Elevated creatinine levels are indicative of kidney damage. Urinary output gives an idea of the kidney function. Edema is also one presenting symptom of underlying kidney damage. High intravenous doses of acyclovir can lead to nephrotoxicity. Disorientation is not directly a symptom of nephrotoxicity. Nephrotoxicity does not present with a loss of sense of taste. Text Reference - p. 1269

question

Sexually transmitted infections that must be reported to state or local health departments include which of the following? Select all that apply. 1 Syphilis 2 Gonorrhea 3 Herpes simplex virus (HSV) 4 Human papilloma virus (HPV) 5 Condylomata acuminate

answer

1 Syphilis 2 Gonorrhea

question

A patient with genital warts is treated with podophyllin. What should the nurse monitor to detect toxic effects? Select all that apply. 1 Respiratory function 2 Leukopenia (low white blood cell count) 3 Increased urinary output 4 Dizziness 5 Numbness of the extremities

answer

1 Respiratory function 2 Leukopenia (low white blood cell count) 4 Dizziness Podophyllin resin is a cytotoxic agent used in treating small external genital warts. It can cause systemic toxic side effects such as respiratory distress, leukopenia, dizziness, and nausea. Urinary output is generally not affected by podophyllin. Podophyllin does not affect the nervous system or cause numbness of the extremities. Text Reference - p. 1269

question

A parent is deciding whether to allow an adolescent child to receive the Gardasil vaccine. Information to provide should include which of the following? Select all that apply. 1 The vaccine provides protection against certain types of cancer 2 Often persons with human papillomavirus (HPV) are asymptomatic 3 The vaccine protects against HPV types 6, 11, 16, 18 4 One dose of the vaccine protects against HPV 5 The vaccine is used to treat active infections 6 It is recommended because one does not know if one's child is sexually active

answer

1 The vaccine provides protection against certain types of cancer 2 Often persons with human papillomavirus (HPV) are asymptomatic 3 The vaccine protects against HPV types 6, 11, 16, 18

question

A patient with genital herpes complains of severe pain and a burning sensation during urination. What are the measures that a nurse can implement to ease this discomfort? Select all that apply. 1 Catheterize the patient. 2 Give frequent sitz baths to sooth the area. 3 Advise the patient to void urine in a warm tub of water or a warm shower. 4 Keep the patient on a fluid-only diet and do not allow the patient to move about. 5 Use drying agents, such as colloidal oatmeal and aluminum salts, and local anesthetics, such as lidocaine.

answer

2 Give frequent sitz baths to sooth the area. 3 Advise the patient to void urine in a warm tub of water or a warm shower. 5 Use drying agents, such as colloidal oatmeal and aluminum salts, and local anesthetics, such as lidocaine.

question

The nurse is counseling a patient with genital warts about treatment options. Which treatment options are patient-managed? Select all that apply. 1 80% to 90% trichloroacetic acid 2 Podophyllin resin (10% to 25%) 3 Podofilox (5%) liquid 4 Podofilox (5%) 5 Imiquimod (5%) cream

answer

3 Podofilox (5%) liquid 4 Podofilox (5%) 5 Imiquimod (5%) cream

question

A patient is diagnosed with genital herpes infection. What symptoms assessed in the patient should be reported immediately? Select all that apply. 1 Diarrhea 2 Constipation 3 Atonic bladder 4 Disorientation or confusion 5 Burning sensation in the vesicles

answer

2 Constipation 3 Atonic bladder 4 Disorientation or confusion Genital herpes can lead to lower motor neuron damage. This motor damage clinically presents as atonic bladder. It can also cause disorientation and confusion, because the central nervous system is affected. Constipation can also be seen due to neuron damage. Genital herpes does not cause diarrhea. A burning sensation in the vesicles is a common symptom in genital herpes and therefore does not indicate a serious complication. Text Reference - p. 1268

question

A woman with gonorrhea delivers a baby. What precautions should the nurse follow to protect the baby from complications of gonorrhea? Select all that apply. 1 Administer paracetamol drops to the baby. 2 Administer amoxicillin solution to the baby. 3 Administer silver nitrate aqueous solution to the baby. 4 Administer erythromycin ophthalmic ointment to the baby. 5 Administer an intramuscular dose of ceftriaxone to the baby.

answer

3 Administer silver nitrate aqueous solution to the baby. 4 Administer erythromycin ophthalmic ointment to the baby.

question

When teaching patients about the side effects of erectile dysfunction treatment, which instructions should the nurse include in the teaching? Select all that apply. 1 Side effects like constipation and weight loss can occur. 2 Side effects like headache, dyspepsia, and flushing can occur. 3 Rare side effects like confusion and redness of eyes can occur. 4 Rare side effects like visual disturbances and hearing loss can occur. 5 Patients should immediately seek medical attention in case of priapism.

answer

2 4 5 Side effects include headaches, dyspepsia, flushing, and nasal congestion. Rare side effects like blurred or blue-green visual disturbances and sudden hearing loss may also occur. Some patients may also experience an erection lasting more than four hours that does not go away, commonly known as priapism. The nurse should advise the patient to seek immediate medical attention if any of these rare reactions occur. Constipation, weight loss, confusion and redness of the eye are not side effects of the treatment of erectile dysfunction. Text Reference - p. 1328

question

A patient is experiencing hot flashes, loss of libido, gynecomastia, and erectile dysfunction. What androgen deprivation therapy medication should the nurse educate the patient about? 1 Goserelin 2 Sildenafil 3 Degarelix 4 Abiraterone

answer

1 Goserelin is an androgen synthesis inhibitor, which is used in the treatment of prostate cancer. It causes side effects of hot flashes, libido, gynocomastia, and erectile dysfunction. Sildenafil has side effects such as dyspepsia, flushing, nasal congestion, and abnormal erection lasting for more than four hours. Degarelix has side effects such as pain, redness, swelling at the injection site, and elevated liver enzymes. Abiraterone has side effects such as joint swelling, fluid retention, and muscle discomfort. Text Reference - p. 1319

question

When teaching a patient with testicular cancer about possible treatment options and their corresponding effects on sexual function, which should the nurse discuss with the patient? Select all that apply. 1 Testicular cancer treatment involves high risk of infertility. 2 Testicular cancer treatment can actually enhance fertility. 3 Consider cryopreservation of sperm in a sperm bank before treatment. 4 Sexual function will be as normal as before the treatment for all patients. 5 Retroperitoneal lymph node dissection can result in ejaculatory dysfunction.

answer

1 3 5 Males with a history of undescended testicles (cryptorchidism) are at greatest risk for testicular cancer. The other answer options—pain and dysuria as early symptoms, testicular cancer as the most common cancer in men older than 50, and the incidence of testicular cancer in African American versus white men—are all incorrect statements. Text Reference - p. 1325 In treatment of testicular cancer, chemotherapy with cisplatin and/or pelvic irradiation often damages the testicular germ cells and hence involves high risk for infertility. The cryopreservation of sperm in a sperm bank before treatment begins should be discussed and recommended. The retroperitoneal lymph node dissection can result in ejaculatory dysfunction. Testicular cancer treatment can lead to infertility and impaired sexual function. Text Reference - p. 1326

question

answer

2 3 4 5 Multiple sex partners contribute to increased incidents of sexually transmitted infection by providing more opportunity for exposure to disease. Alternative lifestyles, such as homosexuality or bisexuality, have an increased risk for syphilis and human immunodeficiency virus (HIV). Use of oral contraceptives causes secretions of the vagina to be more alkaline and favorable for STIs. Alcohol and use of drugs affect judgment and lower inhibitions, which can lead to risky sexual behavior. Monogamous relationships in which partners are exclusive with each other limit the possibility of exposure to STIs, as does correct use of barrier methods of birth control, such as the male or female condom. Text Reference - p. 1270

question

A pregnant woman with a sexually transmitted infection (STI) is admitted for delivery. Which STIs would support the need for a cesarean delivery? Select all that apply. 1 Chlamydial infection 2 Genital warts blocking the cervix 3 Active lesions of genital herpes 4 Syphilis 5 Gonorrheal infection with purulent discharge from the cervix

answer

2 3 Genital warts blocking the cervix will create complications in delivery, so they are an indication for cesarean delivery. Similarly, to prevent complications to the fetus, active genital herpes lesions are also an indication for a cesarean section. During chlamydial infection, syphilis infection, or gonorrheal infection, there is no contraindication to normal delivery. Text Reference - p. 1268

question

A nurse is screening a person for syphilis. What are the behavior patterns that contribute to an increased risk for developing syphilis? Select all that apply. 1 Consumption of polluted water in an area with a high incidence of syphilis 2 Sexual intercourse with an infected person 3 Sharing of intravenous needles for drugs 4 Consumption of food prepared by a person who has syphilis 5 Contact with lesions of a person with syphilis

answer

2 3 5 Syphilis is a sexually transmitted infection. Syphilis spreads during sexual intercourse with an infected person. Syphilis is also transmitted by sharing of intravenous needles and by close contact with infectious lesions. It is not spread by consumption of water or food, so there is no risk based on who does the food preparation. Text Reference - p. 1264

question

When teaching patients with prostate cancer about brachytherapy, which information should the nurse include? Select all that apply. 1 Brachytherapy is a one-time outpatient procedure. 2 Brachytherapy can cause damage to the bladder and rectum. 3 Brachytherapy has side effects that include urinary irritative or obstructive problems. 4 Brachytherapy is best suited for patients with early stage disease. 5 Brachytherapy is advantageous because it preserves erectile function.

answer

1 3 4 Brachytherapy is a one-time outpatient procedure, and the side effects include urinary irritative or obstructive problems. Brachytherapy is best suited for patients with early stage disease, because the procedure involves placing radioactive seed implants into the prostate gland, allowing higher radiation doses directly in the tissue while sparing the surrounding tissue. Brachytherapy is specifically designed to protect surrounding tissues such as the bladder and rectum. The procedure can, however, cause erectile dysfunction. Text Reference - p. 1318

question

The nurse is performing the physical examination of a patient with benign prostatic hyperplasia (BPH). Which finding is likely to be noted on palpation by digital rectal examination (DRE)? 1 The prostate is symmetrical, movable, and hard. 2 The prostate is asymmetrically enlarged and uneven. Correct 3 The prostate is symmetrically enlarged, firm, and smooth. 4 The prostate is asymmetrically enlarged, movable, and hard.

