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Mens Health Flashcards

1
Q
  • ****1. A 63-year-old man is seen in the clinic with a chief complaint of nocturia. Which of the following should be included in the differential diagnosis?
    a. Psychogenic nocturia
    b. Urethral polyp
    c. Irritative posterior urethral lesion
    d. Benign prostatic hypertrophy
A
  1. ANS: D

Benign prostatic hypertrophy

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2
Q

A 76-year-old man is seen in the office for complaints of urinary incontinence. The clinician should explore which of these causes of incontinence in men?

a. Urethral polyps
b. Urinary tract infection (UTI)
c. Anticholinergic medication
d. All of the above

A
  1. ANS: BUrinary tract infection (UTI)
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3
Q

A 14-year-old male is seen with complaints of severe testicular pain. The clinician suspects testicular torsion. Which of the following is the appropriate action?

a. Refer to a urologist immediately.
b. Obtain a computed tomography (CT) scan.
c. Instruct the patient to elevate the scrotum.
d. Prescribe ibuprofen.

A
  1. ANS: ARefer to a urologist immediately.
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4
Q
  • ****4. An 82-year-old man is seen in the primary care office with complaints of dribbling urine and difficulty starting his stream. Which of the following should be included in the list of differential diagnoses?
    a. Benign prostatic hyperplasia (BPH)
    b. Parkinson’s disease
    c. Prostate cancer
    d. All of the above
A
  1. ANS: DAll of the above
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5
Q
  • ****5. Which of the following would be an appropriate treatment for a patient with mild BPH?
    a. Refer to a urologist for surgery.
    b. Prescribe a trial of tamsulosin.
    c. Recommend cranberry supplements.
    d. Reevaluate symptoms in 1 to 3 months.
A
  1. ANS: D

Reevaluate symptoms in 1 to 3 months.

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6
Q
  • ****6. A 30-year-old man is seen with a chief complaint of loss of libido. Which of the following laboratory tests would help establish a diagnosis?
    a. Testosterone level
    b. Prostate-specific antigen
    c. Nocturnal penile tumescence and rigidity
    d. Prolactin level
A
  1. ANS: ATestosterone level
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7
Q
  • ****7. Which of the following should be considered in a patient presenting with erectile dysfunction?
    a. Diabetes mellitus
    b. Hypertension
    c. Atherosclerosis
    d. All of the above
A
  1. ANS: DAll of the above
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8
Q
  • ****8. A 35-year-old man presents with complaints of painful erections, and he notices his penis is crooked when erect. What is the most likely diagnosis?
    a. Peyronie’s disease
    b. Damage to the pudendal artery
    c. Scarring of the cavernosa
    d. All of the above
A
  1. ANS: APeyronie’s disease
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9
Q
  • ****9. The patient with BPH is seen for follow-up. He has been taking finasteride (Proscar) for 6 months. The clinician should assess this patient for which of these side effects?
    a. Erectile dysfunction
    b. Glaucoma
    c. Hypotension
    d. Headache
A
  1. ANS: AErectile dysfunction
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10
Q
  • ****10. The clinician should prescribe an antibiotic that covers which of these organisms for a patient with acute prostatitis?
    a. Gram-positive cocci
    b. Gram-negative cocci
    c. Gram-positive bacillus
    d. Gram-negative bacillus
A
  1. ANS: D

Gram-negative bacillus

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11
Q
  • ****The 56-year-old man with chronic prostatitis should be treated with trimethoprim 80 mg-sulfamethoxazole 400 mg (TMP-SMX, Bactrim) for how long?
    a. 3 to 7 days
    b. 14 to 21 days
    c. 3 to 6 weeks
    d. 6 to 12 weeks
A
  1. ANS: D

6-12 weeks

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12
Q
  1. A 46-year-old man presents with urinary hesitancy and low back pain. He has no history of UTI. Digital rectal examination (DRE) reveals a normal prostate, and a diagnosis of prostatodynia is made. Which is the appropriate treatment?
    a. Terazosin 2 mg PO once a day
    b. Ice pack to the scrotal area
    c. Saw palmetto 320 mg per day
    d. All of the above
A
  1. ANS: ATerazosin 2 mg PO once a day
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13
Q

A 23-year-old sexually active man is seen in the clinic with unilateral painful testicular swelling, and he is diagnosed with epididymitis. In order to prescribe the correct drug, the clinician must understand that which of these is the most common causative organism?

a. Escherichia coli
b. Staphylococcus aureus
c. Chlamydia trachomatis
d. Pseudomonas aeruginosa

A
  1. ANS: CChlamydia trachomatis
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14
Q

