Exam 2

A patient seeks medical care for a carbuncle. What treatment should the nurse expect to be prescribed as a priority for this patient?

1)

Moist heat

2)

Incision and drainage

3)

Topical mupirocin ointment

4)

Clindamycin and peroxide wash

2)

Incision and drainage

A patient has a leg wound that has beige exudate and a fishy odor. For which microorganism should the nurse plan care for this patient?

1)

Proteus

2)

Pseudomonas

3)

Streptococcus

4)

Staphylococcus

1)

Proteus

A patient is demonstrating signs of a herpes simplex virus infection. Which diagnostic test should be prescribed to confirm this diagnosis?

1)

Pap smear

2)

Tzanck's smear

3)

Sedimentation rate

4)

HSV-1 antibody testing

4)

HSV-1 antibody testing

A patient is diagnosed with herpes simplex viral encephalitis. Which medication should the nurse prepare to administer to this patient?

1)

Acyclovir

2)

Famciclovir

3)

Valacyclovir

4)

Parenteral acyclovir

4)

Parenteral acyclovir

A patient is experiencing scaly, patchy skin changes on the upper back, chest, and arms. In some areas the skin is either red, dark in color, or lighter in color. Which type of fungal infection is this patient most likely experiencing?

1)

Intertrigo

2)

Tinea corporis

3)

Tinea unguium

4)

Tinea versicolor

4)

Tinea versicolor

A patient is diagnosed with tinea corporis. Which medication should the nurse expect to be prescribed to treat this infection?

1)

Topical miconazole

2)

Topical terbinafine (Lamisil)

3)

Topical butenafine (Lotrimin)

4)

Topical selenium sulfide 1% (Selsun Blue)

1)

Topical miconazole

During an assessment the nurse notes skin changes on the patient's elbows and knees. Which findings support that these changes are plaque psoriasis?

1)

Red raised areas with inconsistent borders

2)

Thick red plaques covered with silvery scales

3)

Large reddened areas of weeping and maceration

4)

Small raised and reddened areas with fluid-filled pustules

2)

Thick red plaques covered with silvery scales

A patient with psoriasis is prescribed salicylic acid. What should the nurse explain to the patient about this treatment?

1)

Prevents formation of new lesions

2)

Decreases scaling and softens plaques

3)

Suppresses cell division and decreases inflammation

4)

Diminishes proliferation of keratinocytes and decrease inflammation

2)

Decreases scaling and softens plaques

The nurse instructs a patient on medications prescribed to treat psoriasis. Which patient statement indicates that additional teaching is required?

1)

"This medication will cure the disease."

2)

"This medication can stain my skin and clothes."

3)

"This medication can cause my skin to get irritated."

4)

"The condition can get worse if I stop this medication."

1)

"This medication will cure the disease."

A patient is prescribed phototherapy as treatment for psoriasis. Which patient statement indicates that teaching about this treatment has been effective?

1)

"I should expect my skin to feel painful from the treatments."

2)

"I should expect my skin to become red from the treatments."

3)

"I should not have a treatment if my skin gets red or is blistered."

4)

"I should expect occasional blisters and drainage from the treatments."

3)

"I should not have a treatment if my skin gets red or is blistered."

The nurse notes that a patient has several lacerations over the coccyx area. What finding most likely caused these lesions?

1)

Heat

2)

Pressure

3)

Shearing

4)

Moisture

3)

Shearing

The nurse notes that a patient's wound is weeping and edematous. In which phase of healing is this wound?

1)

Maturation

2)

Hemostasis

3)

Proliferative

4)

Inflammatory

4)

Inflammatory

A patient has a secondary closure surgical wound. What was most likely used to close this wound?

1)

Tape

2)

Grafts

3)

Staples

4)

Sutures

2)

Grafts

A patient has a blood-filled blister surrounded by tissue that is painful, mushy, and warm to the touch. How should the nurse classify this skin presentation?

1)

Stage III ulcer

2)

Stage IV ulcer

3)

Unstageable

4)

Suspected tissue injury

4)

Suspected tissue injury

A patient with a pressure ulcer is prescribed a zinc supplement. What should the nurse explain to the patient about this supplement?

1)

It helps strengthen capillaries.

2)

It helps with immune function.

3)

It is needed for protein synthesis.

4)

It aids with red blood cell formation.

3)

It is needed for protein synthesis

A patient with a sacral stage III pressure ulcer has an elevated temperature. What diagnostic test would help determine if this patient is developing osteomyelitis?

1)

CT scan

2)

Bone biopsy

3)

Venous Doppler

4)

Serum electrolytes

1)

CT scan

The nurse is preparing an educational tool to teach high school students about skin cancer. What should the nurse highlight as being the most common precancerous lesion?

1)

Basal cell

2)

Melanoma

3)

Squamous cell

4)

Actinic keratoses

4)

Actinic keratoses

A patient is diagnosed with basal cell carcinoma. What should the nurse expect to assess in this patient?

1)

Translucent papule

2)

Reddish brown plaque

3)

Crusted ulcerated plaque

4)

Asymmetric black lesion

1)

Translucent papule

The nurse is caring for a patient with a squamous cell lesion. For which treatment should the nurse prepare this patient?

1)

Radiotherapy

2)

Mohs' surgery

3)

Photodynamic therapy

4)

Curettage and electrodessication

2)

Mohs' surgery

The nurse is teaching at a community fair about ways to reduce the risk of skin cancer. What should the nurse emphasize in this presentation?

1)

Wear clothing with UV protection

2)

Use sunscreen with an SPF of at least 15

3)

Examine the body every six months for lesions

4)

Spend time in the sun between the hours of 1000 and 1600

1)

Wear clothing with UV protection

A patient is admitted for reconstructive surgery. For which reason should the nurse consider that this surgery is needed?

1)

Cancer

2)

Face lift

3)

Rhinoplasty

4)

Breast augmentation

1)

Cancer

A patient recovering from reconstructive surgery is experiencing unrelenting postoperative pain. What should the nurse consider is occurring with this patient?

1)

Infection

2)

Fluid imbalance

3)

Electrolyte imbalance

4)

Attention-seeking behavior

1)

Infection

After reviewing the visit schedule, the home-care nurse prepares for patients who might have a community acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infection. What skin conditions caused the nurse to take this action? Select all that apply.

1)

Abscess

2)

Eczema

3)

Cellulitis

4)

Impetigo

5)

Folliculitis

1)

Abscess

3)

Cellulitis

4)

Impetigo

5)

Folliculitis

The nurse is concerned that a patient is developing a complicated soft tissue bacterial infection. What assessment findings caused the nurse to come to this conclusion? Select all that apply.