answer

3 The prostate can be palpated by DRE to estimate its size, symmetry, and consistency. In BPH, the prostate is symmetrically enlarged, firm, and smooth. If the prostate is symmetrical, movable, or hard, this does not indicate BPH. An asymmetrical, enlarged, moveable, hard, and uneven prostate is not indicative of BPH. Text Reference - p. 1309

question

Which task can the nurse delegate to unlicensed assistive personnel (UAP) in the care of a patient who recently has undergone prostatectomy? 1 Assessing the patient's incision 2 Irrigating the patient's Foley catheter 3 Assessing the patient's pain and selecting analgesia 4 Performing cleansing of the meatus and perineal region

answer

4 Performing perineal care is an appropriate task for delegation. Selecting analgesia, irrigating the patient's catheter, and assessing his incision are not appropriate skills or tasks for unlicensed personnel. Text Reference - p. 1320

question

Which clinical manifestation of prostate enlargement would the nurse consider when assessing a patient for benign prostatic hyperplasia (BPH)? 1 The onset of symptoms is sudden. 2 The symptoms are immediately noticed. 3 Manifestations are associated with respiratory tract symptoms. 4 Manifestations are associated with lower urinary tract symptoms.

answer

4 Manifestations of BPH are mainly associated with symptoms of the lower urinary tract. The symptoms are not sudden and are usually gradual in onset, and may not be noticed until prostatic enlargement has been present for some time because the bladder can compensate for a small amount of resistance to urine flow. Respiratory tract symptoms are not associated with BPH. Text Reference - p. 1308

question

A patient is one day postoperative following a transurethral resection of the prostate (TURP). Which event is not an expected normal finding in the care of this patient? 1 The patient requires two tablets of acetaminophen #3 during the night. 2 The patient complains of fatigue and claims to have minimal appetite. 3 The patient has continuous bladder irrigation (CBI) infusing, but output has decreased. 4 The patient has expressed anxiety about his planned discharge home the following day.

answer

3 A decrease or cessation of output in a patient with CBI requires immediate intervention. The nurse temporarily should stop the CBI and attempt to resume output by repositioning the patient or irrigating the catheter. Complaints of pain, fatigue, and low appetite at this early postoperative stage are not unexpected. Discharge planning should be addressed, but this should not precede management of the patient's CBI. Text Reference - p. 1313

question

A patient with prostatic hyperplasia presents with obstructive symptoms. What instructions should the nurse give to this patient to relieve the symptoms? Select all that apply. 1 Reduce fluid intake. 2 Urinate every two to three hours. 3 Maintain adequate fluid intake. 4 Rapidly increase fluid intake. 5 Urinate when experiencing the first urge to void.

answer

2, 3, 5 A patient with obstructive symptoms should be advised to urinate every two to three hours, and fluid intake should be maintained at a normal level to avoid dehydration or fluid overload. When the patient experiences the first urge to void, to minimize urinary stasis and acute urinary retention, the patient should urinate immediately. If fluid intake is reduced, it can increase the chances of an infection, and if the patient increases his intake too rapidly, bladder distention can develop because of the prostatic obstruction. STUDY TIP: Laughter is a great stress reliever. Watching a short program that makes you laugh, reading something funny, or sharing humor with friends helps decrease stress. Text Reference - p. 1313

question

The nurse is educating a patient about the treatment of prostate cancer to decrease the prostate specific antigen (PSA) levels. Which medication will the nurse discuss with the patient? 1 Acetonide 2 Finasteride 3 Alprostadil 4 Papaverine

answer

2 PSA levels are used in the diagnosis of prostate cancer. Finasteride, which is used in the treatment of prostate cancer, decreases PSA levels. Therefore, the nurse suspects that the patient is on finasteride therapy. Acetonide is prescribed to increase testosterone levels. Alprostadil is a vasoactive drug that enhances blood flow into the arteries. Papaverine enhances blood flow into the penile arteries. Text Reference - p. 1316

question

A male patient has human immunodeficiency virus (HIV) infection. When educating the patient regarding risk factors for the development of opportunistic diseases, what should the nurse include in the education? 1 Varicocele 2 Prostate cancer 3 Testicular cancer 4 Benign prostatic hyperplasia (BPH)

answer

3 HIV infection is one of the predisposing factors for testicular cancer. Varicocele is caused by exposure to trauma. Prostate cancer occurs in patients older than 65 years. Smoking, alcohol consumption, and erectile dysfunction are risk factors of BPH. Text Reference - p. 1325

question

The nurse is performing a testicular examination and notes that the scrotum feels wormlike when palpated. Based on this finding, which diagnosis does the nurse anticipate? 1 Hydrocele 2 Varicocele 3 Epididymitis 4 Spermatocele

answer

2 Varicocele is a condition in which the veins that drain the testes are dilated and the scrotum feels wormlike when palpated. Hydrocele is a nontender, fluid-filled mass caused by swelling of the tunica vaginalis that surrounds the testes. Epididymitis is an acute, painful inflammatory process of the epididymis caused by infection, trauma, or urinary reflux down the ductus (vas) deferens. Spermatocele is a firm, sperm-containing, painless cyst of the epididymis. Text Reference - p. 1324

question

A patient reports an inability to attain erection and the health care provider suspects a change in axial rigidity. For which diagnostic test will the nurse prepare the patient that is beneficial for diagnosis? 1 Digital rectal examination 2 Magnetic resonance imaging 3 Nocturnal penile tumescence 4 Duplex Doppler ultrasound study

answer

3 Inability to maintain an erection is a clinical manifestation of erectile dysfunction (ED). A change in penile circumference and axial rigidity can be measured by nocturnal penile tumescence. It can differentiate between physiologic and psychogenic causes of ED. Digital rectal examination is performed to assess the prostate size, consistency, and the presence of nodules. Magnetic resonance imaging is used to diagnose the location and extent of the spread of prostate cancer. A duplex Doppler ultrasound study is performed to assess blood flow in the testicle. Text Reference - p. 1328

question

A patient presents with an acute inflammation of the testes, and the nurse suspects orchitis. When taking medical history, about which conditions should the nurse inquire to find the possible cause of orchitis? Select all that apply. 1 Mumps 2 Asthma 3 Syphilis 4 Sinusitis 5 Tuberculosis

answer

1, 3, 5 Orchitis generally occurs after an episode of bacterial or viral infections such as mumps, syphilis, pneumonia, or tuberculosis. It can also be a side effect of epididymitis, prostatectomy, trauma, infectious mononucleosis, influenza, catheterization, or complicated urinary tract infection (UTI). Asthma and sinusitis are not related to orchitis. Text Reference - p. 1324

question

A patient presents with a painless lump in the scrotum, dull pain in the lower abdomen, scrotal swelling, and a feeling of heaviness in the scrotum. Which diagnostic study does the nurse prepare the patient for to diagnose the problem? 1 Ultrasound 2 Vascular study 3 Digital rectal examination 4 Computed tomography (CT)

answer

1 A painless lump in the scrotum, dull pain in the lower abdomen, swelling of the scrotum, and a feeling of heaviness are clinical manifestations of testicular cancer. An ultrasound is used in the diagnosis of testicular cancer. A vascular study is used to assess penile blood inflow and outflow. Digital rectal examination is performed to estimate the size, symmetry, and consistency of prostate cancer cells. CT is used to determine the location and extent of the spread of prostate cancer. Text Reference - p. 1325

question

Which statement made by the student nurse indicates the need for further teaching about the medications for benign prostatic hyperplasia (BPH)? 1 "Alpha-blockers improve urine flow." 2 "Alpha-blockers reduce the size of the prostate." 3 "Tamsulosin is a typical example of alpha-blocker." 4 "Alpha-blockers are commonly used in the treatment of hypertension."

answer

2 Alpha-blockers helps in relaxing the smooth muscles of the prostate, but do not help in reducing the size of the prostate. Alpha-blockers relax the muscles in the neck of the bladder, which in turn improves the urine flow. Tamsulosin is an alpha-blocker used in the treatment of BPH. Alpha-blocker drugs are commonly used in the treatment of hypertension, to reduce the blood pressure. Text Reference - p. 1310

question

A patient has been diagnosed with benign prostatic hyperplasia (BPH). About which medication will the nurse educate the patient that will help reduce the size of the prostate gland? 1 Goserelin 2 Degarelix 3 Acetonide 4 Dutasteride

answer

4 Dutasteride reduces the size of the prostate gland by blocking 5?-reductase inhibitors, which are necessary for the conversion of testosterone to dihydroxytryptamine (DHT). Goserelin and degarelix are used in the treatment of prostate cancer. Acetonide is prescribed to increase serum testosterone levels. Text Reference - p. 1309

question

A male patient presents with nocturia, bladder pain, incontinence, and urinary frequency and is found to have bacteria and white blood cells in the urine. What may be predisposing factors in this patient? Select all that apply. 1 Orchitis 2 Obesity 3 Hypertension 4 Atherosclerosis 5 Erectile dysfunction

answer

2, 5 Nocturia, bladder pain, incontinence, and urinary frequency are the clinical manifestations of benign prostatic hyperplasia (BPH). It can be identified by the presence of bacteria and white blood cells in the urine. Obesity and erectile dysfunction are predisposing factors for developing BPH. Orchitis is a risk factor for testicular cancer. Hypertension and atherosclerosis are risk factors for erectile dysfunction. Text Reference - p. 1308

question

A male patient is infertile after having mumps as a child. Which disorder should the nurse inform the patient might occur related to the infertility? 1 Varicocele 2 Prostate cancer 3 Chronic prostatitis 4 Erectile dysfunction

answer

1 Varicocele is most likely to occur due to male infertility. Prostate cancer does not occur due to male infertility. Chronic prostatitis can predispose the patient to urinary tract infections. Anxiety, obesity, hypertension, and renal failure are risk factors for erectile dysfunction. Text Reference - p. 1330

question

The nurse is providing care to a patient with benign prostatic hyperplasia. When planning the patient's care, which treatment technique does the nurse anticipate because it is the least invasive? 1 Open prostatectomy 2 Transurethral needle ablation 3 Transurethral incision of the prostate 4 Transurethral resection of the prostate

answer

2 Transurethral needle ablation is a minimally invasive method in which the temperature of the prostate tissue is increased by the emission of low-wave radiofrequency, thus causing localized necrosis of the prostate tissue. Open prostatectomy is an invasive procedure that involves an external incision. Transurethral incision of the prostate is an invasive procedure performed under local anesthesia in men with a slightly or moderately enlarged prostate gland. It relieves pressure on the urethra and improves urine flow. Transurethral resection of the prostate is a surgical procedure that involves the removal of prostate tissue using a resectoscope inserted through the urethra. Text Reference - p. 1311

question

A patient presents with a sudden and painful inability to urinate. Which is a priority nursing action to manage acute urinary retention? 1 Place the patient on bed rest. 2 Advise follow-up after two days. 3 Insert a catheter to drain the bladder. 4 Administer antibiotics and IV fluids.

