NR511 Week 7 Quiz Answers

NR511 Week 7 Quiz Answers

Question 1  A 32-year-old male appears with a rapid onset of unilateral scrotal pain radiating up to the groin and flank. The nurse practitioner is trying to differentiate between epididymitis and testicular torsion. Which test should be the provider’s first choice?

Technetium scan.

X-ray.

Ultrasound.

Physical examination.

Question 2 A male patient presents to the clinic for evaluation of infertility. Subjectively, the patient complains of pain and fullness of the testes and states, “My testicles feel like a bag of worms.” On physical examination, the nurse practitioner notes tortuous veins posterior to and above the testes that extend up into the external inguinal ring. Based on the preceding assessment, the nurse practitioner refers the patient to urology with a diagnosis of:

Hydrocele.

Urethritis.

Varicocele.

Orchitis.

Question 3 A patient’s chief complaint is pain and heaviness in the scrotum. The nurse practitioner notes swelling of the testes, along with warm scrotal skin. Which of the following diagnoses is most probable?

Testicular torsion.

Orchitis.

Cryptorchidism.

Epididymitis.

Question 4 A 15-year-old male comes to the clinic in acute distress with “belly pain.” When obtaining his history, the nurse practitioner (NP) finds that he fell off his bike this morning and has vomited. Upon closer examination, the NP determines the belly pain to be left-sided groin pain or pain in his left testicle. He is afebrile and reports no dysuria. Which of the following diagnoses is most likely?

Testicular torsion.

Epididymitis.

Varicocele.

Hydrocele.

Question 5 A patient is being treated for erectile dysfunction. The patient is morbidly obese and is also being treated for a coagulopathy. Which of the following medications would be contraindicated?   NR511 Week 7 Quiz Answers

Alprostadil (Caverject).

Topical testosterone (AndroGel).

Subcutaneous pellet testosterone (Testopel).

Sildenafil (Viagra).

Question 6 A 51-year-old male requests a prescription for sildenafil (Viagra). He says that the only medication he takes is isosorbide mononitrate (Monoket) oral tablets and that he has diabetes which is controlled with diet alone. What should the nurse practitioner tell him?

“Because of your history of diabetes, we can’t use it.”

“I’d better refer you to a urologist.”

“Let’s try a sample and see how you do.”

“Viagra is contraindicated with isosorbide mononitrate; let’s discuss other options.”

Question 7 A 52-year-old male patient is in a new relationship and is not sure whether his erectile dysfunction is organic or is caused by stress about his performance. What simple test could the clinician suggest to determine if he has the ability to have an erection?

Serum prostate-specific antigen (PSA).

Intracavernous injection.

Penile duplex ultrasonography.

Nocturnal penile tumescence and rigidity (NPTR) test.

Question 8 A 72-year-old unmarried, sexually active man, presents to the clinic with complaints of hesitancy, urgency, and occasional uncontrolled dribbling. Although the nurse practitioner suspects benign prostatic hyperplasia, what else should the differential diagnosis include?

Detrusor hyperreflexia.

Urethral stricture.

Antihistamine use.

Renal calculi.

Question 9 A 72-year-old male presents to the office for follow-up of several episodes of orthostatic hypotension. After obtaining a review of systems and a digital rectal examination, it also appears that he has benign prostatic hyperplasia (BPH) with lower urinary tract symptoms. The nurse practitioner reviews his recent ultrasound evaluation, which reports a prostate volume of over 40 mL, and the results of the American Urological Association (AUA) symptom index for BPH, which shows his score to be 12. Based on the preceding information and the patient’s desire for noninvasive medical therapy, what management should he be offered?

Doxazosin (Cardura).

Phenoxybenzamine (Dibenzyline).

Prazosin (Minipress).

Finasteride (Proscar).

Question 10 A 62-year-old male has a low International Prostate Symptom Score for lower urinary tract symptoms associated with his benign prostatic hyperplasia (BPH). The nurse practitioner should recommend: NR511 Week 7 Quiz Answers

Balloon dilation.

Immediate referral to urology.

No treatment at this time.

Starting an alpha blocker.

Question 11 A 58-year-old male has been diagnosed with erectile dysfunction and says that a friend told him about a method that uses a constricting ring around the base of the penis. What is he referring to?

