20Qw/exp Erectile Dysfunction
The nurse is caring for a client diagnosed with ED. The client has diabetes and hypertension and is recovering from having several toes on his left foot amputated due to diabetic complications. He asks you what his treatment options might be for ED. Which is least likely to be an effective treatment option for this client? A. Mechanical devices B. Selective phosphodiesterase type 5 inhibitors C. Revascularization surgery D. Injectable medications
C Revascularization surgery is usually not successful for a client where underlying vascular issues cannot be corrected.
The client, who had been prescribed sildenafil 2 weeks ago for erectile dysfunction, calls the clinic to report that nothing happens, despite taking sildenafil orally and waiting for his erection to develop, Which fact should the nurse consider before responding to the client? A. In clinical trials, the sildenafil was effective only 20% of the time B. Sildenafil is not effective if taken orally and should be taken rectally C. In the absence of sexula stimuli, sidenafil will not cause an erection D. Sildenafil is ineffective if taken with foods high in saturated fats
C Sildenafil (Viagra) enhances the normal erectile response to sexual stimuli by promoting relaxation of arterial and trabecular smooth muscle. The resultant arterial dilation causes engorgement of sinusoidal spaces in the corpus cavernsum. In the absence of sexual stimuli, however, nothing will happen.
The nurse is explaining to a student nurse that lifestyle choices often can be both a risk factor for and a cause of ED. The nurse knows that the student understands the explanation when stating which lifestyle choices as causes of ED? A. Stress, anxiety, low self-esteem B. Injury to the penis, COPD, diabetes mellitus C. Smoking, alcohol use, being overweight, not exercising D. Low level of testosterone, hypothyroidism
C Smoking, alcohol use, being overweight and not exercising are examples of lifestyle choices.
The nurse is caring for a client who was diagnosed with ED several months ago. Knowing that he has poor visual acuity and experiences a tremor in his left hand, which treatment choice for ED is likely not to meet his needs? A. Mechanical devices B. Penile implant C. Selective phosphodiesterase type 5 inhibitors D. Injectable medications
D Injectable medications are often not an acceptable treatment for clients. Many clients report dissatisfaction with them because of difficulty in self-injecting, pain, lack of spontaneity, and cost.
The nurse is caring for a male client, with a history of coronary artery disease and hypertension, who smoked one pack per day of cigarettes for 30 years before quitting 2 years ago. Which is the most likely etiology of the client's newly diagnosed ED? A. Nurogenic B. Hormonal C. Latrogenic D. Vascular
D Vascular causes of ED include atherosclerosis, hypertension, heart disease, and diabetes mellitus.
The nurse should teach the client with erectile dysfunction to alter his lifestyle to: A. Avoid alcohol B. Follow a low-salt diet C. Decrease smoking D. Increase attempts at sexual intercourse
A Avoidance of alcohol can improve the outcome of therapy. Alcohol and smoking can affect a man's ability to have and maintain an erection.
The client diagnosed with angina is prescribed nitroglycerin (Nitrobid) and tells the nurse, "I don't understand why I can't take my Viagra. I need to take it so that I can make love to my wife." Which statement is the nurse's best response? A. "If you take the medications together, you may get very low blood pressure." B. "You are worried your wife will be concerned if you cannot make love." C. "If you wait at least 8 hours after taking you nitroglycerin (NTG), you can take your Viagra." D. "You should get clarification with your HCP about your taking Viagra."
A Life-threatening hypotension can result with concurrent use of nitroglycerin and sildenafil (Viagra).
The nurse is providing discharge instructions to a client and his partner regarding a new penile implant. Which teaching point is not appropriate for the nurse to include in the teaching session A. An implant is softer than a natural penis and may not provide usual partner satisfaction B. Men are usually satisfied with their implant C. It is important to practice with the pump D. Sexual activity can be resumed in six to eight weeks
A Teaching is an essential part of the nurse's role in the discharge process. The nurse would not include the statement that the implant is softer than the natural penis.
Which male client should the nurse consider at risk for complications when taking sildenafil (Viagra), a sexual stimulate? A. A 56-year-old client with unstable angina B. An 87-year-old client with glaucoma C. A 44-year-old client with type 2 diabetes D. A 32-year-old client with an L1 spinal cord injury (SCI)
A Viagra should be used cautiously in clients with coronary heart disease because during sexual activity the client could have a myocardial infarction from the extra demands on the heart. Specifically, clients taking nitroglycerin or any nitrate medication should not take Viagra because the vasodilatation effect of Viagra may cause hypotension. A client with unstable angina would be taking a nitrate medication.
The nurse is discharging a male client with a semirigid penile implant. Which statements by the client indicate the instruction has been successful? (Select all that apply) A. "I think this will take some time to get used to with my partner." B. "If we have problems adjusting to this, I have the number of the therapist you gave me." C. "I guess I'll need to buy some different trousers so my implant won't be so noticeable." D. "I can't wait to try this out tomorrow with my partner." E. "I bet my partner will have a great time - I'll be able to go for hours!"
A,B,C With a simirigid implant, the type of clothing worn can be used to conceal it and decrease self-consciousness. it will take a period of adjustment for the man and his partner to get used to the implant.