Which test is used to confirm a diagnosis of epididymitis?

a. Urinalysis
b. Gram stain of urethral discharge
c. Complete blood cell count with differential
d. Ultrasound of the scrotum

A
  1. ANS: DUltrasound of the scrotum
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15
Q

Treatment for epididymitis includes which of the following?

a. Warm sitz baths
b. Scrotal elevation
c. Masturbation
d. All of the above

A
  1. ANS: B

Scrotal elevation

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16
Q

Which of the following data is indicative of testicular torsion?

a. Absent cremasteric reflex
b. Pain relieved on testicular elevation
c. Testicle very low in the scrotum
d. Swollen scrotum with “red dot sign”

A

A

Absent cremasteric reflex
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17
Q
  1. A 60-year-old man presents with an enlarged scrotum. The clinician uses a penlight to transilluminate the scrotum. In a patient with a hydrocele, what would the clinician expect to find?
    a. The scrotum will be dark.
    b. The scrotum will appear light pink or yellow.
    c. The scrotum will appear milky white.
    d. The internal structures will be clearly visible.
A
  1. ANS: B

The scrotum will appear light pink or yellow.

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18
Q
  • ****During a DRE on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious?
    a. An enlarged rubbery gland
    b. A hard irregular gland
    c. A tender gland
    d. A boggy gland
A
  1. ANS: AAn enlarged rubbery gland
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19
Q
  • ****A 78-year-old man is diagnosed with C2 prostate cancer, and he asks the clinician what that means. In order to answer the patient, the clinician must have which of these understandings of the Jewett rating system?
    a. The cancer involves the seminal vesicles.
    b. There is metastatic disease to regional lymph nodes.
    c. The cancer is confined to the capsule.
    d. There is metastasis to distant organs.
A
  1. ANS: A

The cancer involves the seminal vesicles.

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20
Q
  • ****A 58-year-old patient has been receiving leuprolide as treatment for prostate cancer. The clinician should instruct the patient about which of these side effects?
    a. Risk of osteoporosis
    b. May have hot flushes
    c. May have impotence
    d. All of the above
A
  1. ANS: D

All of the above

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21
Q
  • ****21. A 22-year-old male is seen in the clinic because he found a hard lump in his testicle when performing testicular self-examination (TSE). Which of the following should be included in the list of differential diagnoses?
    a. Testicular cancer
    b. Inguinal hernia
    c. Varicocele
    d. All of the above
A

ANS: D

All of the above

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22
Q
  • ****22. What is the treatment of choice for a patient diagnosed with testicular cancer?
    a. Radical orchidectomy
    b. Lumpectomy
    c. Radiation implants
    d. All of the above
A
  1. ANS: ARadical orchidectomy
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23
Q
  • ****23. A patient with testicular cancer is being followed after completing treatment 1 year ago. He has been symptom-free with no evidence of disease. How often should he have a CT scan?
    a. Every month
    b. Every 3 to 4 months
    c. Every 6 to 12 months
    d. Every year
A
  1. ANS: B

EVery 3-4 months

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24
Q
  1. Patients treated for Neisseria gonorrhoeae also should be treated for Chlamydia trachomatis.
A

True

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25
Q

Hepatitis A is considered a sexually transmitted infection by the Centers for Disease Control and Prevention.

A

True

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26
Q

***** 85. Which of the following is not a common risk factor for erectile dysfunction (ED)?
A. diabetes mellitus
B. hypertension
C. cigarette smoking
D. testosterone
Fitzgerald, Margaret A. Nurse Practitioner Certification Examination and Practice Preparation, 5th Edition. F.A. Davis Company, 20170314. VitalBook file.

A

.testosterone deficiency D.

27
Q

***86. Patient education about the use of sildenafil (Viagra®) includes the following:
A. A spontaneous erection occurs about 1 hour after taking the medication.
B. This medication helps regain erectile function in nearly all men who use it.
C. With the use of the medication, sexual stimulation also is needed to achieve an erection.
D. Nitrates can be safely used

A

. C. With the use of the medication, sexual stimulation also is needed to achieve an erection.

28
Q

***87. When discussing ED with a 70-year-old man, the NP considers that:
A. it is a normal consequence of aging.
B. most cases have an underlying contributing cause.
C. although depression is common in older men, it is usually not correlated with increased rates of ED.
D. treatment options for younger men are seldom effective in older men.

A

. B. most cases have an underlying contributing cause.

