Pathophysiology FINAL questions (CH. 52)

Two nursing students are debating the merits and demerits of infant circumcision. Which of the following statements is most accurate? A) "Circumcised men tend to have a lower incidence of penile cancer." B) "Getting circumcised basically rules out the possibility of getting Peyronie disease later in life." C) "Circumcision reduces pressure on the deep dorsal vein and the dorsal artery, making erection easier later in life." D) "The odds of getting infant priapism fall with circumcision."

A) "circumcised men tend to have a lower incidence of penile cancer"

A 40-year-old African American patient is at increased risk of developing prostate cancer, since his father was diagnosed with the disease at age 60 and his brother at age 56. What diagnostic measures should be undertaken? A) PSA and DRE starting before the age of 50 B) Transrectal ultrasonography starting immediately C) PSA and DRE starting at age 50 D) Transrectal MRI starting at age 45

A) PSA and DRE starting before the age of 50

Of the following list of medications, which would likely be prescribed to a patient with benign prostatic hyperplasia (BPH) as a way to decrease the prostate size by blocking the effects of androgens on the prostate? A) Finasteride (Proscar), a 5a-reductase inhibitor B) Imdur (isosorbide mononitrate), a vasodilator C) Birth control pills containing both estrogen and progestin D) Leuprolide (Lupron), a gonadotropin-releasing hormone analog

A) finasteride, a 5a reductase inhibitor

A 34-year-old male has been diagnosed with testicular cancer after he visited his family physician with a complaint of an enlarged, painful testicle. Biopsy has indicated that his tumor is malignant, and his oncologist believes that the tumor arose in the seminiferous epithelium and is producing a uniform population of cells. What is the client's most likely specific diagnosis? A) Seminoma B) Choriocarcinoma C) Germ cell tumor D) Nonseminoma

A) seminoma

A patient with excruciating back pain that has been getting worse over the past few months comes to the Emergency Department. His chief complaint is excruciating back pain that has been getting worse over the past few months. He has also noticed decreased sensation in his lower extremities, some urinary incontinence, and feels like he never really empties his bladder all the way after voiding. Following diagnostic testing, the patient is diagnosed with advanced prostate cancer with spinal cord compression. The nurse should anticipate administering which medications to this patient? Select all that apply. A) Ketoconazole, a fungicide, to lower serum testosterone levels. B) Bisphosphonates, such as pamidronate, to inhibit bone loss C) Phosphate-binding agents such as aluminum hydroxide D) Sulfonamides with trimethoprim (Bactrim) to treat the urinary tract infection (UTI) E) Calcium carbonate to prevent osteoporosis

A, B

A 66-year-old man has presented to a nurse practitioner to get a refill for his antiplatelet medication. The client has a history of ischemic heart disease and suffered a myocardial infarction 5 years ago and has unstable angina; he uses a transdermal nitroglycerin patch to control his angina. The client has a 40 pack-year smoking history and uses nebulized bronchodilators at home for the treatment of transient shortness of breath. He has long-standing hypertension that is treated with a potassium-sparing diuretic and a β-adrenergic-blocking medication. During the nurse's assessment, the man states that he has been unable to maintain his erection in recent months. Which of the following aspects of the man's health problems and treatments would the nurse identify as contributing to his erectile difficulty (ED)? Select all that apply. His A) antihypertensive medications. B) use of bronchodilators. C) hypertension. D) diuretic use. E) smoking history. F) age.

A, C, E, F

A 54-year-old diabetic patient has come to the urology clinic complaining of erectile dysfunction. His history includes obesity, coronary artery disease that required CABG 3 years ago, hypertension, and gout. The nurse practitioner is reviewing his record in order to prescribe medication. The practitioner is considering prescribing sildenafil (Viagra). Which of the following home medications is contraindicated if taken concurrently with sildenafil? A) Diltiazem (Cardizem), a calcium channel blocker B) Cordarone (amiodarone), an antiarrhythmic C) Imdur (isosorbide mononitrate), a vasodilator D) Lasix (furosemide), a diuretic

C) imdur (isosorbide mononitrate), a vasodilator

A medical student is assessing a 22-year-old male who has come to the emergency department because of pain and swelling in his scrotum over the past 36 hours. The attending physician has told the student that she suspects epididymitis. Which of the medical student's following questions is most likely to be useful in the differential diagnosis of epididymitis? A) "Do you know if your vaccinations for mumps are up to date?" B) "Have you had unprotected sex in the past?" C) "Do you have a sensation of heaviness in the left side of your scrotum?" D) "Has it been painful when you get an erection lately?"

B) "have you had unprotected sex in the past?"

A 20-year-old male has been diagnosed with testicular cancer and is seeking information about his diagnosis from a number of Web sites. Which of the following statements that he has read is most plausible? A) "Testicular cancer is a leading cause of death among males who should be in the prime of their life." B) "Men with cryptorchidism--the term for an undescended testicle--are known to have a higher risk of developing testicular cancer." C) "For most men with testicular cancer, bloody urine is their first sign that something is wrong." D) "Recent developments in the treatment of testicular cancer mean that few men now need to have a testicle removed."