The nurse is caring for a client newly diagnosed with ED. Which items are appropriate for the nurse to include in the assessment process? (Select all that apply) A. Client's current sexual practices B. Client's socioeconomic status C. Client's risk factors for ED D. Client's religious affilation E. Client's history of sexual dysfunction
A,C,E In order to assist a client in coping with ED, the nurse should assess risk factors for ED, sexual dysfunction, and the client's current sexual practices.
The nurse is caring for a postoperative client with an inflatable penile implant. Which statements from the client indicate the need for further instruction? (Select all that apply) A. "Next week is out anniversary - we can be intimate for the first time in years" B. "I think this is going to work very well for us" C. "I think this will take some practice and patience once we get back to sexual activity again" D. "I guess we can practice with this as much as we want" E. "What if we can't get the hang of this? What should we do?"
A,E In teaching the client and his partner about penile implants of the inflatable variety, let them know that practice is important - both to learn how to use the implant and to maintain its position and help tissue grow around it to hold it in place.
A male client reports having impotence. The nurse examines the client's medication regimen and determines that a contributing factor to impotence could be: A. Aspirin B. Antihypertensives C. Nonsteroidal anti-inflammatory drugs D. Anticoagulants
B Antihypertensives, especially beta-blockers such as propranolol, can cause impotence. When a male client has impotence, the nurse should always examine his medication regimen as a potential contributing factor.
The nurse is caring for a client who is newly diagnosed with ED. The client asks why his diabetes caused this to happen. The nurse bases the response on which rationale? A. ED is a normal part of aging that happens to all men at some point B. Vascular disease often associated with diabetes contributes to ED C. The medications he is on for diabetes are iatrogenic causes of ED D. The psychological stress of having a chronic disease brought on the ED
B Damage to arteries and vascular disease, which occurs in diabetes, are a common cause of ED.
A 65-year-old male client with erectile dysfunction asks the nurse, "Is all this just in my head? Am I crazy?" The best response by the nurse is based on the knowledge that: A. ED is believed to be psychogenic in most cases B. More than 50% of the cases are attributed to organic causes C. Evaluation of nocturnal erection does not help differentiate psychogenic or organic causes D. ED is an uncommon problem among men older than age 65
B ED is multifactorial in origin, and more than 50% of the cases can be attributed to organic causes, which include alteration in vascular supply, hormonal changes, neurologic dysfunction, medications, and associated systemic diseases, such as diabetes mellitus or alcoholism.
The nurse is caring for a male client being discharged from the hospital with a nitroglycerin prescription for chest pain. The client states that he takes Viagra for ED, but he knows this is no longer safe. Which treatment option for ED would be appropriate for the nurse to include in the discharge instructions? A. Topical cream B. Mechanical device C. Acupuncture D. Biofeedback device
B If a client is unable to take selective phosphodiesterase type 5 inhibitors, unwilling to try injectable medications, and not a candidate for surgery, a mechanical device such as a vacuum constriction device (VCD) may be prescribed.
The nurse is caring for a client who presents with an exacerbation of hypertension. While obtaining the nursing admission history, the nurse learns that he recently stopped taking his blood pressure medication. When asked why, he is initially reluctant to answer but eventually states that it made him 'have problems in the bedroom.' What is the cause of this client's erectile dysfunction? A. Lifestyle choices B. Latrogenic C. Hormonal D. Psychological
B Latrogenic causes of ED are side effects of medication and surgical procedures.
The nurse is teaching a client about treatment options for ED. Which explanation regarding pharmacological treatment is the most appropriate? A. They allow a man to relax enough to reduce the psychological stress of ED in order to achieve an erection B. They help a man achieve an erection during sexual stimulation by enhancing the effects of nitrous oxide to relax the smooth muscle of the penis and increase blood flow C. They dilate blood vessels all over the body except in the penis, to allow the man to achieve an erection D. They constrict blood flow to other parts of the body in order to shunt it to the penis during sexual stimulation
B Selective phosphodiesterase type 5 inhibitors enhance erections in the presence of sexual stimulation. They increase the effects of nitrous oxide to relax smooth muscle in the penis and increase blood flow during sexual stimulation.
The client is taking sildenafil orally for erectile dysfunction. What instruction should the nurse give the client? A. Sildenafil may be taken more than one time per day B. The HCP should be notified promptly if the client experiences sudden or diminished vision C. Sildenafil offers protection again some STDs D. Sildenafil does not require sexual stimulation to work
B The client should notify his HCP promptly if he experiences sudden or decreased vision loss in one or both eyes.
The nurse teaches the client with erectile dysfunction about the use of alprostadil via subcutaneous penile injection. Which statement indicates the client needs further teaching? A. "I need to keep the needle sterile before I inject my penis" B. "The erection won't last long after alprostadil is injected" C. "The injection will produce an erection within 30 minutes" D. "I should report if I am feeling dizzy after an injection"
B The nurse should correct the statement about an erection not lasting long. Alprostadil (Caverject) injection therapy has the potential of producing a prolonged erection.