1)

Pain

2)

Fever

3)

Tachycardia

4)

Muscle atrophy

5)

Low blood pressure

1)

Pain

2)

Fever

3)

Tachycardia

5)

Low blood pressure

The nurse suspects that a patient is experiencing a recurrent herpes simplex virus infection. What assessment findings were used to make this decision? Select all that apply.

1)

Fever

2)

Anorexia

3)

Areas of redness

4)

Tingling sensation

5)

Fluid-filled vesicles

3)

Areas of redness

4)

Tingling sensation

5)

Fluid-filled vesicles

The nurse determines that a patient's abdominal wound is in the proliferative phase of healing. What is occurring during this phase? Select all that apply.

1)

Granulation

2)

Angiogenesis

3)

Epithelialization

4)

Collagen synthesis

5)

Reorganization of collagen

1)

Granulation

2)

Angiogenesis

3)

Epithelialization

4)

Collagen synthesis

A patient's leg wound is not healing as quickly as expected. What should the nurse do to determine the reason for the patient's poor healing? Select all that apply.

1)

Obtain a referral for a dietician

2)

Elevate the extremity on a pillow

3)

Increase the frequency of dressing changes

4)

Encourage increased independent movement

5)

Obtain an order for prealbumin and albumin levels

1)

Obtain a referral for a dietician

5)

Obtain an order for prealbumin and albumin levels

The nurse sends 10 samples of body sites to assess an intensive care patient’s Candida colonization index.

Seven of the samples came back as being positive. What is this patient’s colonization index? Record your

answer to the nearest tenth decimal point.

0.7

A patient with Duchenne muscular dystrophy has significant muscle damage. What is the primary reason for this destruction?

1) High body fat

2) Lack of dystrophin

3) Breakdown of collagen

4) Decreased body protein

2) Lack of dystrophin

1 In Duchenne muscular dystrophy, muscle damage is not because of high body fat.

2 With progressive deterioration and weakness to the facial, limb, respiratory, and cardiac

muscles, the ultimate result is muscular damage. This is due primarily to the lack of the

key protein (dystrophin) to maintain the integrity of the muscle fibers as well as the

ability to repair muscle tissue as it breaks down and/or deteriorates.

3 In Duchenne muscular dystrophy, muscle damage is not because of the breakdown of

collagen.

4 In Duchenne muscular dystrophy, muscle damage is not because of decreased body

protein.

The nurse is reviewing orders written for a patient with muscular dystrophy. Which medication should the nurse expect to be prescribed for this patient?

1) Cortisol

2) Furosemide

3) Gabapentin

4) Acetaminophen

1) Cortisol

1 There is no specific cure or pharmacological intervention. Glucocorticoid therapy is

frequently the medication of choice in conjunction with supportive and collaborative

care. Cortisol is a glucocorticoid.

2 Furosemide is a diuretic. This is not prescribed as treatment for muscular dystrophy.

3 Gabapentin is an anticonvulsant often prescribed for peripheral neuropathic pain. This

is not prescribed as treatment for muscular dystrophy.

4 Acetaminophen is a NSAID and is not prescribed as treatment for muscular dystrophy.

A patient with osteoporosis asks why the health problem developed. What nursing response would be appropriate for this patient?

1) Osteoclasts break down bone with acids and enzymes.

2) Osteoclastic activity is greater than osteoblastic activity.

3) Osteoblastic activity is greater than osteoclastic activity.

4) Osteoblasts synthesize and add minerals to the bony matrix

2) Osteoclastic activity is greater than osteoblastic activity.

1 Osteoclasts breaking down bone with acids and enzymes is part of the process of

building new bone.

2 Bone loss osteopenia occurs when bone resorption or osteoclastic activity is greater

than bone rebuilding or osteoblastic activity, which ultimately results in a decreased

bone mineral density (BMD).

3 Osteoblastic activity is less than osteoclastic activity.

4 Osteoblasts rebuild bone by synthesis and mineralization of the new bony matrix within

the bone cavity.

A patient is suspected of having osteoporosis. Which diagnostic test should the nurse expect to be prescribed for this patient?

1) MRI

2) CT scan

3) Bone scan

4) DEXA scan

4) DEXA scan

1 An MRI is not used to diagnose osteoporosis.

2 A CT scan is not used to diagnose osteoporosis.

3 A bone scan is not used to diagnose osteoporosis.

4 The gold standard assessment for osteoporosis is bone mineral density measurements.

They are obtained through a dual-energy x-ray absorptiometry (DEXA) scan.

A patient is prescribed alendronate (Fosamax). What instruction should the nurse provide to the patient about this medication?

1) Take at bedtime

2) Take with a full meal

3) Take on an empty stomach

4) Take two hours after breakfast

3) Take on an empty stomach

1 Alendronate (Fosamax) should not be taken at bedtime.

2 Alendronate (Fosamax) is not to be taken with a full meal.

3 Alendronate (Fosamax) should be taken on an empty stomach.

4 Alendronate (Fosamax) is not to be taken two hours after breakfast.

A patient is diagnosed with Paget's disease. What finding should the nurse expect when assessing this patient?

1) Pain

2) Edema

3) Hypotension

4) Abdominal cramps

1) Pain

1 One of the main clinical characteristics of Paget's disease is pain in the affected bony

site.

2 Edema is not a main clinical characteristic of Paget's disease.

3 Hypotension is not a main clinical characteristic of Paget's disease.

4 Abdominal cramps are not associated with Paget's disease.

A patient with Paget's disease is prescribed a bisphosphonate medication. Which additional medication should the nurse expect to be prescribed for this patient?

1) Anticholinergic

2) Thiazide diuretic

3) Antihypertensive

4) Calcium with vitamin D

4) Calcium with vitamin D

1 Anticholinergic medications are not used in the treatment of Paget's disease.

2 Thiazide diuretics are not used in the treatment of Paget's disease.

3 Antihypertensives are not used in the treatment of Paget's disease.

4 Calcium levels may be lowered with treatment with bisphosphonates. Supplemental calcium is suggested as well as vitamin D to facilitate GI absorption of calcium

A patient recovering from total knee replacement surgery develops osteomyelitis. What teaching should the nurse prepare as a priority for this patient?

1) Antibiotic therapy

2) Pain management

3) Debridement of the wound

4) Removal of the knee prosthesis

4) Removal of the knee prosthesis

1 Antibiotics will be prescribed; however, teaching about this medication can be

instructed at any time.

2 The patient will be experiencing pain; however, teaching about pain management

would not be a priority. With appropriate surgical and medical therapy, pain should be

managed and decrease.

3 Surgical intervention with débridement is required when a patient with osteomyelitis

demonstrates failure to respond to antibiotic therapy, evidence of soft tissue abscess or

subperiosteal collection, suspected or confirmed joint infection, and/or progressive

neurological deficits or spinal instability in the case of vertebral osteomyelitis. Since

this patient's osteomyelitis is from orthopedic hardware, the hardware needs to be

removed.