answer

3 Acute urinary retention is a complication of urinary obstruction that is manifested by sudden and painful inability to urinate. The most appropriate action is to insert a catheter to drain the bladder. Placing the patient on bed rest, advising follow-up after two days, and administering antibiotics and IV fluids are not advisable at this stage. Text Reference - p. 1308

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A patient presents with symptoms of benign prostatic hyperplasia (BPH). Which symptom should the nurse record as a symptom related to obstruction? 1 Incontinence 2 Bladder pain 3 Urinary frequency 4 Difficulty in initiating voiding

answer

4 Difficulty in initiating voiding is an obstructive symptom of BPH, which occurs due to urinary retention. Incontinence, bladder pain, and urinary frequency are irritative symptoms of BPH. Text Reference - p. 1308

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What instructions should the nurse tell a patient regarding the management of urinary incontinence after prostate surgery? Select all that apply. 1 Limit fluid intake. 2 Drink citrus juices. 3 Perform Kegel exercise. 4 Avoid caffeine products. 5 Avoid alcohol consumption.

answer

3 Perform Kegel exercise. 4 Avoid caffeine products. 5 Avoid alcohol consumption

question

Which medication is administered to a patient with benign prostatic hyperplasia associated with erectile dysfunction? 1 Tadalafil 2 Ibuprofen 3 Bleomycin 4 Carbenicillin

answer

1 Tadalafil

question

The treatment plan for a patient diagnosed with benign prostatic hyperplasia (BPH) includes taking finasteride. When teaching the patient about this drug, which instructions should the nurse include as essential information? Select all that apply. 1 The drug takes about six months to be effective. 2 The drug should be taken for a short time. 3 The drug can be taken intermittently with good results. 4 Serum PSA levels are decreased during this drug therapy. 5 The drug should be taken continuously to maintain results

answer

1 The drug takes about six months to be effective 4 Serum PSA levels are decreased during this drug therapy. 5 The drug should be taken continuously to maintain results

question

Which treatment is recommended for a patient who has symptomatic bone metastases? 1 Avanafil 2 Carbachol 3 Alprostadil 4 Radium-223 dichloride

answer

4 Radium-223 dichloride Leakage of cancerous cells from a primary tumor that deposit on a bone results in symptomatic bone metastases. Radium-223 dichloride is an alpha particle-emitting radiotherapy drug that mimics calcium and forms complexes with hydroxyapatite at areas of increased bone turnover. Thus, this drug is recommended for patients with symptomatic bone metastases. Avanafil is used to treat erectile dysfunction. Carbachol is used to treat prostatitis. Alprostadil is a vasoactive drug. Text Reference - p. 1320

question

The nurse is teaching the patient about transurethral microwave thermotherapy (TUMT) prior to the procedure. Which instruction is most appropriate for the nurse to include? 1 This procedure is performed within 10 minutes. 2 This procedure is performed in young patients. 3 This procedure is appropriate for men with rectal problems. 4 This procedure is not appropriate for men with rectal problems

answer

4 This procedure is not appropriate for men with rectal problems In TUMT, a rectal temperature probe is used during the procedure to ensure that the temperature is kept below 110° F (43.5° C) to prevent rectal tissue damage, so this procedure is not appropriate for men with rectal problems. The procedure takes about 90 minutes. The age of the patient is not relevant. Text Reference - p. 1310

question

To accurately monitor progression of a decreased urinary stream, the nurse should encourage the patient to have which primary screening measure done on a regular basis? 1 Uroflowmetry 2 Transrectal ultrasound 3 Digital rectal examination (DRE) 4 Prostate specific antigen (PSA) monitoring

answer

3 Digital rectal examination (DRE) Digital rectal examination is part of a regular physical examination and is a primary means of assessing decreased urinary stream, which often is caused by benign prostatic hyperplasia in men over 50 years of age. The uroflowmetry helps determine the extent of urethral blockage and the type of treatment needed, but is not done on a regular basis. Transrectal ultrasound is indicated with an abnormal DRE and elevated PSA to differentiate between benign prostatic hyperplasia (BPH) and prostate cancer. PSA monitoring is done to rule out prostate cancer, although levels may be elevated slightly in patients with BPH. Text Reference - p. 1309

question

The nurse is preparing education for a patient scheduled to begin radiation therapy and hormone manipulation for prostate cancer. What information is appropriate for the nurse to include? 1 Constipation is usually a problem; a high-fiber diet is recommended. 2 Sexual ability may be affected; discussion with the partner is recommended. 3 An intense daily exercise program will help prevent urinary dysfunction and fatigue. 4 Facial hair loss and a change in voice tone are expected side effects of hormone therapy

answer

2 Sexual ability may be affected; discussion with the partner is recommended. Sexual function is usually affected by radiation therapy and hormone manipulation for the treatment of prostate cancer. Therefore it is important for the nurse to suggest options to assist the patient and his partner in adapting and coping with the changes in sexual function that may become permanent. Constipation is usually not a problem with a patient undergoing radiation therapy for prostate cancer. Instead, these patients usually experience diarrhea. Radiation therapy will cause urinary dysfunction and fatigue. Intense exercise in these patients will likely worsen these symptoms. Facial hair loss and change in voice tone are not expected side effects of hormone therapy. Text Reference - p. 1318 Topics

question

While caring for a patient after a transurethral procedure, the nurse observes that the patient is showing signs of bladder spasms. Which medication does the nurse expect to be prescribed to the patient? 1 Buserelin 2 Triptorelin 3 Oxybutynin 4 Zoledronic acid

answer

3 Oxybutynin A transurethral procedure involves the insertion of a resectoscope; this tool can irritate the bladder mucosa and result in urinary bladder spasms. Oxybutynin reduces bladder spasms. Buserelin is used to treat prostate cancer. Triptorelin is recommended for prostate cancer treatment. Zoledronic acid reduces bone mineral loss. Text Reference - p. 1314

question

When compared with traditional approaches to prostatectomy, what advantages would the nurse consider regarding robotic-assisted radical prostatectomy? Select all that apply. 1 Better visualization during procedure 2 Increased precision during procedure 3 Increased length of bed rest after procedure 4 Less positive outcomes after procedure 5 Improved recovery time after procedure

answer

1 Better visualization during procedure 2 Increased precision during procedure 5 Improved recovery time after procedure

question

Which treatment is given to a patient with advanced hormone-refractory prostate cancer? 1 Alfuzosin 2 Cephalexin 3 Sipuleucel-T 4 Indomethacin

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3 Sipuleucel-T Sipuleucel-T vaccine stimulates the patient's immune system against cancer and prolongs survival. Alfuzosin reduces discomfort related to prostatitis. Cephalexin treats bacterial prostatitis. Indomethacin controls pain related to prostatitis. Text Reference - p. 1320

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The patient's report shows abnormal findings after a digital rectal examination and elevated prostate-specific antigen levels. Which examination should be recommended for the patient? 1 Cystoscopy 2 Transrectal ultrasound 3 White blood cell count 4 Computerized tomography scan

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2 Transrectal ultrasound Abnormal findings on a digital rectal examination and elevated prostate-specific antigen levels indicate both benign prostatic hyperplasia and prostate cancer. Thus, a transrectal ultrasound is necessary to determine which disease the patient has. A cystoscopy is performed in the patient who is scheduled for prostatectomy. The white blood cell count should be monitored when the patient has an infection. A computerized tomography scan is used to diagnose testicular cancer. Text Reference - p. 1309

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When explaining transurethral needle ablation (TUNA) as a treatment option to a patient, which common disadvantages of the procedure should the nurse include? Select all that apply. 1 Hematuria 2 Risk of erectile dysfunction 3 Urinary retention 4 Retrograde ejaculation 5 Irritative voiding symptoms

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1 3 5

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A nurse assesses a male patient who has numerous urinary symptoms. Which early signs of benign prostatic hypertrophy does the nurse recognize? Select all that apply. 1 Nocturia 2 Urinary frequency 3 Erectile dysfunction 4 Overflow incontinence 5 Reduced force of urinary stream 6 Difficulty in starting the flow of urine

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1,2,5,6 Because the prostate surrounds the urethra, enlargement interferes with voiding. Early symptoms include the urge to urinate often, some delay in starting urination, nocturia, and decreased force of the urinary stream. Later signs include increased difficulty in initiating a urinary stream and significantly reduced force of stream. Overflow incontinence and erectile dysfunction are not signs associated with benign prostatic hypertrophy. Text Reference - p. 1308

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When evaluating the criteria for open prostatectomy, which types of patients would the nurse identify as appropriate candidates? Select all that apply. 1 Men with large prostates 2 Men with low sperm counts 3 Men with bladder damage 4 Men without complicating factors 5 Men with benign prostatic hyperplasia (BPH)

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1 3 5 Men with large prostates, bladder damage, and other complicating factors can be chosen for open prostatectomy. Men with BPH are candidates for an open prostatectomy. A low sperm count is not an indication for an open prostatectomy. For men with small prostates and men with no other complicating factors, open prostatectomy is not indicated. Text Reference - p. 1311

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The nurse is providing care to a patient with a new diagnosis of benign prostatic hyperplasia. Which medication does the nurse anticipate will be prescribed by the primary care provider to facilitate urinary flow through the urethra by bringing about smooth muscle relaxation? 1 Tadalafil 2 Doxazocin 3 Dutasteride 4 Rye-grass pollen extract

