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RNSG 1538 IN PROGRESS EXAM QUESTIONS WITH COMPLETE ANSWERS
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RNSG 1538 IN PROGRESS EXAM QUESTIONS WITH COMPLETE ANSWERS
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RNSG 1538 IN PROGRESS EXAMQUESTIONS WITH COMPLETE
ANSWERS
A 52-year-old man tells the nurse that he decided to seek treatment for erectile
dysfunction (ED) because
his wife is losing patience with the situation. The most appropriate nursing diagnosis for
the patient is
a. situational low self-esteem related to effects of ED.
b. ineffective role performance related to effects of ED.
c. anxiety related to inability to have sexual intercourse.
d. ineffective sexuality patterns related to infrequent intercourse. - Answer-ANS: B
The patients statement indicates that the relationship with his wife is his primary
concern. Although anxiety, low self-esteem, and ineffective sexuality patterns may also
be concerns, the patient information suggests that
addressing the role performance problem will lead to the best outcome for this patient.
A 22-year-old man tells the nurse at the health clinic that he has recently had some
problems with erectile
dysfunction. Which question should the nurse ask first to assess for possible etiologic
factors?
a. Do you experience an unusual amount of stress?
b. Do you use any recreational drugs or drink alcohol?
c. Do you have chronic cardiovascular or peripheral vascular disease?
d. d. Do you have a history of an erection that lasted for 6 hours or more? - Answer-
ANS: B
A common etiologic factor for erectile dysfunction (ED) in younger men is use of
recreational drugs or alcohol. Stress, priapism, and cardiovascular illness also
contribute to ED, but they are not common etiologic
factors in younger men.
A 58-year-old man with erectile dysfunction (ED) tells the nurse he is interested in using
sildenafil (Viagra). Which action should the nurse take first?
a. Assure the patient that ED is common with aging.
b. Ask the patient about any prescription drugs he is taking.
c. Tell the patient that Viagra does not always work for ED.
d. Discuss the common adverse effects of erectogenic drugs. - Answer-ANS: B
Because some medications can cause ED and patients using nitrates should not take
sildenafil, the nurse should first assess for prescription drug use. The nurse may want to
teach the patient about realistic expectations and adverse effects of sildenafil therapy,
but this should not be the first action. Although ED does increase with aging, it may be
secondary to medication use or cardiovascular disease.
,The nurse in a health clinic receives requests for appointments from several patients.
Which patient should
be seen by the health care provider first?
a. A 48-year-old man who has perineal pain and a temperature of 100.4 F
b. A 58-year-old man who has a painful erection that has lasted over 6 hours
c. A 38-year-old man who states he had difficulty maintaining an erection last night
d. A 68-year-old man who has pink urine after a transurethral resection of the prostate
(TURP) 3 days ago - Answer-ANS: B
Priapism can cause complications such as necrosis or hydronephrosis, and this patient
should be treated immediately. The other patients do not require immediate action to
prevent serious complications.
A nurse is reviewing concepts related to physiological responses that occur during
sexual acts. Which statement should the nurse identify as not being accurate?
a. During resolution, ADH and oxytocin are released.
b. Most often in males, orgasm occurs with ejaculation.
c. Genital congestion occurs as part of a reflexive response.
d. Dopamine secretion acts as an inhibitory transmitter. - Answer-ANS: D
The general phases of sexual arousal include motivation, arousal, genital congestion,
orgasm
and resolution. Dopamine secretion is considered to be an excitatory and released
during the arousal stage. Orgasm and ejaculation occur more frequently in males.
Genital congestion is under reflexive autonomic response.
The nurse is obtaining a sexual history from an adolescent patient. Which finding has
the greatest implication for this patient's care?
a. Patient denies any sexual activity.
b. Patient states that he/she uses "safe sex" practices.
c. Patient states that he/she is in a monogamous relationship.
d. Patient has been intimate with more than one person in the last year. - Answer-ANS:
D
The Center for Disease Control (CDC) had identified the 5P's with regard to obtaining
information for a sexual history. They focus on partners, practices, protection from
infection, past history of infection, and prevention of pregnancy. An individual who has
had more than one partner within the time frame should be questioned regarding
condom use. Denial of sexual activity is part of the patient's self-disclosure. The patient
stating that he/she is in a monogamous relationship again represents self-disclosure.
Use of "safe sex" practices may need to be further explored but it does not have the
greatest implication at this point.
A 45-year-old female patient, gravida 3 para 3, presents with complaints of decreased
desire to engage in sexual activity with her husband as it is becoming more painful.
What physical assessment data should the nurse focus on?
a. Urine culture to identify potential STD.
b. Obtain vital signs as a baseline to rule out infection.
c. Prepare for a vaginal exam.
, d. Inspection of the abdomen for pelvic mass - Answer-ANS: C
Based on the patient's reported complaint and obstetrical history, it may be likely that
the
patient has a pelvic prolapse. Therefore, a vaginal exam would be indicated to help
identify possible anatomical changes. There is no clinical data that supports a potential
pelvic mass and inspection alone would not confirm this finding. Obtaining vital signs as
well as a urine culture may be needed, but the focus should be on determination of
physical findings related to the pelvic area.
An adult patient comes for a well-check up to the primary care provider's office. In
completing the office admission form, the patient does not indicate gender on the form
and
seems somewhat agitated when providing the form back to the nurse. How should the
nurse respond?
a. Ask the patient to complete all of the information at this time.
b. Ask the patient if you can assist with completing the form.
c. The nurse should just indicate which gender she/he thinks is appropriate.
d. Tell the patient that if the form is not completed, then the doctor will not see you. -
Answer-ANS: B
Gender identity is defined by the individual patient. The nurse should not designate this
description or identity nor should the nurse tell the patient that if the form is not
completed,
that the patient will not be seen by the healthcare provider. Asking the patient to
complete the information without acknowledging that the patient is exhibiting signs of
distress is not therapeutic. The nurse should offer to provide assistance to the patient.
A nurse is working with a male patient being treated for erectile dysfunction. Which
statement indicates that additional teaching is needed?
a. "I like to go walking around my community each night after dinner."
b. "I have a few drinks during the week when I go out after work."
c. "I have maintained my weight for the past 5 years after losing 20 pounds."
d. "I monitor my blood pressure at home using a portable cuff." - Answer-ANS: B
Erectile dysfunction (ED) is a common problem affecting the male population and can
be
chronic or transient in nature. Alcohol use can affect ED, so the patient's reported
alcohol
intake indicates that additional teaching is warranted. Exercise, maintaining a healthy
weight and monitoring of blood pressure are examples of appropriate activities.
A nursery nurse performing the first physical assessment of the newborn observes that
there is no clear identification of genitalia as being either female or male. How should
the nurse identify this newborn?
a. Gender neutral
b. Bisexual
c. Observation of intersex
d. Asexual - Answer-ANS: C
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