4 In the event that a patient has known or suspected infected orthopedic hardware,

surgical removal is often warranted.

The nurse is evaluating dietary teaching provided to a patient recovering from osteomyelitis. Which meal choice indicates that additional teaching is required?

1) Green salad, meat loaf, brown rice, and broccoli

2) Caesar's salad, pork loin slices, sauerkraut, baked potato, and sautéed carrots

3) Tossed salad, spaghetti with marinara sauce, Italian bread, and creamed spinach

4) Iceberg lettuce wedge, baked chicken breast, parsley red potatoes, and green beans

3) Tossed salad, spaghetti with marinara sauce, Italian bread, and creamed spinach

1 Adequate ingestion of vitamin C, zinc, iron, thiamine, folic acid, and protein can help

with wound healing and eliminating infection. This meal choice would be adequate.

2 Adequate ingestion of vitamin C, zinc, iron, thiamine, folic acid, and protein can help

with wound healing and eliminating infection. This meal choice would be adequate.

3 This meal choice has no protein. It may have adequate zinc and folic acid; however,

protein is missing, which is required for wound healing.

4 Adequate ingestion of vitamin C, zinc, iron, thiamine, folic acid, and protein can help

with wound healing and eliminating infection. This meal choice would be adequate.

A middle-aged person with scoliosis asks why exercises are prescribed when the pain is already severe. How should the nurse respond to this patient?

1) "Exercise will stop the pain caused by the deformity."

2) "Pain medication should not be needed for people with scoliosis." 3) "Exercise can reverse and prevent the progression of the spinal deformity."

4) "Exercise helps with weight management, which is a major reason for the problem."

3) "Exercise can reverse and prevent the progression of the spinal deformity."

1 Exercise is not used as complete pain control. Many people with scoliosis will have

some amount of pain.

2 Pain management is a medical strategy for people with scoliosis.

3 Exercise can reverse the signs and symptoms of spinal deformity and prevent further

progression within adolescents and adults.

4 Although obesity is a risk factor for the development of scoliosis, exercises are not

being prescribed for weight management but rather to prevent the progression of the

deformity.

A patient with severe hip pain is diagnosed with osteoarthritis (OA). What information should the nurse provide to the patient about this disease process?

1) "OA causes an overgrowth of cartilage in the joints."

2) "OA causes joint fluid to become bluish-white in color."

3) "OA causes a decrease in joint fluid that affects the cartilage."

4) "OA causes a build of fluid in the joints, hindering movement."

3) "OA causes a decrease in joint fluid that affects the cartilage."

1 OA causes a breakdown of the cartilage in the joints.

2 OA causes joint fluid to change to yellow-brown in color.

3 In OA, there is a decrease in the proteoglycans, which are responsible for the

management of the fluid within the joints. The result is a loss of cartilage strength and

functionality.

4 OA does not affect the volume of joint fluid.

The blood pressure of a patient recovering from total hip replacement surgery is dropping. What should the nurse suspect is occurring with this patient?

1) Blood loss

2) Pain medication overdose

3) Development of a deep vein thrombosis

4) Development of a postoperative infection

1) Blood loss

1 Hypotension may signal blood loss.

2 A reduction in respiratory rate would be seen in the patient who is overmedicated for

pain.

3 Pain, redness, and edema would indicate a deep vein thrombosis.

4 Increased temperature and purulent drainage would indicate a postoperative infection.

A patient recovering from total hip replacement surgery is having difficulty with position changes and ambulation. Which member of the interdisciplinary team should be consulted to address this patient's issues?

1) Orthopedic nurse

2) Physical therapist

3) Orthopedic surgeon

4) Occupational therapist

2) Physical therapist

1 Devices to assist with position changes and ambulation would not be recommended by

the orthopedic nurse.

2 Assistive walking devices such as a walker or crutches are recommended by physical

therapy.

3 Devices to assist with position changes and ambulation would not be recommended by

the orthopedic surgeon.

4 Devices to assist with position changes and ambulation would not be recommended by

the occupational therapist.

The manager notes that several nurses have been seen in employee health for low back pain over the last month. What type of education should the manager plan to help reduce the incidence of this health problem?

1) Safety

2) Body mechanics

3) Coordinating care

4) Stress management

2) Body mechanics

1 Education about safety will not reduce the risk for low back pain.

2 Risk factors for low back pain include poor body mechanics, which would be helpful

for nurses.

3 Coordinating care is not a risk factor for low back pain.

4 Stress is not a risk factor for low back pain even though stress is a part of the diagnosis

for low back pain.

The nurse is preparing material about back pain for a community health fair. What should be included as a reason why this pain occurs most frequently in the lumbar region of the spine?

1) It contains peripheral nerves.

2) It is the most rigid area of the spine.

3) It is the most flexible area of the spine.

4) It anchors the weight of the lower body.

3) It is the most flexible area of the spine.

1 The lumbar region contains nerve roots that are susceptible to injury or disease.

2 The lumbar region is the most flexible area of the spine.

3 The lumbar region is the most flexible area of the spine.

4 The lumbar region supports the weight of the upper body.

A patient is experiencing severe lower back pain that radiates down the leg causing weakness. Which diagnostic test should be considered after an MRI?

1) CT scan

2) Bone scan

3) Spinal x-ray

4) Electromyography

4) Electromyography

1 A CT scan is indicated when the spinal and neurological levels or exam are clear

(normal) and bony pathology is suspected such as a disk rupture, spinal stenosis, or

damage to vertebrae.

2 A bone scan may be performed to rule out a pathologic condition or infection.

3 An x-ray can help determine the obvious causes of LBP such as fractures, degenerative

changes, curves, and deformities.

4 Electromyography assesses the electrical activity in a nerve to detect muscle weakness.

A patient is seeking medical treatment for chronic low back pain. Which approach will help speed this patient's recovery?

1) Regular exercise

2) Spinal injections

3) Nonsteroidal anti-inflammatory agents (NSAIDs)

4) Transcutaneous electrical nerve stimulation (TENS)

1) Regular exercise

1 Regular exercise is an effective way to speed recovery and help strengthen the back and

core muscles.

2 Spinal injections ease inflammation.

3 NSAIDs are recommended for pain relief.

4 Transcutaneous electrical nerve stimulation (TENS) stimulates the peripheral nerves via

skin surface electrodes.

A patient with bone cancer is admitted for treatment. What finding should the nurse expect to observe when assessing this patient?