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2 Doxazocin is an ?-adrenergic blocker that promotes smooth muscle relaxation and facilitates urinary flow through the urethra. It is often prescribed to treat benign prostatic hyperplasia. Rye-grass pollen extract is an herbal drug that has shown success in reducing the symptoms of benign prostatic hyperplasia; however, it is available over the counter and would not be prescribed. Tadalafil is used in men with benign prostatic hyperplasia with or without erectile dysfunction, because it reduces the symptoms of both conditions. Dutasteride is a dual inhibitor of 5?-reductase type 1 and type 2 isoenzymes. It inhibits the enzyme 5?-reductase and helps retard the growth of hyperplastic tissue by suppression of androgens. Text Reference - p. 1310

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When caring for a patient with prostate cancer who is receiving drug therapy with androgen receptor blockers, which side effects should the nurse observe for? Select all that apply. 1 Hot flushes 2 Loss of libido 3 Joint swelling 4 Muscle discomfort 5 Erectile dysfunction

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1 2 5

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An older adult patient complains of urinary urgency. What diagnostic findings may indicate benign prostatic hyperplasia (BPH)? Select all that apply. 1 Negative urinalysis and culture 2 Enlarged prostate, as observed on ultrasonography 3 Vesicle neck obstruction, as observed on cystoscopy 4 Elevated serum creatinine levels 5 Residual urine with postvoiding catheterization

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2 3 5

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When managing postoperative hemorrhage following transurethral resection of the prostate (TURP), which actions should the nurse perform to maintain patient safety during the initial postoperative period? Select all that apply. 1 Apply traction on the catheter. 2 Remove the catheter and observe. 3 Relieve the pressure of the traction on a scheduled basis. 4 Ask the patient to walk for prolonged periods. 5 Advise the patient to avoid straining during bowel movements.

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1 3 5 Applying traction on the catheter to provide counter pressure (tamponade) on the bleeding site helps to reduce bleeding. The pressure of the traction should be relieved on a scheduled basis to avoid local necrosis. The patient should be advised to avoid straining during bowel movements, because this can increase the intraabdominal pressure and can cause more bleeding. Removing the catheter and observing are not advisable, and the patient should not be encouraged to walk for prolonged periods, because this too increases the intraabdominal pressure. Text Reference - p. 1313

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When assessing a patient with benign prostatic hyperplasia (BPH), which diagnostic tests should the nurse anticipate performing to rule out related conditions? Select all that apply. 1 Hemoglobin levels 2 Serum uric acid levels 3 Urine analysis with culture 4 Serum creatinine levels 5 Prostate-specific antigen (PSA)

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3 4 5

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A patient will undergo a transurethral resection of the prostate (TURP). What preoperative care should the nurse perform? Select all that apply. 1 Treat any urinary infection with antibiotics. 2 Restore urinary drainage and maintain fluid intake. 3 Inform the patient that surgery may affect sexual function. 4 Ensure that bladder irrigation is done before the surgery. 5 Inform the patient that there will be no complications after surgery.

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1 2 3 Treating any urinary infection with antibiotics, restoring urinary drainage and maintaining fluid intake, and informing the patient that surgery may affect sexual function are actions that should be performed during the preoperative period. Bladder irrigation is done postoperatively and is not included in preoperative care. Informing the patient that there will be no complications after surgery is not appropriate, because the main complications that may occur after surgery are hemorrhage, bladder spasms, urinary incontinence, and infection. Text Reference - p. 1312

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1 3 4

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What appropriate actions should the nurse perform when managing a patient with acute prostatitis? Select all that apply. 1 Manage fever. 2 Decrease fluid intake. 3 Administer prescribed antibiotics. 4 Encourage patient to walk. 5 Perform prostatic massage.

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1 3 5

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What adverse effect does the nurse expect in a patient using leuprolide? 1 Diarrhea 2 Priapism 3 Gynecomastia 4 Erectile dysfunction

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The patient has a low-grade carcinoma on the left lateral aspect of the prostate gland and has been monitored for five years. Six months ago his last prostate-specific antigen (PSA) level was 5 ng/mL. Which manifestations now indicate that the prostate cancer may be growing and he needs a change in his care? Select all that apply. 1 Casts in his urine 2 Presence of ?-fetoprotein 3 Serum PSA level 10 ng/mL 4 Onset of erectile dysfunction 5 Nodularity of the prostate gland

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3 5

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Which treatment is most likely to be used for a patient who has nonmetastatic prostate cancer? 1 Paclitaxel 2 Cabazitaxel 3 Denosumab 4 Radium-223 dichloride

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The nurse is teaching measures to be followed by a patient who has acute bacterial prostatitis. During the follow-up visit, the nurse finds that the patient's condition has improved. What did the patient likely do in order for his condition to have improved? Select all that apply. 1 Drinking citrus juice 2 Drinking plenty of fluids 3 Doing prostate massage 4 Performing Kegel exercises 5 Taking doxycycline regularly

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2 3 5 Drinking plenty of fluids will help flush out bacteria from the urinary tract. Prostate massages will help drain the prostate and provide relief. Taking doxycycline helps treat infection. Patients with urinary incontinence should avoid citrus juices because they irritate the bladder. Kegel exercises are recommended for patients with urinary incontinence. Text Reference - p. 1322

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A patient is discharged with an indwelling catheter in place following prostate cancer surgery. What instructions should the nurse include when teaching the patient about catheter care? Select all that apply. 1 Maintain a high fluid intake. 2 Report bladder spasms, fever, and hematuria. 3 Attach the catheter to the waistband or pant leg. 4 Clean the urethral meatus with soap and water once a day. 5 Keep the collection bag higher than the bladder at all times

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1 2 4 The nurse should advise the patient to maintain a high fluid intake, to report bladder spasms, fever, and hematuria, to keep the catheter securely attached to the inner thigh or abdomen rather than to clothing, to clean the urethral meatus with soap and water once a day, and to keep the collecting bag lower, not higher, than the bladder at all times. Text Reference - p. 1321

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When explaining to a patient about the advantages of contact laser techniques over transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH), what information should the nurse include? Select all that apply. 1 The laser cauterizes blood vessels, so bleeding is minimal. 2 The contact laser techniques lead to shorter recovery times. 3 There is no need for a catheter after the surgery. 4 The contact laser technique can be performed on patients taking anticoagulants. 5 The laser does not directly touch the prostate, so there is less tissue damage

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1 2 4

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When explaining to a patient the use of laparoscopic techniques when performing a prostatectomy, which advantages should the nurse include? Select all that apply. 1 Less pain 2 Less bleeding 3 Faster recovery 4 Less risk of infection 5 Short hospital stay

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1 2 3 Laparoscopic approaches to prostatectomy involve making small incisions into the abdomen. This approach to prostatectomy results in less pain, less bleeding, and a faster recovery time compared to other approaches. Lower risk of infection and a short hospital stay are not necessarily indicated with laparoscopic techniques. Text Reference - p. 1317

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The nurse is assessing a patient with stage II prostate cancer. Which findings would the nurse expect to note? Select all that apply. 1 PSA level is 10-20. 2 Gleason score is 2. 3 Tumor is seen by imaging. 4 Tumor is confined to prostate. 5 Cancer has spread to seminal vesicles

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1 3 4 The possible findings that indicate stage II prostate cancer include a PSA level of 10 to 20, a tumor that is seen by imaging, and a tumor that is confined to the prostate. A Gleason score of 6 or less indicates stage I, not stage II prostate cancer. Cancer spreading to the seminal vesicles indicates stage III cancer. Text Reference - p. 1317

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When explaining treatment options for benign prostatic hyperplasia (PBH) to a patient, which options should the nurse consider as minimally invasive therapy? Select all that apply. 1 Laser prostatectomy 2 Open prostatectomy 3 Transurethral needle ablation (TUNA) 4 Transurethral resection of the prostate (TURP) 5 Transurethral microwave thermotherapy (TUMT)

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1 3 5

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When taking the medical history of a patient, which conditions should the nurse consider as risk factors for benign prostatic hyperplasia (BPH)? Select all that apply. 1 Aging 2 Vegetarian diet 3 Physical inactivity 4 Less fluid intake 5 Alcohol consumption

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1 3 5

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The nurse is reviewing the medication administration record for a patient with benign prostatic hypertrophy. Which medication inhibits of the synthesis of dihydroxytestosterone? 1 Saw palmetto 2 Tadalafil 3 Silodosin 4 Finasteride

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A patient who underwent bladder surgery three hours ago is receiving a continuous bladder irrigation (CBI). The nurse should increase the rate of the CBI for what type of return? 1 Absent 2 Slow 3 Yellow and cloudy 4 Dark red

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A patient presents with mild symptoms of benign prostatic hyperplasia (BPH). What should the nurse teach the patient to help minimize the symptoms? Select all that apply. 1 Implement a timed voiding schedule. 2 Use decongestants as needed. 3 Decrease caffeine consumption. 4 Restrict fluids in the evening. 5 Use artificial sweeteners in place of real sugar.

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1 3 4

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The nurse categorizes patients with prostatic problems as having moderate symptoms based on their American Urologic Association (AUA) scores. Which scores are considered to be moderate? Select all that apply. 1 3 2 9 3 12 4 18 5 22

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2 3 4

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A patient receives continuous bladder irrigation (CBI) after invasive prostate surgery. Which priority actions does a registered nurse (RN) perform? Select all that apply. 1 Record intake and output. 2 Clean around catheter daily. 3 Assess for bleeding and clots. 4 Discontinue CBI and notify the primary health care provider if obstruction occurs. 5 Provide care instructions for patients being discharged with an indwelling catheter

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3 4 5

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A patient reports to the hospital with a curved penis and a plaque formation in one of the corpora cavernosa. What condition does the nurse suspect from these findings? 1 Orchitis 2 Prostatitis 3 Paraphimosis 4 Peyronie's disease

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After a vasectomy, what teaching should be included in the discharge teaching? 1 "You will want to use an alternative form of contraception for six weeks." 2 "You may lose some secondary sexual characteristics after this surgery." 3 "You may have erectile dysfunction for several months after this surgery." 4 "You will be uncomfortable, but you may safely have sexual intercourse today."