Urethral suppositories.

Surgery.

An external vacuum device.

Intracavernous injection therapy.

Question 12 Regular testicular self-exams have not been studied enough to show if they lower the risk of dying from testicular cancer. This is why the American Cancer Society and other agencies do not have a recommendation about regular testicular self-exams for all men. Still, some practitioners do recommend that all men examine their testicles monthly after reaching puberty. In teaching a patient how to do a testicular self-examination, which of the following should the clinician advise?

“Make sure your hands are dry to create friction.”

“Examine your testicles when you are cold because this makes them more sensitive.”

“If you feel firmness above and behind the testicle, make an appointment.”

“Make an appointment if you note any hard lumps directly on the testicle, regardless of whether they are tender.”

Question 13 A 32-year-old male presents with complaints of a scrotal mass; however, the scrotum is so edematous that it is difficult to assess. How would the nurse practitioner (NP) best determine whether the condition is a hernia or a hydrocele?

Bowel sounds may be heard over a hernia.

With a hydrocele, a bulge appears on straining.

The NP can transilluminate a hernia.

The NP can always return a hernia’s contents to the abdominal cavity.

Question 14 A 54-year-old male is complaining of erectile dysfunction. He also has a condition that has reduced arterial blood flow to his penis. The most common cause of this condition is:

Parkinson disease.

Diabetes mellitus.

Multiple sclerosis.

Epilepsy.

Question 15 A 63-year-old man presents to your office with hematuria, hesitancy, and dribbling. Digital rectal examination (DRE) reveals a smooth, moderately enlarged prostate. The client’s prostate-specific antigen (PSA) is 1.2. What is the most appropriate management strategy at this time?

Recommending saw palmetto extract.

Referring the client to urology.

Prescribing an alpha-adrenergic blocker.

Prescribing an antibiotic. NR511 Week 7 Quiz Answers

 

MORE INFO 

International Prostate Symptom Score

Introduction

The International Prostate Symptom Score (IPSS) is a tool to measure the severity of symptoms. The IPSS was created by researchers at the University of Oxford and was first published in 2007. It has been updated several times since then, but it’s still considered an excellent way to measure prostate disease severity.

A tool to measure the severity of symptoms.

The Prostate Symptom Score (PSS) is a tool to measure the severity of symptoms. It was developed by researchers at the University of California San Francisco and published in 2003.

The PSS is a questionnaire that asks about seven different areas: urinary retention, difficulty passing urine, pain during urination or ejaculation, burning or tenderness when passing urine (or around prostate), feeling like there’s something stuck in your urethra (the tube that connects your bladder to your penis), needing more than one attempt to urinate every day and having trouble getting an erection. Each question has two possible answers: 0 means no problem as opposed to 1—which means severe problems with these symptoms are occurring regularly or often enough for them to interfere with daily life activities such as work or relationships

How the IPSS works

The IPSS is a tool that measures the severity of symptoms. It is used to help doctors decide whether to treat the prostate, and it can also be used as part of a screening process for prostate cancer.

The seven questions in the IPSS are:

• Have you had an abnormal digital rectal exam (DRE)?

• Do you have trouble having a bowel movement?

• Are there blood in your urine or semen?

• Do you have burning during urination or ejaculation (and not just feeling wet)?

• Does this happen more often than normal?

• Do you feel pain in your lower stomach area after going to the bathroom or having sex, or do these pains continue for more than one hour without interruption; if so, how long does this last before feeling better after passing gas during sex; did someone tell them that what they were experiencing was called “prostate problems” when he/she suggested it might be something else besides being constipated/having hemorrhoids at all times but only once every couple weeks instead of everyday like most people do..

The International Prostate Symptom Score is based on seven questions.

The IPSS is a tool to measure the severity of symptoms. It’s based on seven questions, each with four possible answers:

• Question 1: How many times per day do you experience any pain during urination? (0-3)

• Question 2: Does your pain ever wake you from sleep? (1-5)

• Question 3: Is there any blood in the urine, which is yellow or brownish-yellow in color (1) or dark red/brownish in color (2)? If so, what type(s) would be present – for example: blood clots or crystals.

1. Over the past month, how often have you had a sensation of not emptying your bladder completely after you finished urinating?