1) Limp

2) Muscle atrophy

3) Skin discoloration

4) Dependent edema

1) Limp

1 Pain may cause the patient to limp.

2 Muscle atrophy is not a manifestation of bone cancer.

3 Skin discoloration is not a manifestation of bone cancer.

4 Although swelling is associated with bone cancer, dependent edema does not typically

occur.

A patient is diagnosed with a primary bone tumor. Which treatment should the nurse expect to be prescribed first for this patient?

1) Surgery

2) Amputation

3) Radiotherapy

4) Chemotherapy

3) Radiotherapy

1 Surgery may occur after radiotherapy.

2 The goal of therapy is to prevent limb amputation.

3 In the case of primary bone tumors, radiotherapy is used to destroy or to reduce the size

of the tumor so that chemotherapy and/or surgical excision can be used for treatment.

4 Chemotherapy may occur after radiotherapy.

The nurse is planning care for a patient with osteosarcoma. What should be done before encouraging the patient to increase activity?

1) Assess for pain

2) Assess heart rate

3) Measure blood pressure

4) Provide assistive devices

1) Assess for pain

1 Independence versus dependence is a potential problem for patients with bone cancer.

Pain and the disability caused by osteosarcoma may limit the ability to perform

activities of daily living independently.

2 Alteration in heart rate is not typically associated with bone cancer.

3 Alteration in blood pressure is not typically associated with bone cancer.

4 Providing assistive devices would support activity; however, the nurse needs to first

find out if the patient is able to perform independent activity.

A patient recovering from surgery for bone cancer is scheduled for postoperative radiation treatments. What should the nurse emphasize when providing teaching before a treatment?

1) Apply lotion to the skin

2) Examine the condition of the skin

3) Coat the skin with protective cream

4) Lightly dust the skin with talcum powder

2) Examine the condition of the skin

1 No lotion should be applied to the skin before a radiation treatment.

2 Radiation therapy can cause localized skin irritation, blisters, and burns. The condition

of the skin should be known before a treatment.

3 No creams should be applied to the skin before a radiation treatment.

4 No talcum powder should be applied to the skin before a radiation treatment.

The nurse is assigned to care for a patient with muscular dystrophy. What should the nurse expect to assess in this patient? Select all that apply.

1) Nausea and vomiting

2) Alteration in cardiac rhythm

3) Progressive muscle weakening

4) Reduction in respiratory excursion

5) Wasting of voluntary muscle groups

3) Progressive muscle weakening

5) Wasting of voluntary muscle groups

1. Nausea and vomiting are not primary symptoms of muscular dystrophies.

2. Alterations in cardiac rhythm are not primary symptoms of muscular dystrophies.

3. The primary symptoms of muscular dystrophies are progressive muscle weakening.

4. Reduction in respiratory excursion is not a primary symptom of muscular dystrophy.

5. The primary symptoms of muscular dystrophies are wasting of skeletal or voluntary muscle

groups

The nurse is reviewing orders written for a patient with Paget's disease. Which medications should the nurse expect to be prescribed? Select all that apply.

1) Etidronate (Didronel)

2) Ibandronate (Boniva)

3) Risedronate (Actonel)

4) Calcitonin (Miacalcin)

5) Zoledronic acid (Zoledronate)

2) Ibandronate (Boniva)

3) Risedronate (Actonel)

5) Zoledronic acid (Zoledronate)

1. Etidronate (Didronel) was the first bisphosphonate used with a 50% reduction in disease

activity noted. Presently, it is used less, secondary to the fact that the therapeutic doses

required for effective management have been linked to side effects such as bone

demineralization.

2. Ibandronate (Boniva) is one of six nitrogen-containing bisphosphonates used for the initial

treatment of Paget's disease.

3. Risedronate (Actonel) is one of six nitrogen-containing bisphosphonates used for the initial

treatment of Paget's disease.

4. Calcitonin was the first therapeutic treatment used for Paget's disease, but long-term

management is difficult because of side effects and the need for ongoing subcutaneous

injections. Patients also may develop resistance to this medication.

5. Zoledronic acid (Zoledronate) is one of six nitrogen-containing bisphosphonates used for the initial treatment of Paget's disease.

The nurse suspects that a home care patient recovering from hip replacement surgery is developing osteomyelitis. What findings caused the nurse to come to this conclusion? Select all that apply

1) Fever

2) Bone deformity

3) Pain unrelieved by rest

4) Progressive muscle weakness

5) Tenderness and warmth at the surgical site

1) Fever

3) Pain unrelieved by rest

5) Tenderness and warmth at the surgical site

1. Clinical manifestations of acute osteomyelitis include fever.

2. Bone deformity is associated with Paget's disease.

3. Clinical manifestations of acute osteomyelitis include pain relieved by rest.

4. Progressive muscle weakness is associated with muscular dystrophy.

5. Clinical manifestations of acute osteomyelitis include tenderness and warmth at the site.

A middle-aged person is surprised to learn of the development of scoliosis. What factors in the patient's history increased the risk for this health problem? Select all that apply.

1) Body mass index 31.4

2) Plays tennis twice a week

3) Smokes 1 PPD of cigarettes

4) Cares for two aging parents

5) Employed as a factory worker

1) Body mass index 31.4

3) Smokes 1 PPD of cigarettes

4) Cares for two aging parents

5) Employed as a factory worker

1. Obesity is a risk factor associated with scoliosis.

2. Sedentary lifestyle is a risk factor associated with scoliosis.

3. Smoking is a risk factor associated with scoliosis.

4. Psychologically strenuous work is a risk factor associated with scoliosis.

5. Occupations that require heavy, physical work are risk factors associated with scoliosis.

The nurse suspects a patient has scoliosis. What observations caused the nurse to make this decision? Select all that apply.

1) Even gait

2) Uneven waist

3) Different arm lengths

4) Lateral curve of the spine

5) Uneven hem line at the knees

2) Uneven waist

3) Different arm lengths

4) Lateral curve of the spine

5) Uneven hem line at the knees

1. An uneven gait is identified as a symptom of scoliosis.

2. Uneven waist is a symptom of scoliosis.

3. Different arm lengths is a symptom of scoliosis.

4. Lateral curve of the spine is a symptom of scoliosis.

5. Uneven hemline at the knees could indicate one hip is higher than the other, which is a

symptom of scoliosis

The nurse is planning care for a patient with osteoarthritis (OA). On what should the nurse focus when preparing teaching material for this patient? Select all that apply.

1) Weight management

2) Nonsteroidal therapy

3) Activity modification

4) Joint replacement surgery

5) Glucosamine and chondroitin

1) Weight management

2) Nonsteroidal therapy

3) Activity modification

5) Glucosamine and chondroitin

1. The initial medical management prior to joint replacement is focused on weight management.

2. The initial medical management prior to joint replacement is focused on nonsteroidal therapy.

3. The initial medical management prior to joint replacement is focused on activity modification.

4. The National Institute for Health and Care Excellence states that a total hip replacement

(THR) or a total knee replacement (TKR) can be considered once self-management, exercise,

and analgesia are no longer effective in relieving pain during activities of daily living.

