Porth's Pathophysiology, Concepts of Altered Health States 9th Edition by Sheila Grossman-Carol Mattson Porth
Porth's Pathophysiology, Concepts of Altered Health States 9th Edition by Sheila Grossman-Carol Mattson Porth
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Chapter 52- Disorders of the Male Genitourinary System
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
| 1. | 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 | |
| Ans: | B | |
| Feedback: | ||
| Because the foreskin is often used in surgical repair of hypospadias, circumcision is normally contraindicated. Chromosomal studies are frequently warranted, and surgery is the standard treatment for the repair of the urethra. Testosterone supplementation is often necessary. | ||
| 2. | 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.” | |
| Ans: | C | |
| Feedback: | ||
| While spontaneous resolution is possible, surgery is sometimes necessary for the treatment of Peyronie disease. Circumcision would not be an effective treatment, and lifestyle factors are not noted to contribute to the etiology or resolution. | ||
| 3. | 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 b-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. | |
| Ans: | A, C, E, F | |
| Feedback: | ||
| Hypertension, antihypertensive medications, age, and smoking are all implicated in the etiology of ED. Ischemic heart disease and bronchodilators are less likely to directly contribute to the condition. | ||
| 4. | 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 | |
| Ans: | C | |
| Feedback: | ||
| Sildenafil (Viagra) is a selective inhibitor of phosphodiesterase type 5 (PDE-5), the enzyme that inactivates cGMP. This acts by facilitating corporeal smooth muscle relaxation in response to sexual stimulation. The concomitant use of PDE-5 inhibitors and nitrates (Imdur) is absolutely contraindicated because of the risk of profound hypotension. The other medications listed are not nitrates and do not have this adverse reaction. | ||
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