29
Q 
*******88. Which of the following medications for ED treatment has the longest half-life?
A. sildenafil (Viagra®)
B. tadalafil (Cialis®)
C. vardenafil (Levitra®)
D. avanafil (Stendra®)
A

. B. tadalafil (Cialis®)

30
Q

**89. When taking a phosphodiesterase-5 (PDE-5) inhibitor, concomitant use of which medication must be avoided?
A. statins
B. sulfonylurea
C. angiotensin-converting enzyme (ACE) inhibitors
D. nitrates

A

. D. nitrates

31
Q

****90. For patients with erectile dysfunction who fail therapy with a PDE-5 inhibitor, alternative approaches include all of the following except:
A. alprostadil injection into the penis.
B. mechanical vacuum devices.
C. insertion of a nitroglycerin pellet in the urethra.
D. implantation of a prosthetic device. (Fitzgerald

A

C. insertion of a nitroglycerin pellet in the urethra.

32
Q

Men’s health

  • Loss of libido- causes and treatment
  • Erectile dysfunction- causes and treatment
  • BPH- treatments and medication side effects
  • Chronic prostatitis- presentation and treatment
  • Prostate cancer- Patient presentation
A

Study guide

33
Q

Which of the following is inconsistent with the description of BPH?

A. Obliterated median sulcus
B. Size larger than 2.5 cm x 3 cm
C. Sensation of incomplete emptying
D. Boggy gland

A

D. Boggy gland

34
Q

When prescribing antihypertensive therapy for a man with BPH and hypertension, the nurse practitioner considers that

A. Loop diuretics are the treatment of choice.
B. An alpha one antagonist should not be used as a solo or first line therapeutic agent
C. Angiotensin receptor antagonist use is contra indicated
D. Beta Andrenergic antagonist use often enhances urinary flow

A

B. An alpha one antagonist should not be used as a solo or first line therapeutic agent

35
Q

When assessing a 78-year-old man with suspected BPH, the NP considers that:

A. Prostate size does not correlate well with severity of symptoms
B. BPH affects less than 50% of them in this age.
See. He is at increased risk for prostate cancer
D. Limiting fluids is a helpful method of relieving severe symptoms

A

A. Prostate size does not correlate well with severity of symptoms

36
Q
  1. Which of the following medications can contribute to the development of acute urinary retention in an older man with BPH?
    A. amitriptyline
    B. loratadine
    C. enalapril
    D. lorazepam (Fitzgerald 197)

Fitzgerald, Margaret A. Nurse Practitioner Certification Examination and Practice Preparation, 5th Edition. F.A. Davis Company, 20170314. VitalBook file.

A

A. amitriptyline

37
Q
  1. A 78-year-old man presents with a 3-day history of new-onset fatigue and difficulty with bladder emptying. Examination reveals a distended bladder but is otherwise unremarkable. Blood urea nitrogen level is 88 mg/dL (31.4 mmol/L); creatinine level is 2.8 mg/dL (247.5 μmol/L). The most likely diagnosis is:
    A. prerenal azotemia.
    B. acute glomerulonephritis.
    C. tubular necrosis.
    D. postrenal azotemia. (Fitzgerald 197)

Fitzgerald, Margaret A. Nurse Practitioner Certification Examination and Practice Preparation, 5th Edition. F.A. Davis Company, 20170314. VitalBook file.

A

D. Post renal azotemia

38
Q
  1. Surgical intervention in BPH should be considered with all of the following except:
    A. recurrent urinary tract infection.
    B. bladder stones.
    C. persistent obstruction despite medical therapy.
    D. acute tubular necrosis. (Fitzgerald 197)

Fitzgerald, Margaret A. Nurse Practitioner Certification Examination and Practice Preparation, 5th Edition. F.A. Davis Company, 20170314. VitalBook file.

A

D. acute tubular necrosis.

39
Q
  1. Finasteride (Proscar®, Propecia®) and dutasteride (Avodart®) are helpful in the treatment of BPH because of their effect on:
    A. bladder contractility.
    B. prostate size.
    C. activity at select bladder receptor sites.
    D. bladder pressure. (Fitzgerald 197)

Fitzgerald, Margaret A. Nurse Practitioner Certification Examination and Practice Preparation, 5th Edition. F.A. Davis Company, 20170314. VitalBook file.

A

B. prostate size.

40
Q
  1. Tamsulosin (Flomax®) is helpful in the treatment of BPH because of its effect on:
    A. bladder contractility.
    B. prostate size.
    C. activity at select bladder receptor sites.
    D. bladder pressure. (Fitzgerald 197)

Fitzgerald, Margaret A. Nurse Practitioner Certification Examination and Practice Preparation, 5th Edition. F.A. Davis Company, 20170314. VitalBook file.