5. The initial medical management prior to joint replacement is focused on the use of joint

supplements such as glucosamine and chondroitin.

A patient is diagnosed with metastatic bone cancer. Which laboratory value should the nurse expect to see elevated for this patient? Select all that apply.

1) Serum calcium

2) Serum alkaline phosphatase

3) Lactate dehydrogenase (LD)

4) Erythrocyte sedimentation rate (ESR)

5) Serum aspartate aminotransferase (AST)

1) Serum calcium

2) Serum alkaline phosphatase

3) Lactate dehydrogenase (LD)

4) Erythrocyte sedimentation rate (ESR)

1. With metastasis from the breast, kidney, or lung to the bone, elevated calcium levels are

frequently noted.

2. Serum alkaline phosphatase is frequently elevated with osteosarcomas due to the increased

enzyme activity at the level of the muscle, the deterioration of bone, and the inflammatory

response.

3. LD is frequently elevated with osteosarcomas due to the increased enzyme activity at the level

of the muscle, the deterioration of bone, and the inflammatory response.

4. ESR is frequently elevated with osteosarcomas due to the increased enzyme activity at the

level of the muscle, the deterioration of bone, and the inflammatory response.

5. AST is frequently elevated with muscular dystrophy (MD), not metastatic bone cancer. The

AST level is monitored to assess for muscle wasting and deterioration in MD.

1. A patient recovering from a hysterectomy does not want to take the prescribed estrogen replacement therapy

because of the fear of developing breast cancer. Which response by the nurse is the most appropriate?

1) "The risk of breast cancer is slightly increased for women who opt to take estrogen

replacement therapy."

2) "Perhaps you should consider an estrogen-progestin combination therapy."

3) "The risk of breast cancer is not increased for women who have had a hysterectomy and

take estrogen replacement medications."

4) "Taking estrogen replacement is required after a hysterectomy."

3) "The risk of breast cancer is not increased for women who have had a hysterectomy and

take estrogen replacement medications."

3 Estrogen replacement therapy is not associated with breast cancer for women who have

undergone a hysterectomy. Taking estrogen after a hysterectomy is optional, not

required.

2. The nurse is instructing a group of women between the ages of 40 and 50 about early detection of breast

cancer. What should the nurse include in this teaching?

1) Perform monthly breast self-exams

2) See a health-care provider if there is a strong family history of breast cancer

3) Have a yearly mammogram

4) Have a clinical breast exam performed by a health-care provider every five years

3) Have a yearly mammogram

3 Yearly mammography for all women over the age of 40 is encouraged, as it decreases

the mortality from breast cancer.

3. During an assessment, the nurse notes that a patient receiving radiation treatments for breast cancer has

excoriated skin. What is the priority nursing diagnosis for this patient?

1) Excess Fluid Volume

2) Ineffective Breathing Pattern

3) Risk for Infection

4) Activity Intolerance

3) Risk for Infection

3 Radiation causes skin excoriation. With the excoriation, the patient is at risk for

infection due to skin breakdown.

4. The nurse is caring for a patient with metastatic breast cancer receiving chemotherapy. Even though the

prognosis is poor, the patient tells the nurse that the plan is to do everything to survive. How should the nurse

respond to this patient?

1) "You have a great attitude, and I am here to support you through education."

2) "It is important to plan for your death, even though there is a chance you will survive."

3) "You should face the reality of the situation. You do not have a good chance of survival."

4) "I am going to speak with your family regarding your unrealistic expectations."

1) "You have a great attitude, and I am here to support you through education."

1 This patient is in the earliest stages of cancer treatment, with removal of the primary

tumor about to take place. The nurse’s role is to support this patient’s optimism and

help in fighting the disease by teaching about nutrition and other supportive actions the

patient can take to minimize complications of treatment.

5. The nurse is reviewing the plan of care for a patient being treated with brachytherapy for breast cancer. Which assessment finding indicates that the patient's skin integrity has been maintained?

1) Skin intact

2) Skin dry and excoriated

3) Skin stretched

4) Skin damp and sweaty

1) Skin intact

1 The goal for the patient receiving radiation therapy to the chest is intact skin, which the

nurse would expect to find. If the goal were not met, the nurse would find excoriation.

6. A patient prescribed tamoxifen (Nolvadex) for breast cancer treatment asks the nurse how the medication

works. What is the best response by the nurse?

1) "Tamoxifen works by inhibiting the cellular mitosis of breast cancer."

2) "Tamoxifen works by blocking estrogen receptors on breast tissue."

3) "Tamoxifen works by binding to the DNA of breast cancer cells."

4) "Tamoxifen works by inhibiting the metabolism of breast cancer cells."

2) "Tamoxifen works by blocking estrogen receptors on breast tissue."

2 Breast cancer is dependent on estrogen for growth. Tamoxifen (Nolvadex) acts by blocking estrogen receptors; the tumor is deprived of estrogen.

7. The nurse instructs a patient recovering from a mastectomy on ways to prevent lymphedema. Which patient

statement indicates that teaching has been successful?

1) "I should do the exercises on my affected arm every day."

2) "I have to take no special precautions."

3) "I should avoid cleansing my skin with soap."

4) "Eating fresh fruits and vegetables will prevent my arm from swelling."

1) "I should do the exercises on my affected arm every day."

1 Range-of-motion exercises in the affected arm help develop collateral drainage and

prevent the development of lymphedema.

8. A menopausal patient is concerned that intercourse with her spouse has become increasingly painful. What

should the nurse explain about the changes in this patient's body after menopause?

1) Cervical mucus is thicker.

2) Estrogen levels increase.

3) Sexual desire diminishes.

4) Vaginal lubrication decreases.

4) Vaginal lubrication decreases.

4 Older women remain capable of multiple orgasms and may, in fact, experience an increase in sexual desire after menopause. Vaginal lubrication and elasticity decrease with menopause along with decreased estrogen, and phases of the sexual response cycle may take longer to occur.

9. A female patient is prescribed an androgen medication to treat an estrogen-sensitive type of breast cancer.

What should the nurse instruct this patient about the medication?

1) There is an increased risk of multiple births.

2) Monitor weight weekly.

3) Report calf pain or dyspnea.

4) It must be taken with food.

2) Monitor weight weekly.

2 Older women remain capable of multiple orgasms and may, in fact, experience an

increase in sexual desire after menopause. Vaginal lubrication and elasticity decrease

with menopause along with decreased estrogen, and phases of the sexual response cycle

may take longer to occur.