• Over the past month, how often have you had a sensation of not emptying your bladder completely after you finished urinating?

• How often do these feelings make it difficult for you to sleep at night?

• On average, how many times per day does one or more of these conditions cause difficulty for one or more of your friends living in the same house as you (e.g., with whom)?

2. Over the past month, how often have you had to urinate again less than two hours after you finished urinating?

• Over the past month, how often have you had to urinate again less than two hours after you finished urinating?

This question is asking about the amount of time between your last and first urination. This information can help doctors determine if there is something wrong with your bladder or kidney function that may be causing urinary frequency (and thus getting up frequently in the middle of the night).

3. Over the past month, how often have you found you stopped and started again several times when you urinated?

• Over the past month, how often have you found you stopped and started again several times when you urinated?

This is a symptom of an enlarged prostate, which can cause symptoms such as difficulty urinating and the need to use a bedpan (a toilet system designed for people with disabilities). When something is obstructing your urethra (the tube that carries urine from the bladder to outside of body), it may be difficult for you to pass urine normally or at all.

4. Over the past month, how often have you found it difficult to postpone urination?

• Over the past month, how often have you found it difficult to postpone urination?

This is a common symptom of prostate cancer. If you have trouble postponing urination and see that your problem is not helped by drinking more water or using antidiuretic medications (such as furosemide or Lasix), see your doctor.

5. Over the past month, how often have you had a weak urinary stream?

How often do you urinate?

A weak urinary stream is when the flow of urine is very light and difficult to detect, making it difficult to start or stop going to the bathroom. The test can be performed in a hospital setting or at home using special equipment.

How can I strengthen my urinary stream?

The following exercises may help with strengthening your urinary stream:

6. Over the past month, how often have you had to push or strain to begin urination?

You can use the IPSS to keep track of your symptoms and progress. The IPSS is a tool that helps men monitor their prostate health, but it’s also useful for women to know how they feel about their symptoms and whether they’re at risk for more serious conditions.

The first question on the test is: Have you had any difficulty initiating urination during the past month? If so, score 1 point; if not, score 0 points. Next comes: In the past year (or since onset of regular stream or flow), how often have you needed help with urinating? This question asks about having difficulty starting or stopping urine flow; either answer will count as one point here—but make sure that when answering this question specifically about initiating urine flow (as opposed to just needing help in general), you’re being accurate! Next comes: Has there been any change in frequency from what was reported at last month’s visit? If yes—which means either increasing frequency or severity/duration of urinary incontinence—score 2 points; otherwise zero points

7. Over the past month, how many times did you most typically get up to urinate from the time you went to bed at night until the time that you got up in the morning (for example, zero times, one time)?

This question is not about how often you urinate, but how many times you get up to urinate. It’s a measure of how many times you get up in the night and go pee before going back to bed.

This question is different from “How much urine do I pass at night?” because it doesn’t measure volume; rather, it measures frequency of passing urine during a given period of time. The result may be higher than what would be considered normal for most people (about six times per night), but it doesn’t mean that they’re doing something wrong or abnormal—it just means their bladder empties more frequently than average!

The International Prostate Symptom Score measures prostate symptoms

The International Prostate Symptom Score (IPSS) is a tool to measure severity of symptoms. It’s based on seven questions:

• Over the past month, how often have you had a sensation of not emptying your bladder completely after you finished urinating?

• During your last sexual intercourse, did the man inserted his penis into the vagina but could not achieve an erection due to erectile dysfunction; or did he achieve an erection but could not maintain it for any length of time because he was unable to become sexually aroused?

• At what age would you consider yourself “old enough” for sex?

• Has anyone ever told you that they were afraid for their life when having sex with someone else because it made them feel vulnerable or threatened by that person’s actions towards them?

• . Have there been times when someone has said something hurtful about one’s body appearance such as being overweight or having acne scars which caused emotional distress and led them toward self-mutilation behavior such as cutting off parts off fingers etc., even though these statements were made by others who didn’t know better than themselves how much pain those words caused within themselfs–or maybe even worse–were said out loud while everyone else around heard every word spoken aloud!

Conclusion

We hope this article has been helpful for you. If you have any questions or comments, please feel free to leave them in the comment section below. Thanks for reading!