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1 Because vasectomies usually are done for sterilization purposes, the patient will need to use an alternative form of contraception until semen examination reveals no sperm, which usually takes at least 10 ejaculations or six weeks, during which sperm distal to the surgical site are evacuated. Hormones are not affected, so there is no loss of secondary sexual characteristics or erectile function. Most men experience too much pain to have sexual intercourse on the day of their surgery, so this is not an appropriate comment by the nurse. Text Reference - p. 1326

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A male patient had an abnormal digital rectal exam (DRE) followed by an elevated prostate specific antigen (PSA). For what diagnostic study will the nurse prepare the patient after receiving these results? 1 Cystoscopy 2 Uroflowmetry 3 Transrectal ultrasound (TRUS) 4 Magnetic resonance imaging (MRI)

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The nurse is providing care to a patient with erectile dysfunction. Standard medications have been attempted with little success. Which highly invasive intervention that carries a high degree of risk might be considered for this patient? 1 Penile implant 2 Erectogenic drug 3 Intraurethral device 4 Vacuum constriction device

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The nurse is assessing a male patient and suspects paraphimosis. What physical finding causes the nurse to determine this? 1 Curved or crooked penis 2 Inflammation of the testis 3 Abnormal prolonged erection of the penis 4 Permanent retracted position of the foreskin behind the penis

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The nurse observes that a male child has the urethral meatus on the ventral surface of the penis. What condition does the nurse document this child has? 1 The child has orchitis. 2 The child has epididymitis. 3 The child has hypospadias. 4 The child has cryptorchidism.

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The nurse is preparing a male patient for therapy to treat castration-resistant prostate cancer. What therapy should the nurse educate the patient about? 1 Cryotherapy 2 Radiotherapy 3 Chemotherapy 4 Brachyotherapy

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A patient who has cardiovascular disease has now developed erectile dysfunction. He is frustrated, because he cannot take erectogenic medications because he takes nitrates for his cardiac disease. What should the nurse do first to help this patient? 1 Give the patient choices for penile implant surgery 2 Recommend counseling for the patient and his partner 3 Obtain a thorough sexual, health, and psychosocial history 4 Assess levels of testosterone, prolactin, luteinizing hormone (LH), and thyroid hormones

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33 The nurse's first action to help this patient is to obtain a thorough sexual, health, and psychosocial history. Alternative treatments for the cardiac disease then would be explored if that has not been done already. Further examination or diagnostic testing would be based on the history and physical assessment, including hormone levels, counseling, or penile implant options. Text Reference - p. 1327

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The nurse is educating a patient scheduled for a procedure to destroy or cut a portion of the prostate. About what procedure will the nurse educate the patient? 1 Laser prostatectomy 2 Intraprostatic urethral stents 3 Transurethral needle ablation (TUNA) 4 Transurethral microwave thermotherapy (TUMT)

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1 Laser prostatectomy procedure uses a laser beam to cut or destroy a part of the prostate with the help of different techniques such as visual laser ablation of the prostate, contact laser, and photovaporization of prostate. An intraprostatic urethral stent involves insertion of a self-expandable metallic stent into the urethra where there is an enlarged area of the prostate. TUNA uses low-wave radiofrequency to heat the prostate, causing necrosis. TUMT involves the use of microwave radiating heat to produce coagulative necrosis of the prostate. Text Reference - p. 1311

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A patient presents with a lump in the scrotum. Which findings would lead the nurse to suspect testicular cancer? Select all that apply. 1 Feeling of heaviness 2 Bloating in upper abdomen 3 Aching in lower abdomen 4 Feeling of nausea and vomiting 5 Nontender and firm scrotal mass

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1 3 5 The patient may have a feeling of heaviness. Some patients complain of a dull ache or heavy sensation in the lower abdomen, the perianal area, or the scrotum, and the scrotal mass is usually nontender and firm. Bloating in the upper abdomen and a feeling of nausea and vomiting are not directly related to testicular cancer. Text Reference - p. 1325

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The nurse is examining a patient diagnosed with varicocele. Which findings is the nurse likely to find in the patient? Select all that apply. 1 Patient is infertile. 2 Patient is a smoker. 3 Patient has gastritis. 4 On palpation, the scrotum feels wormlike. 5 Veins on left side of scrotum are dilated.

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1 4 5

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When explaining follow-up care after treatment of testicular cancer, what investigations should the nurse tell the patient to anticipate for detecting relapse? Select all that apply. 1 Chest x-ray 2 Semen analysis 3 Assessment of human chorionic gonadotropin (hCG) and alpha-fetoprotein (AFP) 4 Urine and stool examinations 5 Regular physical examinations

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1 3 5

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A patient is experiencing dribbling, dysuria, nocturia, and hesitancy and has elevated levels of the prostatic isoenzyme, serum acid phosphatase. For what procedure should the nurse prepare this patient? 1 Orchiectomy 2 Open prostatectomy 3 Transurethral incision of prostate (TURP) 4 Transurethral resection of prostate (TUIP)

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The nurse is conducting a health history interview for a patient diagnosed with benign prostatic hyperplasia (BPH). Which questions are appropriate while assessing the patient's cognitive-perceptual pattern? Select all that apply. 1 "Do you experience nocturia?" 2 "Do you have bladder discomfort?" 3 "Do you experience urinary retention?" 4 "Do you have a sensation of incomplete voiding?" 5 "Do you experience anxiety about sexual dysfunction?"

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2 4

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Which assessments should the nurse perform during primary screening of a patient with erectile dysfunction? Select all that apply. 1 PSA tests 2 Abdominal scans 3 Self-administered assessment 4 Treatment-related questionnaires 5 Sexual, health, and psychosocial history

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3 4 5 The nurse should use self-administered assessments and treatment-related questionnaires and perform a thorough sexual, health, and psychosocial history as primary screening tools. PSA tests and abdominal scans are not related to erectile-dysfunction screening. Text Reference - p. 1327

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The nurse is teaching a group of male patients with erectile dysfunction about surgical implants. Which information should the nurse include? Select all that apply. 1 Surgical penile implants are a noninvasive way to correct erectile dysfunction. 2 Surgical penile implants are associated with potential complications. 3 Surgical penile implants have a pump that is inserted into the base of the penis. 4 Surgical penile implants are usually indicated for men with severe erectile dysfunction. 5 Surgical penile implants are associated with problems such as mechanical failure, infection, and erosions.

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2 4 5

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A patient is suspected of having testicular cancer. Which diagnostic tests should the nurse anticipate for confirmation of the diagnosis and detection of metastasis? Select all that apply. 1 Chest x-ray 2 Gastric endoscopy 3 Ultrasound of the testes 4 Pulmonary function tests 5 CT-scan of abdomen and pelvis 6 Blood tests to detect tumor markers

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1 3 5 6 Whenever testicular cancer is suspected, a chest x-ray and CT scan of the abdomen and the pelvis are done to detect metastasis. Ultrasound of the testes is indicated to confirm the diagnosis. Blood tests to determine tumor markers like serum levels of alpha-fetoprotein (AFP), lactate dehydrogenase (LDH), and human chorionic gonadotropin (hCG) are advised. Gastric endoscopy and pulmonary function tests are not related and need not be advised in initial stages. Text Reference - p. 1325

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When treating testicular cancer patients with chemotherapy, for which side effects should the nurse observe? Select all that apply. 1 Bone pain 2 Nerve damage 3 Kidney damage 4 Septic shock 5 Pulmonary toxicity

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2 3 5 Some of the drugs used to treat testicular cancer can cause serious long-term side effects like nerve damage (which can cause numbness and tingling), kidney damage, pulmonary toxicity, and hearing loss (from nerve damage). Bone pain and septic shock have not been specified. Text Reference - p. 1326

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A male patient presents with severe scrotal pain, tenderness, swelling, nausea, and vomiting. Urinary symptoms, fever, and white blood cells (WBCs) or bacteria in the urine are absent. Which findings in the patient would indicate a testicular torsion? Select all that apply. 1 Scrotal pain reduces on elevation of the scrotum. 2 Cremasteric reflex is absent on the side of the swelling. 3 Cremasteric reflex is present on the side of the swelling. 4 Scrotal pain does not reduce on elevation of the scrotum. 5 Doppler ultrasound of the testes shows decreased blood flow.

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2 4 5 Testicular torsion is likely if the cremasteric reflex is absent on the side of the swelling, scrotal pain does not subside with rest or elevation of the scrotum, and the Doppler ultrasound shows decreased or absent blood flow. Cremasteric reflex is present as a normal response of contraction of the cremaster muscle, which pulls up the scrotum and testis on the side stroked. Text Reference - p. 1325

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The nurse is teaching a patient about the effects of a vasectomy. Which effects should the nurse discuss to best inform the patient? Select all that apply. 1 Vasectomy can affect the ability to ejaculate. 2 Vasectomy can affect the production of hormones. 3 Vasectomy does not affect the production of hormones. 4 Vasectomy does not affect the physiologic mechanisms related to erection or orgasm. 5 Psychologic adjustment may be a problem after the surgery.

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3 4 5

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A patient presents with chronic pelvic pain syndrome. What possible actions can the nurse take to reduce the patient's pain and discomfort? Select all that apply. 1 Give warm sitz bath. 2 Advise reduced fluid intake. 3 Administer tamsulosin as prescribed. 4 Advise walking for one hour daily. 5 Administer antiinflammatory medication.

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1 3 5 The nurse can help to decrease the pain by providing warm sitz baths. Tamsulosin can be administered as prescribed to relax muscle tissue of the prostate. In addition, antiinflammatory medication may be used to control pain. Advising reduced fluid intake and advising walking for one hour daily are not relevant. Text Reference - p. 1322

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When explaining treatment of testicular cancer to a patient, which treatment options should the nurse suggest as a part of collaborative care? Select all that apply. 1 No treatment at early stages 2 Radical orchiectomy in early stages 3 Retroperitoneal lymph node dissection 4 Radiation therapy for patients with a seminoma 5 Radiation therapy for patients with nonseminomas

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2 3 4

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When teaching patients about the use of the drug sildenafil, which instructions should the nurse include in the teaching? Select all that apply. 1 The drug may cause an erection lasting more than four hours. 2 The drug should only be taken once a day. 3 The drug is contraindicated in patients taking nitrates. 4 The drug should be taken three to four hours before sexual activity. 5 The drug should be taken 30 to 60 minutes before sexual activity.