B) "men with cryptorchidism - the term for an undescended testicle- are known to have a higher risk of developing testicular cancer"

A nurse practitioner has a 30-year-old male patient presenting with fever and chills, urinary frequency and urgency, and pain with urination. A urine sample displays cloudy and foul-smelling urine. During digital rectal exam of the prostate, the nurse notes a thick white discharge. A likely diagnosis would be A) urinary tract infection requiring a prescription of sulfur drugs. B) acute bacterial prostatitis requiring antimicrobial therapy. C) testicular cancer requiring appointment with an urologist. D) Inflammation of the epididymis requiring scrotal elevation.

B) acute bacterial prostatitis requiring antimicrobial therapy

Following a long history of intermittent back pain and urinary urgency, a 50-year-old client has been diagnosed with chronic bacterial prostatitis. Which of the following factors is most likely to influence his health care provider's choice of treatment? A) The diagnosis is thought to have an autoimmune etiology with limited response to steroid treatments. B) Antibacterial drugs penetrate poorly into the chronically inflamed prostate. C) Urethral catheterization provides symptom relief and contributes to resolution of the underlying infection. D) There are no proven treatments for chronic prostatitis that address the infectious process.

B) antibacterial drugs penetrate poorly into the chronically inflamed prostate

A newborn male has been diagnosed with hypospadias following his postpartum assessment by a pediatrician. Which of the following diagnostics and treatment options is the physician most likely to rule out first? A) Chromosomal studies B) Circumcision C) Surgical repair D) Testosterone supplementation

B) circumcision

While teaching a health class to junior and senior male high school students, the school nurse educates them regarding the first sign of testicular cancer, which would include A) one testicle being lower than the other in the scrotal sac. B) enlargement of the testicle. C) back pain. D) coughing bloody sputum.

B) enlargement of the testicle

When explaining to a patient why his prostate is enlarging, the nurse will mention that which of the following hormones may contribute to the prostatic hyperplasia? Select all that apply. A) Glucocorticoids B) Testosterone C) Dihydrotestosterone D) Estrogens E) Progesterone

B, C, D

A 14-year-old boy has been brought to the emergency department by his mother in excruciating pain that is radiating from his scrotum to his inguinal area. The boy's heart rate is 122 beats/minute, and he has vomited twice before arrival at the hospital. Examination reveals that his scrotum is reddened and slightly swollen, and the testes are firm to touch and tender, with extensive cremaster muscle contraction noted. What is the boy's most likely diagnosis? A) Epididymitis B) Hydrocele C) Testicular torsion D) Varicocele

C) testicular torsion

A 41-year-old male has presented to his family physician stating that for the last 2 years his erection "is as crooked as a dog's hind leg and hurts too." He has subsequently been diagnosed with Peyronie disease. Which of the following statements by his physician is most appropriate? A) "Even though it's obviously distressing, you should know that this will likely resolve on its own with time." B) "I'll refer you to a urologist who will likely want to perform a circumcision." C) "This might need surgery, but it could possibly disappear over time without needing treatment." D) "There are things you can do to minimize this, such as getting more exercise, stopping smoking, and maintaining a healthy diet."

C) "this might need surgery, but it could possibly disappear over time without needing treatment"

Which of the following teaching points by an oncologist is most appropriate for a 33-year-old male who will begin treatment shortly for his testicular cancer? A) "Thanks to new treatment advances, there's a very good chance that I won't have to remove a testicle." B) "If steroid treatment fails, then we can consider surgery and/or chemotherapy." C) "You should know that there might be adverse effects on your sexual function after treatment is finished." D) "The advantage of performing an orchiectomy over other treatments is that it rules out recurrence."

C) "you should know that there might be adverse effects on your sexual function after treatment is finished"

A 51-year-old man is receiving his annual physical exam, and his care provider is explaining the rationale for performing a digital rectal exam (DRE). Which of the following statements best captures the rationale for the procedure? A) DRE, combined with a measurement of prostate-specific antigen (PSA), is the easiest way to confirm or rule out benign prostatic hyperplasia (BPH). B) The presence of an enlarged prostate provides a definitive diagnosis of prostate cancer. C) If the prostate is hardened on examination, a biopsy is indicated for further investigation. D) DRE is a screening test recommended for men who are experiencing either reduced urine flow or pain on urination.

C) if the prostate is hardened on examination, a biopsy is indicated for further investigation

A 71-year-old man diagnosed with a stage T2 prostate tumor 2 years ago has elected watchful waiting, based upon an underlying heart condition that renders surgery potentially fatal. Recently, his PSA has jumped considerably, as have his levels of serum acid phosphatase. Which course of action would be least appropriate at this stage? A) Combination treatment with an antiandrogen and a GnRH agonist B) Treatment with bisphosphonates C) Treatment with GnRH agonists alone D) Treatment with ketoconazole

C) treatment with GnRH agonists alone

A care aide at a long-term care facility has left a note for the care director stating that an 82-year-old resident has a grossly distended scrotum and a likely inguinal hernia. On examination, the resident has been diagnosed instead with hydrocele. What will the care team most likely tell the resident and his family about his diagnosis? A) "We'll get you to the hospital quickly, because if this isn't treated, it can result in a blockage in the blood flow to your testes." B) "This isn't a result of your intestine entering your scrotum, but an accumulation of fluid within your testes." C) "This can sometimes result from the lower level of sex hormones that comes with age, so you will likely benefit from a testosterone supplement." D) "While distressing to look at, this condition usually doesn't have any significant consequences and won't need treatment."

D) "while distressing to look at, this condition usually doesn't have any significant consequences and won't need treatment"