10. A nurse is caring for a patient who is perimenopausal and states that she has recently had frequent bacterial

vaginal infections. Which reason for these infections will the nurse include in the response to the patient?

1) Decreased vaginal pH

2) Increased vaginal pH

3) Increased estrogen level

4) Decreased vasomotor stability

2) Increased vaginal pH

2 Older women remain capable of multiple orgasms and may, in fact, experience an

increase in sexual desire after menopause. Vaginal lubrication and elasticity decrease

with menopause along with decreased estrogen, and phases of the sexual response cycle

may take longer to occur.

11. A nurse working in an outpatient women's health clinic is caring for a patient in menopause. When discussing

hormone replacement therapy (HRT) with the patient, the nurse should include which statement?

1) "Most healthy, recently menopausal women should not use HRT for relief of hot flashes

and vaginal dryness."

2) "HRT is the least effective treatment for menopausal hot flashes and vaginal dryness."

3) "If vaginal dryness and painful intercourse are the only symptoms, then low-dose vaginal

estrogen is preferred."

4) "The risk of blood clots in the legs or lungs is further increased by using transdermal

patches, gels, or sprays."

3) "If vaginal dryness and painful intercourse are the only symptoms, then low-dose vaginal

estrogen is preferred."

3 If vaginal dryness and dyspareunia (painful intercourse) are the only symptoms, then low-dose vaginal estrogen is preferred.

12. A female patient asks what causes the symptoms of menopause. On which hormonal function should the

nurse focus when responding to this patient's question?

1) Increased estrogen levels

2) Increased progesterone levels

3) Estrone as the major hormone

4) Increased luteinizing hormone levels

3) Estrone as the major hormone

3 Estrone is produced in small amounts and has only about one-tenth the biological activity of estradiol.

13. A patient with a history of breast cancer who is entering menopause is seeking information about how to

manage hot flashes. What information can be provided to the patient?

1) Soy and black cohosh can be used to manage the hot flashes associated with menopause.

2) The patient should be advised that she will have to wait until menopause has finished for

the hot flashes to cease.

3) Estrogen is the only reliable method of treatment for hot flashes.

4) Olive oil and black cohosh are effective in the management of hot flashes.

1) Soy and black cohosh can be used to manage the hot flashes associated with menopause.

1 The hot flashes can be successfully managed with soy and black cohosh.

14. A patient who is postmenopausal confides in the nurse about pain experienced during intercourse. What

should the nurse instruct the patient to do?

1) Use vaginal lubricants during intercourse

2) Avoid intercourse

3) Tolerate this problem because it is a normal part of aging

4) Decrease the frequency of intercourse to decrease the pain

1) Use vaginal lubricants during intercourse

1 It is not uncommon for a postmenopausal female to report painful intercourse that is related to a decrease in vaginal lubrication. Vaginal lubricants can be very effective in reducing the pain experienced during intercourse. It is stereotypical to assume the patient would have less of a desire for intercourse at an older age.

15. A nurse is caring for a patient who complains of pain with menstruation. What is true regarding the etiology

and pathophysiology of this condition?

1) Primary dysmenorrhea is caused by decreased levels of prostaglandins, causing the

contractions of the uterus to increase in strength.

2) Primary dysmenorrhea begins within the first three or four menstrual periods after

menarche and will occur with each ovulatory cycle during the teens and 20s of a woman's

life.

3) Secondary dysmenorrhea is more common than primary dysmenorrhea.

4) Primary dysmenorrhea causes include endometriosis, tumors, cysts, pelvic adhesions,

pelvic inflammatory disease, infections, cervical stenosis, uterine leiomyomas, and

adenomyosis.

2) Primary dysmenorrhea begins within the first three or four menstrual periods after menarche and will occur with each ovulatory cycle during the teens and 20s of a woman's life.

2 Pain associated with menses, called dysmenorrhea, is one of the most common menstrual dysfunctions. Primary dysmenorrhea is very common among women with normal menstrual function and is more common than secondary dysmenorrhea. Primary dysmenorrhea begins within the first three or four menstrual periods after menarche and will occur with each ovulatory cycle during the teens and 20s of a woman's life.

16. The nurse identifies that a patient is at risk for dysfunctional uterine bleeding. What did the nurse assess in

this patient to lead to this clinical diagnosis?

1) Low level of stress

2) Weight gain of 5 lbs in five years

3) Uses birth control pills for contraception

4) Limits intake of high-fat foods

3) Uses birth control pills for contraception

3 A number of factors may predispose a woman to dysfunctional uterine bleeding. These factors include stress, extreme weight changes, and use of oral contraceptive agents.

17. A young adolescent patient is concerned about experiencing severe cramps with menstruation. How should

the nurse respond to this patient?

1) "This is not normal but is something that can be treated."

2) "You have cramps because you started your periods too early."

3) "Cramps are seen in those who just start having periods and will become less severe as

you get older."

4) "You need to see a gynecologist for a pelvic examination."

3) "Cramps are seen in those who just start having periods and will become less severe as you get older."

3 Primary dysmenorrhea occurs without specific pelvic pathology and is most often seen in girls who have just begun menstruating, becoming less severe after the mid-20s. Cramps are normal in the age range.

18. The nurse has identified the diagnosis of Ineffective Coping for a patient with severe premenstrual syndrome.

What should be included in this patient's plan of care?

1) Encourage frequent rest periods

2) Suggest four ounces of wine each day

3) Encourage exercise and relaxation techniques

4) Instruct to avoid contraception during menstruation if engaging in sexual intercourse

3) Encourage exercise and relaxation techniques

3 Interventions to aid with ineffective coping for a patient with severe premenstrual syndrome include encouraging exercise and relaxation techniques and avoiding alcohol intake.

19. The nurse is developing strategies to be used for the relief of menstrual cramping in a teaching session to a

group of young women. What should be the focus of these strategies?

1) Minimization of menstrual flow

2) Avoidance of uterine contraction

3) Increase of blood flow to the uterine muscle

4) Decrease in estrogen production

3) Increase of blood flow to the uterine muscle

3 Menstrual cramping is a result of the muscle ischemia that occurs when the patient experiences powerful uterine contractions. Increase of blood flow to the uterine muscle through rest, some exercises, application of heat to the abdomen, and presence of milder uterine contractions (such as those associated with orgasm) can decrease pain and cramping.

20. The nurse instructs a patient on ways to reduce premenstrual difficulty. Which patient statement indicates the

instruction was beneficial?

1) The patient states the need to increase dietary sugar intake to promote energy.

2) The patient states that guided imagery does not help with the symptoms.

3) The patient states the need to increase intake of simple carbohydrates.

4) The patient states that reducing caffeine intake will help.