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1 2 3 5

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When teaching a patient about testicular self-examination, which observations should the nurse identify as normal findings? Select all that apply. 1 The testes are pain free. 2 One testis may be larger than the other. 3 The testis feels lumpy and has irregularities. 4 The testis feels round and smooth. 5 Spermatic cord is firm, smooth, and goes up toward the groin

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1 2 4 During a testicular self-examination, the nurse should explain that pain-free testes, one testis larger than the other, and round, smooth testes are normal findings. The spermatic cord may be found firm, smooth, and going up toward the groin. If the testis feels lumpy or has irregularities, the health care provider should be notified. Text Reference - p. 1325

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The nurse is preparing a patient for a cystoscopy in order to remove prostate tissue. What procedure does the nurse anticipate the healthcare provider will use to treat this patient? 1 Laser prostatectomy 2 Intraprostatic urethral stents 3 Transurethral incision of prostate (TUIP) 4 Transurethral resection of prostate (TURP)

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A male patient presents with complaints of loss of libido, fatigue, and mood swings, and is diagnosed with andropause. What are the important points for the nurse to note when considering testosterone replacement therapy for this patient? Select all that apply. 1 The therapy can worsen sleep apnea. 2 Oral testosterone replacement therapy is preferred. 3 The treatment can lower high-density lipoprotein (HDL) cholesterol. 4 The therapy is indicated for patients with testosterone levels above 800 ng/dL. 5 The treatment is contraindicated for a patient with benign prostatic enlargement (BPH)

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1 3 5

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The nurse is caring for a patient with severe symptoms of benign prostatic hyperplasia (BPH). What might be the American Urological Association (AUA) symptom score? 1 1 2 7 3 15 4 25

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A patient is diagnosed with coronary artery disease and elevated serum triglyceride and cholesterol levels. The nurse finds that the patient is on androgen drug therapy. Which medications does the nurse suspect is the reason for the patient's condition? Select all that apply. 1 Buserelin 2 Cypionate 3 Enanthate 4 Vardenafil 5 Leuprolide

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1 5 Patients who are on androgen drug therapy are at increased risk of coronary artery disease and elevated serum triglyceride and cholesterol levels, which are side effects of buserelin and leuprolide. Cypionate and enanthate cause a cyclic rise and fall of serum testosterone levels, resulting in mood swings. Vardenafil is used to promote erectile function. Text Reference - p. 1319

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About which medications does the nurse educate the patient who presents with incontinence, nocturia, urgency, and intermittency and is also found to have excessive accumulation of dihydroxytestosterone (DHT) in the prostate cells? Select all that apply. 1 Terazosin 2 Vardenafil 3 Finasteride 4 Papaverine 5 Phentolamine

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1 3 Incontinence, nocturia, urgency, and intermittency are symptoms of benign prostatic hyperplasia (BPH). It is caused by excessive accumulation of DHT in the prostate cells. Terazosin and finasteride are used in the treatment of benign prostatic hyperplasia. Terazosin blocks alpha-adrenergic receptor and promotes smooth muscle relaxation in the prostate, thereby facilitating urinary flow in the urethra. Finasteride works by reducing the size of the prostate. Vardenafil is used to promote erectile function. Papaverine and phentolamine enhance the blood flow into penile arteries. Text Reference - p. 1310

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A patient presents with loss of libido, erectile dysfunction, fatigue, and mood swings and laboratory tests show that testosterone levels are 190 ng/dL. Which medications will the nurse educate the patient about that are beneficial to treat the patient's condition? Select all that apply. 1 Testim 2 Acetonide 3 Androderm 4 Dutasteride 5 Abiraterone

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1 2 3

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A patient presents with severe scrotal pain, nausea, and vomiting. For which diagnostic tests should the nurse prepare the patient? Select all that apply. 1 Nuclear scan 2 Doppler ultrasound 3 Transrectal ultrasound 4 Microscopic evaluation 5 Magnetic resonance imaging

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1 2 Severe scrotal pain, nausea, and vomiting are the clinical manifestations of testicular torsion. The twisting of the spermatic cord results in insufficient blood supply to the testes and epididymis. A nuclear scan and Doppler ultrasound are used to assess the blood flow within the testicle. Transrectal ultrasound is used in the diagnosis of prostatic cancer. Microscopic evaluation is used in the evaluation of prostatitis. Magnetic resonance imaging is used in the diagnosis of prostatic cancer. Text Reference - p. 1325

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The nurse finds that a patient has nocturia, bladder pain, and an enlarged prostate. The laboratory findings reveal a serum creatinine level at 1.7 mg/dL, white blood cell count at 18,000 per microliter, and prostate-specific antigen levels at 6.0 ng/mL. Which complication does the nurse expect in the patient? 1 Hypospadias 2 Peyronie's disease 3 Benign prostatic hyperplasia 4 Nonmetastatic prostate cancer

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3 Nocturia, bladder pain, and enlargement of the prostate are the symptoms of benign prostatic hyperplasia. Normal serum creatinine level in men is in the range of 0.7 to 1.3 mg/dL; a level of 1.7 mg/dL is abnormal. The normal white blood cell count is in the range of 4,500 to 10,000 per microliter; a count of 18,000 per microliter indicates infection. The normal prostate-specific antigen level is 4.0 ng/mL; a level of 6.0 ng/mL indicates benign prostatic hyperplasia. Hypospadias is a congenital condition characterized by the presence of the urethral opening at the underside of the penis. Peyronie's disease is a condition in which a fibrous region is formed in the erectile tissue of the penis; this disease causes pain and curvature during erection. Nonmetastatic prostate cancer is characterized by breakdown of bone and decreased bone mass. Text Reference - p. 1309

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To accurately monitor progression of the symptom of decreased urinary stream, the nurse should encourage the patient to have which primary screening measure on a regular basis? 1 Transurethral resection of the prostate 2 Urinalysis with urine culture and sensitivity 3 Prostate specific antigen (PSA) monitoring 4 Digital rectal examination

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4 Digital rectal examination is part of a regular physical examination and is a primary means of tracking symptoms of decreased urinary stream, which often is caused by benign prostatic hyperplasia in men over 50 years of age. A transurethral resection is an invasive surgical procedure indicated for active prostate cancer. A urinalysis will not evaluate prostate size or nodules. A PSA level is not the most definitive evaluation of prostate size and the presence of abnormal masses. Text Reference - p. 1313

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A patient is diagnosed with benign prostatic hyperplasia. The primary health care provider has recommended using low-wave radiofrequency to heat the prostate. Which complication would the nurse expect in the patient after the procedure? 1 Infection 2 Hematuria 3 Hydrocele 4 Retrograde ejaculation

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2 Transurethral needle ablation is involved in using low-wave radiofrequency to heat the prostate, which can cause necrosis in the patient and lead to hematuria (blood in the urine). Open prostatectomy can cause infection as a side effect. Hydrocele occurs due to swelling of the tunica vaginalis, which surrounds the testis, and interference with lymphatic drainage of the scrotum. A possible side effect of laser prostatectomy is retrograde ejaculation. Text Reference - p. 1311

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What treatment should the nurse anticipate for a patient with orchitis? Select all that apply. 1 Pain medication 2 Following the usual routine 3 Exercising, walking, and maintaining activity 4 Antibiotic treatment if organism is known 5 Bed rest with scrotum elevated on ice pack

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1 4 5 Treatment of orchitis involves the use of pain medications, antibiotics (if the organism is known), and bed rest with the scrotum elevated on an ice pack. Continuing with the usual routine, walking and maintaining activity can worsen the pain. Text Reference - p. 1324

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The nurse is providing care to a patient who reports a tightened penile foreskin. When assessing this patient, the nurse is unable to pull the foreskin forward from the retracted position. Based on these data, which diagnosis does the nurse anticipate? 1 Priapism 2 Phimosis 3 Paraphimosis 4 Peyronie's disease

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3 Paraphimosis is a condition in which the patient experiences tightness of the foreskin over the penis, resulting in an inability to pull it forward from the retracted position. An ulcer can develop if the foreskin remains contracted. This condition occurs when the foreskin is pulled back during bathing; for the insertion of urinary catheters; and during intercourse if the foreskin is not placed back in the forward position. Priapism is a condition in which the patient experiences a painful erection that can last longer than six hours. It is caused by complex vascular and neurologic factors that result in an obstruction of venous outflow from the penis. Phimosis is tightness or constriction of the foreskin around the head of the penis, which is caused by edema or inflammation of the foreskin. Peyronie's disease is caused by plaque formation in one of the corpora cavernosa of the penis, resulting in a crooked or curved penis. Text Reference - p. 1323

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The nurse is teaching a patient about testicular self-examination. Which suggestions should the nurse include in the teaching? Select all that apply. 1 Each testis should be palpated separately. 2 Testicular self-exams should begin around the age of 20. 3 Medical advice should be followed for any abnormal finding. 4 Testicular self-examination can be performed during a shower. 5 The testes should be the size of a tennis ball.