A

C. activity at select bladder receptor sites.

41
Q
  1. Concerning BPH, which of the following statements is true?
    A. Digital rectal examination is accurate in diagnosing the condition.
    B. The use of a validated patient symptom tool is an important part of diagnosing the condition.
    C. Prostate size directly correlates with symptoms and bladder emptying.
    D. Bladder distention is usually present in early disease. (Fitzgerald 197)

Fitzgerald, Margaret A. Nurse Practitioner Certification Examination and Practice Preparation, 5th Edition. F.A. Davis Company, 20170314. VitalBook file.

A

B. The use of a validated patient symptom tool is an important part of diagnosing the condition.

42
Q
  1. Concerning herbal and nutritional therapies for BPH treatment, which of the following statements is false?
    A. The mechanism of action of the most effective and best studied products is similar to prescription medications for this condition.
    B. These therapies are currently considered emerging therapies by the American Urological Association.
    C. Major areas of concern with use of these therapies include issues of product purity and quality control.
    D. These therapies are safest and most effective when used with prescription medications. (Fitzgerald 198)

Fitzgerald, Margaret A. Nurse Practitioner Certification Examination and Practice Preparation, 5th Edition. F.A. Davis Company, 20170314. VitalBook file.

A

D. These therapies are safest and most effective when used with prescription medications. (Fitzgerald 198)

43
Q 
PPT
PSA (Prostate-specific Antigen)
•A protein produced by normal and malignant prostatic epithelial cells
•Normal- < 4.0 ng/mL
•Elevated
•Prostate tumor
•BPH
•Prostatitis
•UTI
•Chemotherapy
A

Ppt

44
Q

Ppt

Benign Prostatic Hyperplasia
•Caused by proliferation of both the smooth muscle and epithelial cell lines of the prostate causing compression of the urethra
•Incidence
•8%-20% by age 40 (Wu, Davidian & Desemone, 2017)
•50% of men over 50 (Kennedy-Malone, 2019)
•70%-90% by age 80 (Wu, Davidian & Desemone, 2017)
•AA males more likely to have BPH. Asian Males are less likely to require surgery (Kennedy- Malone, 2019)
•Responsible for 1.1 billion in healthcare costs annually

A

.

45
Q

Ppt

History
•Symptoms
•Lower Urinary track symptoms
•Frequency, nocturia, urgency and urge incontinence
•Difficulty initiating stream, incomplete voiding, weak stream
•Can lead to acute or chronic obstructive symptoms
•Sexual dysfunction
•Erectile dysfunction
•Ejaculatory disorders
•History
•Screen for other causes of symptoms

A

.

46
Q 
52. You perform a digital rectal examination (DRE) on a 72-year-old man and find a lesion suspicious for prostate cancer. The findings are described as:
A. a rubbery, enlarged prostatic lobe.
B. an area of prostatic induration.
C. a boggy gland.
D. prostatic tenderness.
A
  1. B.

an area of prostatic induration.

47
Q 
53. Which part of the prostate is readily palpable during a DRE?
A. anterior lobe
B. median lobe
C. lateral lobes
D. posterior lobe
A

53 D.

Posterior lobe

48
Q 
54. A 54-year-old white man with no obvious risk for prostate cancer opted to undergo prostate-specific antigen (PSA) screening and DRE testing. The DRE findings are normal and his PSA is 3.7 ng/mL. You recommend:
A. repeating the PSA test immediately.
B. repeat screening in 1 year.
C. repeat screening in 2 years.
D. repeat screening in 5 years.
A
  1. B

repeat screening in 1 year.

49
Q 
55. Risk factors for prostate cancer include all of the following except:
A. African ancestry.
B. history of genital trauma.
C. family history of prostate cancer.
D. high-fat diet.
A
  1. B.

history of genital trauma.

50
Q 
56. The average American man has an approximately \_\_\_\_\_\_\_% lifetime risk of prostate cancer and an approximately \_\_\_\_\_\_\_% likelihood of clinical disease.
A. 15, 5
B. 25, 8
C. 40, 10
D. 60, 15
. VitalBook file.
A
  1. C

40, 10

51
Q 
57. All of the following can cause an elevated PSA level except:
A. current prostate infection.
B. recent cystoscopy.
C. BPH.
D. prostatectomy.
A
  1. D prostatectomy
52
Q 
58. According to recent epidemiologic studies, prostate cancer is the number \_\_\_\_\_ cause of cancer death in men residing within the United States.
A. 1
B. 2
C. 3
D. 4
A
  1. B

2

53
Q 
40. Risk factors for acute bacterial prostatitis include all of the following except:
A. having unprotected sex.
B. use of a urinary catheter.
C. prior bladder infection.
D. age >70 years.
A

D. age >70 years.

54
Q
  1. The most common causative organisms of acute bacterial prostatitis in men <35 years are:
    A. E. coli and Klebsiella pneumoniae.
    B. N. gonorrhoeae and C. trachomatis.
    C. Pseudomonas and Acinetobacter species.
    D. enterococci. (Fitzgerald 206)

Fitzgerald, Margaret A. Nurse Practitioner Certification Examination and Practice Preparation, 5th Edition. F.A. Davis Company, 20170314. VitalBook file.