4) The patient states that reducing caffeine intake will help.

4 The patient stating that a reduction in caffeine intake will help is evidence that instruction was beneficial.

21. The nurse is caring for a patient recovering from a total hysterectomy. What should the nurse include when

instructing this patient prior to discharge?

1) The importance of douching after intercourse for at least 6 weeks

2) Why bed rest is indicated for at least a month after the surgery

3) The risks and benefits of hormone replacement therapy

4) The importance of returning to normal activities of daily living as soon as possible

3) The risks and benefits of hormone replacement therapy

3 If the ovaries have been removed with a hysterectomy, the nurse should provide information on the risks and benefits of hormone replacement therapy because the patient is immediately thrust into menopause.

22. The nurse is conducting a health history interview for a female patient with a family history of ovarian cancer.

Which information noted by the nurse indicates this patient has an increased risk for developing this type of

cancer?

1) Two noted pregnancies

2) Long term oral contraceptive use

3) Currently breastfeeding an infant

4) Body mass index indicates obesity

4) Body mass index indicates obesity

4 Obesity is a risk factor for the development of ovarian cancer.

23. The nurse is assessing a patient who is at risk for endometrial cancer. Which is the priority question for the

nurse to include in the health history?

1) "How many times have you been pregnant?"

2) "Do you experience irregular or heavy periods?"

3) "How often do you engage in sexual intercourse?"

4) "Have you ever been diagnosed with a sexually transmitted infection?"

2) "Do you experience irregular or heavy periods?"

2 Irregular or heavy periods prior to menopause is a clinical manifestation associated with

endometrial cancer.

24. Which patient has an increased risk for being diagnosed with cervical cancer in the later stages of the disease

process?

1) 35-year-old Hispanic woman with a Pap smear one year ago

2) 45-year-old Caucasian woman with a Pap smear three years ago

3) 50-year-old Native American woman with a Pap smear four years ago

4) 55-year-old African American woman with a Pap smear six years ago

4) 55-year-old African American woman with a Pap smear six years ago

4 About half of cervical cancer cases are diagnosed in the late stages of the disease. Diagnosis in later stages occurs more frequently in women older than 50, black women, and women who have not had a Pap smear for more than five years.

25. The nurse is preparing education for a patient who is diagnosed with endometriosis. Which should the nurse

plan to include in the teaching session as a first-line treatment option?

1) Oral contraceptives

2) Aromatase inhibitors

3) Laparoscopy with biopsy

4) Gonadotropin-releasing hormone agonists

1) Oral contraceptives

1 Oral contraceptives are first-line treatment for endometriosis.

26. The nurse is reviewing data collected during a health history and physical assessment and determines that a patient is at risk for developing breast cancer. Which data supports this patient's risk for developing breast

cancer? Select all that apply.

1) Age 60

2) Breastfed both children

3) Sister had breast cancer

4) Body mass index 22

5) Menopause at age 58

1) Age 60

3) Sister had breast cancer

5) Menopause at age 58

1. This is correct. The risk for developing breast cancer increases with age.

2. This is incorrect. Breastfeeding and maintaining a normal body weight lower a person's risk

for developing breast cancer.

3. This is correct. Having a first-degree relative with breast cancer increases the risk.

4. This is incorrect. Breastfeeding and maintaining a normal body weight lower a person’s risk

for developing breast cancer.

5. This is correct. Menopause after the age of 55 also increases the risk for developing breast

cancer.

27. The nurse is teaching a 34-year-old patient who has a sister and mother with a history of breast cancer about

early screening for the health problem. Which should the nurse include in this teaching session? Select all that

apply.

1) Routine monthly breast self-examination

2) Annual screening mammography

3) Routine breast exams to begin after age 35

4) Clinical breast examination every three years

5) Reporting of any changes in breast tissue to the health provider at the next routine visit

2) Annual screening mammography

4) Clinical breast examination every three years

1. This is incorrect. While the American Cancer Society recommends that woman be familiar

with what is normal regarding breast tissue, routine monthly breast self-examination is no

longer recommended.

2. This is correct. Since this patient’s mother and sister both have a history of breast cancer, she

would be eligible for annual mammography.

3. This is incorrect. Routine breast exams should begin at age 20, not age 35.

4. This is correct. The American Cancer Society recommends clinical breast examination every

three years from ages 20 to 39.

5. This is incorrect. Prompt reporting of any change in the breast tissue to a health-care provider

is recommended by the American Cancer Society.

28. The nurse is providing care to a patient who was recently diagnosed with breast cancer. The nurse is

providing education regarding the possible treatment options. Which options will the nurse include in the

teaching session? Select all that apply.

1) Mastectomy

2) Hormone therapy

3) Lumpectomy

4) Palliative care

5) Radiation

1) Mastectomy

2) Hormone therapy

3) Lumpectomy

5) Radiation

1. This is correct. Treatment options appropriate for a patient newly diagnosed with breast cancer

may include mastectomy, hormone therapy, lumpectomy, and radiation.

2. This is correct. Treatment options appropriate for a patient newly diagnosed with breast cancer

may include mastectomy, hormone therapy, lumpectomy, and radiation.

3. This is correct. Treatment options appropriate for a patient newly diagnosed with breast cancer

may include mastectomy, hormone therapy, lumpectomy, and radiation.

4. This is incorrect. Palliative care will only be implemented once the patient’s cancer is

considered to be terminal in nature.

5. This is correct. Treatment options appropriate for a patient newly diagnosed with breast cancer

may include mastectomy, hormone therapy, lumpectomy, and radiation.

The nurse is preparing an educational program on risk factors for the development of

prostate cancer. Which information will the nurse include as being the greatest risk factor for

developing prostate cancer?

1) The patient's age

2) A family history

3) A history of a vasectomy

4) A diet high in fat

The patient's age

The greatest risk for developing prostate cancer is age. Prostate cancer affects one out of every eight men over the age of 60.

While receiving discharge teaching, an adult patient recovering from a prostatectomy is

distressed to learn that episodes of incontinence may occur. Which should the nurse teach the patient to help minimize incontinence?

1) Proper administration of incontinence medication

2) Steps to change the Foley catheter bag every day

3) Fluid restriction

4) Kegel exercises

Kegel exercises

Urinary incontinence after surgery is not unexpected. Teaching the patient Kegel exercises is the best way to help him eliminate or reduce occasions of stress incontinence.

A patient is scheduled to undergo a prostate biopsy. The patient asks the nurse what is

expected immediately following the procedure. Which response by the nurse is the most appropriate?

1) "You will need to avoid strenuous activity for 24 hours."

2) "Your sexual partners will need to be notified."

3) "You will likely experience discomfort for 24-48 hours after the procedure."