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1 3 4 The nurse should teach the patient to palpate each testis separately. The patient should be instructed to follow medical advice for any abnormal finding. Examinations can be performed during a shower, because warm temperatures make the testes hang lower in the scrotum. Testicular self-examination for the purpose of detecting testicular tumors or other scrotal abnormalities such as varicoceles should begin at puberty. The testes should feel round and smooth, like a hard-boiled egg. Testes that are the size of a tennis ball would indicate an abnormality. Text Reference - p. 1325

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The nurse is educating a patient regarding erectile dysfunction. What risk factor should the nurse be sure to discuss with the patient? 1 Orchitis 2 Epididymitis 3 Atherosclerosis 4 Cryptorchidism

answer

3 Atherosclerosis is a risk factor for erectile dysfunction, due to the decreased blood flow caused by thinning of arteries, which results in a less firm erection. Orchitis is a predisposing factor for testicular cancer. Epididymitis is a risk factor for orchitis. Cryptorchidism is a predisposing factor for testicular cancer. Text Reference - p. 1328

question

A patient is receiving treatment for a sexually transmitted infection prior to culture results being obtained. The nurse is to administer ceftriaxone intramuscularly. What sexually transmitted infection does the nurse recognize is being treated? Correct 1 Gonorrhea 2 Candidiasis 3 Herpes simplex virus type 2 4 Human immunodeficiency virus

answer

1 Treatment for gonorrhea is ceftriaxone or cefiximine. In addition, treatment for chlamydia, which often coexists, may be included. Candidiasis is a yeast infection that may be treated with amphotericin B or fluconazole for systemic infections, or topical azole for vaginal infections. Herpes is treated with acyclovir (Zovirax), famciclovir (Famvir), or valacyclovir (Valtrex). Human immunodeficiency virus is managed rather than treated and several categories of drugs are used. Text Reference - p. 1263

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Which sexually transmitted infection can be cured? 1 Herpes 2 Chlamydia 3 Condylomata acuminata 4 Human immunodeficiency virus (HIV)

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2 The usual treatment for chlamydia bacterial infection is doxycycline or tetracycline. Concurrent treatment of all sexual partners is needed to prevent recurrence. Because no cure is known for herpes, treatment focuses on pain relief and preventing secondary infections. Condylomata acuminata is caused by the human papillomavirus. No treatment eradicates the virus. Because no cure is known for HIV, prevention and early detection are the main focus. Text Reference - p. 1267

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A pregnant patient is told that she will require a cesarean birth due to active genital lesions. Which viral infection does the nurse suspect in this patient? 1 Gonorrhea 2 Genital warts 3 Genital herpes 4 Chlamydial infection

answer

3 Genital herpes is a viral infection caused by the herpes simplex virus. Women with a primary episode of genital herpes have the highest risk of transmitting the virus to a neonate. An active viral lesion indicates that the patient has genital herpes. Gonorrhea is usually asymptomatic in women. Genital warts tend to grow in size during pregnancy and may block the birth canal, but genital lesions do not develop in patients due to genital warts. Chlamydial infection is usually asymptomatic in women. Text Reference - p. 1268

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The nurse is teaching a group of young women about prevention of sexually transmitted infections (STIs). Which method of contraception also helps give some protection against STIs? 1 Condoms 2 Intrauterine devices 3 Oral contraceptive pills 4 Medroxyprogesterone

answer

1 Condoms act as a barrier against the spread of STIs. Oral contraceptive pills make the cervical secretions alkaline, which may enhance the spread of STIs. Intrauterine devices and medroxyprogesterone are not barrier devices and they do not give any protection against STIs. Text Reference - p. 1272

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The nurse has instructed a male patient who has gonorrhea about self-care. Which statement made by the patient indicates the need for further teaching? 1 "I should ask my partner to get tested." 2 "I need to take the antibiotics until they're finished." 3 "I can keep taking showers while I'm getting treated." 4 "I can have sex tonight as long as I make sure to wear a condom."

answer

4 Condom use may not provide a total barrier to the gonorrhea-causing organism. Therefore this patient should be instructed to abstain from sexual intercourse until the treatment is effective, as evidenced by a negative culture. The statements in the other answer options reflect that the patient has learned aspects of self-care in regard to gonorrhea. Text Reference - p. 1264

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A patient is being treated with doxycycline. What precaution should the nurse take with this patient? 1 Keep the room cool and avoid direct sunlight. 2 Instruct the patient to take walks in sunlight. 3 Give the doxycycline dose with a glass of cold milk. 4 Administer the doxycycline dose with an antacid.

answer

1 Doxycycline causes sunlight sensitivity. The nurse should keep the patient's room cool and prevent excessive sunlight in the room. The patient should be instructed not to take walks in sunlight. Doxycycline should never be given with antacids and dairy products, because this combination can cause adverse drug reactions. Text Reference - p. 1264

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When providing teaching to a patient with a sexually transmitted infection, which statement is indicative that further teaching is needed? 1 "I'll take the medication until the discharge is gone." 2 "I will wear cotton panties rather than a thong." 3 "I will skip sex for the next week, then use a condom." 4 "My partner has to come to the clinic to be treated too."

answer

1 Further teaching is needed with the statement "I'll take the medication until the discharge is gone" because completing the prescription is necessary rather than taking the medication only until the symptoms subside. In addition, the patient should understand the need for follow-up care. Wearing cotton panties provides for better absorption of moisture and more comfort. Avoiding sex is indicated while communicable, and using a condom will prevent reinfection. Treating the partner for the sexually transmitted infection is a means of preventing reinfection. Text Reference - p. 1272

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Upon examination of a male patient, the nurse notes profuse, purulent urethral discharge. The patient also complains of dysuria and "painful testicles." Based on these findings, which diagnosis does the nurse anticipate? 1 Gonorrhea 2 Syphilis 3 Herpes 4 Human papillomavirus (HPV)

answer

1 The initial site of infection with gonorrhea in men is usually the urethra. Symptoms of urethritis consist of dysuria and profuse, purulent urethral discharge developing two to five days after infection. Painful or swollen testicles also may occur. The reported clinical manifestations do not align with syphilis, herpes, or HPV in the male patient. Text Reference - p. 1262

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A patient had successful treatment for an existing sexually transmitted infection (STI). What instructions should the nurse provide to this patient to prevent reinfection or complications? Select all that apply. 1 Use condoms. 2 Avoid using tampons. 3 Use an intrauterine device. 4 Avoid having multiple sexual partners. 5 Make sure to get periodic Pap smears.

answer

1 4 5 Condoms prevent the spread of STIs and act as a barrier. Having multiple sexual partners exposes the patient to many sexually transmitted infections; therefore, sex with multiple partners should be avoided. Partners must be screened and checked for STIs. Women with STIs are at a higher risk of developing cervical cancer, so periodic Pap tests should be performed. Intrauterine devices and oral contraceptive pills do not protect against STIs. Use of tampons has not been reported to cause or spread STIs. Text Reference - p. 1272

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There are several pregnant women ready to deliver their babies. Which woman should the nurse expect to need a cesarean section to deliver her baby? 1 The woman who had contact with an individual with syphilis two weeks ago 2 The woman who had treatment for gonococcal pharyngitis before conception 3 The woman who has herpes simplex virus type 2 vesicles on her cervix at the time of delivery 4 The woman who received treatment for Chlamydia trachomatis at her 20th week of gestation

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3 The woman with active herpes simplex virus type 2 at the time of delivery has the greatest risk for the fetus and the baby will be delivered by cesarean section to prevent infection of the baby. Syphilis has an average incubation period of 21 days, so even if the contact was sexual, the syphilis should not infect the baby at birth. The woman treated for gonococcal phyaryngitis should have been cured with treatment, but the baby's eyes will be treated at birth to prevent gonorrheal eye infection regardless. Treatment of the pregnant woman with C. trachomatis prevents transfer of the infection to the fetus. Text Reference - p. 1268

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When explaining the advantages of acyclovir therapy for herpes infection, what information should the nurse include? Select all that apply. 1 Acyclovir cures herpes infection. 2 Acyclovir shortens the duration of viral shedding. 3 Acyclovir shortens the healing time of genital lesions. 4 Acyclovir makes the patient noninfectious. 5 Acyclovir reduces outbreaks of the lesions.

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2 3 5 Acyclovir therapy for herpes infection shortens the duration of viral shedding and the healing time of genital lesions, and it reduces outbreaks by 75%. The therapy does not cure the disease or make a person noninfectious during the treatment. Text Reference - p. 1269

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The nurse is caring for a patient with genital herpes. What should the nurse emphasize while providing psychologic support to this patient? Select all that apply. 1 Encourage the patient to verbalize feelings. 2 Instruct the patient to avoid interaction with others. 3 Help the patient realize that he or she should never be sexually active henceforth. 4 Help the patient understand that the treatment could run for a long duration. 5 Help the patient identify and avoid the factors that precipitated the condition.

answer

1 4 5 It is extremely important for the nurse to provide psychologic support to the patient, because the diagnosis of a sexually transmitted infection may be met with a variety of emotions. Encourage the person to verbalize feelings, especially the negative feelings. The treatment may involve a prolonged course, and sometimes it may be frustrating for the patient. Help the patient understand the importance of fully completing treatment. Help the patient identify and avoid factors that may precipitate the condition. Avoiding interaction will only increase the patient's depression and frustration. Because abstinence prevents STIs, encouraging it is helpful, but the health care team cannot command this patient never to have sex again. Text Reference - p. 1273

question

When evaluating a patient for sexually transmitted infections (STIs), the nurse is aware that which STI is the most common bacterial STI? 1 Gonorrhea 2 Syphilis 3 Chlamydia 4 Trichomoniasis

answer

3 Chlamydia is the most common and fastest spreading STI among American women, with an estimated three million new cases each year. Gonorrhea is a bacterial STI; however, it is not the most common among American women. Syphilis is a bacterial STI; however, it is not the most common among American women. Trichomoniasis is caused by a protozoan parasite, not by bacteria. Text Reference - p. 1266

question

What instructions should the nurse give a patient with lesions of herpes? Select all that apply. 1 Maintain good hygiene. 2 Keep the lesions clean and dry. 3 Take frequent sitz baths. 4 Burst the vesicles to drain the fluid. 5 Use hot fomentation on the vesicles. 6 Wear loose-fitting cotton undergarments.

answer

1 2 3 6 Maintaining good hygiene is extremely important in managing herpes. Keeping the lesions clean and dry helps to avoid complications. Frequent sitz baths soothe the area and reduce inflammation. Loose-fitting cotton undergarments allow the patient to be comfortable and hygienic. The patient should not try to burst the vesicles; they burst spontaneously. Using hot fomentation will not give relief to the burning sensation of the herpes vesicles. Text Reference - p. 1269

question

The herpes simplex virus (HSV) causes genital herpes. The development of genital herpes involves several pathophysiologic processes. Arrange the processes in the order of occurrence. 1. HSV enters through the mucous membranes or breaks in the skin during contact with an infected person. 2. The virus reproduces inside the cell and spreads to the surrounding cells. 3. The virus enters the peripheral or autonomic nerve endings and ascends to the sensory or autonomic nerve ganglion, where it often becomes dormant. 4. Viral reactivation may occur when the virus descends to the initial site of infection (either the mucous membranes or the skin).