A

B. N. gonorrhoeae and C. trachomatis.

55
Q
  1. When choosing an antimicrobial agent for the treatment of chronic bacterial prostatitis, the NP considers that:
    A. gram-positive organisms are the most likely cause of infection.
    B. cephalosporins are the first-line choice of therapy.
    C. choosing an antibiotic with gram-negative coverage is critical.
    D. length of antimicrobial therapy is typically 5 days.
A

C. choosing an antibiotic with gram-negative coverage is critical.

56
Q
  1. All of the following are likely to be reported by patients with acute bacterial prostatitis except:
    A. perineal pain.
    B. irritative voiding symptoms.
    C. penile discharge.
    D. fever. (Fitzgerald 206)

Fitzgerald, Margaret A. Nurse Practitioner Certification Examination and Practice Preparation, 5th Edition. F.A. Davis Company, 20170314. VitalBook file.

A

C. Penile discharge

57
Q 
44. During acute bacterial prostatitis, the digital rectal examination usually reveals a gland described as:
A. boggy.
B. smooth.
C. irregular.
D. cystic.
A

A. Boggy

58
Q

.
45. A 30-year-old man with prostatitis presents with a fever of 102.3°F (39.1°C). What would be the expected CBC findings from this patient?
A. WBC = 15,000/mm3; neutrophils = 4000/mm3
B. WBC = 18,000/mm3; neutrophils = 11,500/mm3
C. WBC = 7200/mm3; neutrophils = 3200/mm3
D. WBC = 4000/mm3; neutrophils = 1200/mm3 (Fitzgerald 206)

Fitzgerald, Margaret A. Nurse Practitioner Certification Examination and Practice Preparation, 5th Edition. F.A. Davis Company, 20170314. VitalBook file.

A

B. WBC = 18,000/mm3; neutrophils = 11,500/mm3

59
Q
  1. Appropriate antimicrobial treatment for a 25-year-old man with acute bacterial prostatitis is:
    A. oral azithromycin.
    B. IM ceftriaxone followed by oral doxycycline.
    C. oral ofloxacin.
    D. oral amoxicillin-clavulanate.
A

B. IM ceftriaxone followed by oral doxycycline.

60
Q 
47. Appropriate antimicrobial treatment for a 65-year-old man with acute bacterial prostatitis is a course of oral:
A. erythromycin.
B. cefepime.
C. TMP-SMX.
D. ciprofloxacin. (Fitzgerald 206)
A

D. ciprofloxacin

61
Q 
48. Symptoms in chronic bacterial prostatitis often include:
A. fever.
B. gastrointestinal upset.
C. low back pain.
D. penile discharge.
A

C. low back pain.

62
Q
  1. The most common causative organisms in chronic bacterial prostatitis include:
    A. gram-negative rods.
    B. gram-positive cocci.
    C. gram-negative cocci.
    D. gram-positive coccobacilli. (Fitzgerald 206)

Fitzgerald, Margaret A. Nurse Practitioner Certification Examination and Practice Preparation, 5th Edition. F.A. Davis Company, 20170314. VitalBook file.

A

A. gram-negative rods.

63
Q
  1. Which of the following is the best choice of therapy in chronic bacterial prostatitis?
    A. oral trimethoprim-sulfamethoxazole for 2 weeks
    B. parenteral ampicillin for 4 weeks
    C. oral ciprofloxacin for 4 weeks
    D. injectable gentamicin for 2 weeks
A

C. oral ciprofloxacin for 4 weeks

64
Q
  1. The best diagnostic test to identify the offending organism in acute bacterial prostatitis is:
    A. a urine culture.
    B. a urethral culture.
    C. antibody testing.
    D. a urine Gram stain.
    (Fitzgerald 206-207)

Fitzgerald, Margaret A. Nurse Practitioner Certification Examination and Practice Preparation, 5th Edition. F.A. Davis Company, 20170314. VitalBook file.

A

A. A urine culture

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