4) "You will not have any restrictions following the biopsy."

"You will likely experience discomfort for 24-48 hours after the procedure."

The patient may experience discomfort for one to two days after the procedure.

The nurse is caring for a patient who has a continuous bladder irrigation running following

a prostatectomy. During the shift, a total of 1500 mL of irrigant is infused. The Foley bag is emptied

twice for the shift with totals of 850 mL and 950 mL. What is the patient's actual urine output for the

shift?

1.300 mL

2.250 mL

3.100 mL

4.950 mL

300 mL

The total infused is 1500 mL. The total drained is 1800 mL. The total, or true output, is 300mL greater than the input.

The nurse is caring for a patient who returns to the unit following transurethral resection of

the prostate due to prostate cancer with a three-way Foley catheter in place. The patient states that he

has the urge to urinate and wants the catheter removed. Which response by the nurse is the most

appropriate?

1) "This must be a complication, because the Foley catheter is supposed to evacuate clots that cause the sensation you are describing."

2) "The spasm is an unexpected finding because the procedure does not invade the urethra."

3) "The sensation is caused by the silicone used in the catheter. I will speak to the doctor about switching to a different catheter."

4) "This is an expected sensation, but the Foley catheter must remain in place."

"This is an expected sensation, but the Foley catheter must remain in place."

Patients with a three-way Foley catheter usually complain of sensations of having to void despite the presence of the catheter. This urge to void is caused by the pressure exerted by the balloon in the internal sphincter of the blad

The nurse is preparing to discharge a patient recovering from prostate surgery for cancer.

What should the nurse emphasize when providing discharge instructions for this patient?

1) "You may drive yourself home."

2) "Avoid strenuous activity and heavy lifting for two weeks."

3) "It is quite common to notice blood in your urine following this type of surgery."

4) "Reduce your fluid intake so you won't need to void as often."

"It is quite common to notice blood in your urine following this type of surgery."

Blood in the urine is fairly common after surgery.

A nursing instructor is teaching a group of student nurses about the cultural implications of

prostate cancer. Which statement will the nursing instructor include in the teaching session?

1) "African-American men are at lowest risk for prostate cancer."

2) "Asian- and Native American men have the highest risk for developing prostate cancer."

3) "Approximately one in eight men ages 70 and older will be diagnosed with prostate cancer."

4) "A diet low in dairy increases a man's risk for developing prostate cancer."

"Approximately one in eight men ages 70 and older will be diagnosed with prostate

cancer."

Approximately one in eight men ages 70 and older will be diagnosed with prostate cancer.

The nurse is assessing a patient for symptoms of prostate cancer. Which symptoms would

indicate the patient is experiencing an enlarged prostate?

1) Dysuria

2) Nerve pain

3) Bone pain

4) Bowel dysfunction

Dysuria

Symptoms of an enlarged prostate include hematuria, dysuria, reduction in urinary stream, nocturia, frequency of urination, and abnormal size of prostate on digital exam.

A patient with prostate cancer is being discharged from the hospital. Which educational

topic is inappropriate for this patient?

1) Provide information on doses of complementary herbs

2) Teach the patient and his family noninvasive methods of pain control

3) Stress the importance of keeping patient appointments with health-care providers

4) Provide the patient and the patient's family information on support groups

Provide information on doses of complementary herbs

The nurse does not have authorization to provide information on doses of complementary herbs.

During a health history, the nurse learns that a patient has a recent onset of impotence.

Which question will help identify a potential cause of this manifestation?

1) "Does this occur often?"

2) "For what diseases and disorders have you been treated?"

3) "Are you on any medications?"

4) "How does your partner feel about this problem?"

"For what diseases and disorders have you been treated?"

A patient's health history can provide clues to the underlying cause of impotence. The question "for what diseases and disorders have you been treated" would provide the nurse

The nurse is conducting a health history with a patient diagnosed with erectile

dysfunction. Which finding could provide a possible cause for the patient's problem?

1) Blood pressure of 118/68 mmHg

2) Body mass index (BMI) of 24.5

3) Alcohol intake of four to six beers each day

4) Plays golf twice a week

Alcohol intake of four to six beers each day

The risk factors for erectile dysfunction are numerous. They include advancing age, diseases such as heart disease and diabetes, trauma, and the use of prescription or illicit drugs. Excessive use of alcohol can also result in erectile dysfunction.

A patient is concerned about becoming impotent because of the inability to sustain an

erection and a history of a sexually transmitted infection as a young adult. What is the nurse's best

response to this patient's concerns?

1. "An occasional incident like this is normal and common, and there is no reason to be concerned."

2. "Sexually transmitted infections may result in sexual problems in adults."

3. "Erectile dysfunction is the correct term for the inability to achieve or sustain an erection."

4. "The medical diagnosis of erectile dysfunction is not made until the man has erection difficulties in 25% or more of his interactions."

"An occasional incident like this is normal and common, and there is no reason to be

concerned."

This patient is concerned about his masculinity and sexual abilities. The correct answer at this point is to tell him that it is common and normal for men to experience occasional erectile difficulties.

A male patient tells the nurse that he has no idea why his wife wants to stay married to

him because he has not been able to "perform" sexually since his prostate surgery. Which diagnosis would be appropriate for this patient?

1) Ineffective Coping

2) Situational Low Self-Esteem

3) Hormonal Imbalance

4) Sexual Dysfunction

Situational Low Self-Esteem

The patient may or may not be experiencing ineffective coping.

The nurse is planning care for a patient with erectile dysfunction. What should the nurse

include in this patient's plan of care?

1) Names of psychologists with experience in treating the disorder

2) Types of devices and surgeries available to help with the disorder

3) Reason for disorder as being side effect of prescribed medication

4) Information on exact cause

Types of devices and surgeries available to help with the disorder

When planning the care of a patient with erectile dysfunction, the nurse should include information on medications

The nurse is instructing a patient about the medication sildenafil (Viagra). Which patient

statement indicates teaching has been effective?

1) "Viagra should be taken with food."

2) "I can take Viagra anywhere from one to six hours before sex."

3) "I can take only one pill in a 24-hour period."

4) "Grapefruit juice will decrease the effects of Viagra."

"I can take only one pill in a 24-hour period."

Taking only one pill in a 24-hour period is the recommended dosing for sildenafil (Viagra).

A patient asks for a prescription for tadalafil (Cialis). What would be important for the

nurse know prior to planning interventions for this patient?

1) "Do you have diabetes mellitus?"

2) "Do you take blood pressure medication?"

3) "Do you have any sexually transmitted infections?"

4) "Do you use nitroglycerine?"

"Do you use nitroglycerine?"

Combining tadalafil (Cialis) with nitroglycerine can lead to serious hypotension.