answer

HSV enters through the mucous membranes or breaks in the skin during contact with an infected person. The virus then reproduces inside the cell and spreads to the surrounding cells. The virus next enters the peripheral or autonomic nerve endings and ascends to the sensory or autonomic nerve ganglion, where it often becomes dormant. Viral reactivation (recurrence) may occur when the virus descends to the initial site of infection (either the mucous membranes or the skin). Text Reference - p. 1267

question

A patient who is sexually active with multiple partners is at the clinic with symptoms of purulent vaginal discharge, dysuria, and dyspareunia. What should the nurse explain to the patient as the rationale for screening her for chlamydia? 1 Chlamydia frequently is comorbid with human immunodeficiency virus (HIV) 2 Chlamydial infections may progress to sepsis 3 Untreated chlamydial infections can lead to infertility 4 Chlamydial infections are treatable only in the early stages of infection

answer

3 Because of the potential for infertility, routine screening for chlamydia is recommended for sexually active women under age 25 and annually for those over 25 with one or more risk factors for the infection. Chlamydia is not a primary risk for sepsis, and is not noted to be strongly correlated with HIV infection. The disease is treatable at all stages of infection. Text Reference - p. 1267

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A clinic nurse is seeing a patient who is receiving treatment for condylomata. The patient asks the nurse, "Why is it important to get this treatment?" What is the best response by the nurse? 1 "If you don't take this treatment, then it will turn into gonorrhea." 2 "The human papillomavirus (HPV) also can cause you to develop a herpes outbreak." 3 "Genital warts make you more likely to develop recurrent urinary tract infections (UTIs)." 4 "Because this sexually transmitted infection increases the risk of developing cervical cancer."

answer

4 HPV is associated with cervical dysplasia and cancer. A vaccine has been developed and is recommended for young women. HPV does not cause gonorrhea, recurrent UTIs, or herpes. Text Reference - p. 1269

question

A nurse is assessing the risk behaviors for the spread of sexually transmitted infections (STIs) in a group of people. Which patients are at high risk of contracting an STI? Select all that apply. 1 A woman who has not had a sexual relationship 2 A man having sexual relationships with multiple partners 3 A woman having polygamous relationships and who is on oral contraceptive pills 4 A man having a monogamous relationship with his partner and using a condom 5 A woman having a monogamous relationship, whose partner has a history of a recent STI 6 A man having a monogamous relationship who uses condoms but often consumes drugs with shared needles

answer

2 3 5 6 STIs spread mainly through sexual contact. They are commonly seen in people having multiple partners or polygamous relationships, because these people are exposed to various hosts. In a monogamous relationship, if one partner is infected, then the other partner is at risk. STIs also spread through blood, blood products, and sharing of needles and syringes. People who have not been sexually active are at the lowest risk of STIs. A condom is a good measure to avoid exposure to STIs. Text Reference - p. 1272

question

The physical assessment and history of a patient are indicative of human papillomavirus (HPV) infection. What teaching should the nurse provide to the patient? 1 Gardasil 2 Antibiotic therapy 3 Wart removal options 4 Treatment with antiviral drugs

answer

3 Although patient teaching should focus on the various options for physically removing the symptomatic warts, the removal may or may not decrease infectivity. The HPV vaccine (Gardasil) is ineffective in cases of existing HPV and neither antiviral nor antibiotic drugs are effective treatments. Text Reference - p. 1270

question

The nurse is caring for a patient with chlamydial infection. For which complications does the nurse monitor this patient on the basis of the current diagnosis? Select all that apply. 1 Abscess 2 Infertility 3 Cold sores 4 Atonic bladder 5 Reactive arthritis

answer

1 2 5 Chlamydial infection is a common sexually transmitted infection in humans caused by the bacterium Chlamydia trachomatis. The complications of chlamydial infection include abscess, infertility, and reactive arthritis, which is a systemic condition accompanied by skin lesions and inflammation of the eyes and urethra. Cold sores are a complication of the autoinoculation of the herpes simplex virus to extragenital sites such as the fingers and lips that can occur in patients with genital herpes. Neuron damage results in an atonic bladder, which is also a complication of genital herpes disease. Text Reference - p. 1267

question

What hygiene tips should the nurse teach patients with sexually transmitted infections? Select all that apply. 1 Perform regular douching 2 Avoid using public toilets 3 Use cotton underwear 4 Frequently wash hands and regularly bathe 5 Avoid any physical contact with strangers

answer

3 4 Using cotton underwear helps to keep the genital area dry. Frequent hand washing and regular bathing help in maintaining hygienic conditions. Because douching may spread the infection or undermine local immune responses, it is contraindicated. Using public toilets can sometimes cause a few infections, but sexually transmitted infections are not among them. Casual contact with other people does not cause any harm. Text Reference - p. 1273

question

answer

question

A patient is going to receive doxycycline as treatment for a chlamydial infection. What information should the nurse provide to the patient? 1 Avoid unnecessary exposure to sunlight. 2 Take with milk unless lactose intolerant. 3 Doxycycline is safe to use if one is pregnant. 4 Take with an antacid if experiencing stomach upset.

answer

1 Avoid exposure to sunlight and tanning beds, because doxycycline makes a person more susceptible to sunburn. Taking it with milk or other dairy products inhibits absorption. Doxycycline is not safe to use in pregnancy. The Food and Drug Administration pregnancy category is D. It can harm the fetus or cause permanent tooth discoloration. Doxycycline should not be taken with antacids. Text Reference - p. 1267

question

When teaching a group of women about risks for contracting sexually transmitted infections (STIs), who would be considered to be at low risk of contracting STIs? Select all that apply. 1 One who takes oral contraceptive pills 2 One who has a monogamous sexual partner 3 One who has already reached menopause 4 One who uses condoms during sexual activity 5 One who has yet to become sexually active

answer

2 4 5 Having a monogamous relationship is an important preventive measure to avoid STIs. Another important measure is the use of condoms. Abstinence is the surest way to avoid STIs. Oral contraceptives do not give any protection against STIs. Menopause does not confer any protection against STIs. Text Reference - p. 1270

question

A woman with chlamydial infection complains of pelvic pain, nausea, vomiting, fever, and abnormal vaginal bleeding. What might be the possible cause of these symptoms? 1 Pelvic inflammatory disease 2 Ectopic pregnancy 3 Infertility 4 Reactive arthritis

answer

1 Complications from chlamydial infections in women may result in pelvic inflammatory disease, which can lead to chronic pelvic pain. Pelvic inflammatory disease can also cause nausea, vomiting, fever, malaise, and abnormal vaginal bleeding. Ectopic pregnancy and infertility do not manifest with these symptoms. Reactive arthritis is a systemic condition accompanied by skin lesions and inflammation of the eye; it is usually a complication of epididymitis-related chlamydial infection. Text Reference - p. 1267

question

A nurse is caring for a patient who has undergone radical prostatectomy. During the early postoperative period, the nurse should closely monitor the patient for what? 1 Septicemia 2 Hemorrhage 3 Renal failure 4 Respiratory distress

answer

2 Hemorrhage is the most common complication after prostate surgery. The main reason for this is that the prostate lies deep within the pelvis and is surrounded by highly vascular tissue that requires resection before the prostate is reached. Septicemia, renal failure, and respiratory distress are all potential postoperative complications related to any abdominal or genitourinary surgical procedure. However, after radical prostatectomy, hemorrhage is considered a higher risk. Text Reference - p. 1318

question

A patient is being treated at a college health care clinic for gonorrhea. Which teaching point should the nurse include in patient teaching? 1 "While being treated for the infection, you will not be able to pass this infection on to your sexual partner." 2 "While you're taking the antibiotics, you will need to abstain from participating in sexual activity and drinking alcohol." 3 "It's important to complete your full course of antibiotics to ensure that you become resistant to reinfection." 4 "The symptoms of gonorrhea will resolve on their own, but it is important for you to abstain from sexual activity while this is occurring."

answer

2 Treatment for gonorrhea necessitates abstinence from sexual activity (to prevent infection of partners) and alcohol (to avoid urethral irritation). Gonorrhea can be passed on to sexual partners. Completing the full course of antibiotics does not mean the patient will be resistant to reinfection. Gonorrhea is not self-limiting. Text Reference - p. 1264

question

The nurse is assessing a male patient who has had testing showing a large fluid-filled mass in the scrotom. How should this mass be documented? 1 Hydrocele 2 Varicocele 3 Hypospadias 4 Testicular torsion

answer

1 Hydrocele is a fluid-filled mass that results from the interference with lymphatic drainage of the scrotum and tunica vaginalis, which surround the testis. Varicocele is a dilation of the veins that drains the testis. Hypospadias is a condition that involves the abnormal position of the urethral meatus on the ventral surface of the penis. Testicular torsion involves twisting of spermatic cord that supplies blood to the testes and epididymis. Text Reference - p. 1324

question

The patient is being treated for a recurrent episode of chlamydia. What should the nurse include in this teaching? 1 If you are treated, your sexual partner will not need to be treated. 2 Abstain from sexual intercourse for seven days after finishing the treatment. 3 You will probably get gonorrhea if you have another recurrence of chlamydia. 4 Because you have been treated before, you do not need to take a full course of medication this time.

answer

2 Patients treated for chlamydia infections should abstain from sexual intercourse for seven days after treatment, until all sexual partners have completed a full course of treatment to prevent recurrence and a follow-up culture is done. A single-dose treatment also is available. Because chlamydia and gonococcal infections are associated closely, they are frequently both treated, but having chlamydia does not give the patient gonorrhea. Each time a patient is treated for chlamydia, a full course of treatment is required. Text Reference - p. 1267

question

A patient is seeking treatment for sexually transmitted infection (STI) because a recurrence is imminent due to the tingling, burning, and itching experienced. Based on these symptoms, what type of medication does the nurse anticipate administering? 1 Antivirals 2 Antibiotics 3 Vaccination 4 Contraceptives

answer

1 This patient is experiencing a reoccurrence of genital herpes (HSV2). Although not a cure, he will be treated with antiviral medications to decrease the duration of viral shedding and the healing time of genital lesions and to reduce outbreaks. Antibiotics and contraceptives are not used to treat acute HSV2. There are no vaccinations for HSV. Text Reference - p. 1268

question

A female patient has sought care because of the recent appearance of itchy lesions on her vulva, some of which have burst recently. What problem should the nurse first suspect related to the patient's description of her problem? 1 Gonorrhea 2 Chlamydia 3 Genital herpes 4 Human immunodeficiency virus (HIV)

answer

3 A primary episode of genital herpes often is marked by multiple small, vesicular lesions on the genitals. This symptomatology is not associated commonly with HIV, gonorrhea, or chlamydia. Text Reference - p. 1268

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