NURS 671 Dunphy Clinical Final Exam - Questions and Answers

NURS 671 Dunphy Clinical Final Exam - Questions and Answers A 63yo man is seen in the clinic with a CC 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 76yo man is seen in the office for c/o urinary incontinence. The clinician should explore which of these causes of incontinence in men? a. Urethral polyps b. UTI c. Anticholinergic medication d. All of the above A 14yo male is seen with c/o severe testicular pain. The clinician suspect testicular torsion. Which of the following is the appropriate action? a. Refer to a urologist immediately b. Obtain a CT c. Instruct the pt to elevate the scrotum d. Prescribe ibuprofen An 82yo man is seen in the primary care office with c/o dribbling urine and difficulty starting his stream. Which of the following should be included in the list of differential diagnoses? a. BPH b. Parkinson's disease c. Prostate cancer d. All of the above Which of the following would be an appropriate treatment for a pt with mild BPH? a. Refer to a urologist for surgery b. Prescribe a trial of tamsulosin c. Recommend cranberry supplements d. Reevaluate symptoms in 1-3 months A 30yo man is seen with a chief complaint of loss of libido. Which of the following lab tests would help establish a dx? a. Testosterone level b. Prostate-specific antigen c. Nocturnal penile tumescence and rigidity d. Prolactin level Which of the following should be considered in a pt presenting w/erectile dysfunction? a. Diabetes mellitus b. HTN c. Atherosclerosis d. All of the above A 35yo man presents with c/o painful erections, and he notices his penis is crooked when erect. What is the most likely diagnosis? a. Peyronie's Dz b. Damage to the pudendal artery c. Scarring of the cavernosa d. All of the above The pt with BPH is seen for follow-up. He has been taking finasteride (Proscar) for 6mo. The clinician should assess this pt for which of these side effects? a. Erectile dysfunction b. Glaucoma c. Hypotension d. HA The clinician should prescribe an antibiotic that covers which of these organisms for a pt with acute prostatitis? a. Gram-positive cocci b. Gram-negative cocci c. Gram-positive bacillus d. Gram-negative bacillus The 56yo man with chronic prostatitis should be treated with trimethoprim 80mg sulfamethoxazole 400mg (TMP-SMX, Bactrim) for how long? 6-12 weeks A 46yo man presents with urinary hesitancy and low back pain. He has no h/o UTI. Digital rectal exam reveals a normal prostate, and a diagnosis of prostatodynia is made. Which is the appropriate treatment? a. Terazosin 2mg PO once a day b. Ice pack to the scrotal area c. Saw palmetto 320mg per day d. All of the above A 23yo 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 Which test is used to confirm a Dx of epididymitis? Ultrasound of the scrotum Treatment for epididymitis includes which of the following? a. Warm sitz baths b. Scrotal elevation c. Masturbation d. All of the above 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 60yo man presents with an enlarged scrotum. The clinician uses a penlight to transilluminate the scrotum. In a pt with a hydrocele, what would the clinician expect to find? The scrotum will appear light pink or yellow During a DRE on a 75yo man, the clinician suspects the pt has prostate cancer. What physical finding should make the clinician suspicious? An enlarged rubbery gland A 78yo man is diagnosed with C2 prostate cancer and he asks the clinician what that means. In order to answer the pt, 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 58yo pt has been receiving leuprolide as treatment for prostate cancer. The clinician should instruct the pt about which of these side effects? a. Risk of osteoporosis b. May have hot flashes c. May have impotence d. All of the above A 22yo male is seen in the clinic because he found a hard lump in his testicle when performing a testicular self-exam. 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 What is the treatment of choice for a pt diagnosed with testicular cancer? Radical orchidectomy A pt with testicular cancer is being followed after completing treatment 1 yr ago. He has been symptom-free with no evidence of disease. How often should he have a CT? Every 3-4mo T/F Pt's treated for Neisseria gonorrhoeae also should be treated for Chlamydia trachomatis. True T/F Hep A is considered an STI by the CDC. True A 35yo female pt is seen in the clinic c/o abdominal pain. Which of the following should be included in the history and physical exam? a. Digital rectal exam b. Pelvic exam c. Sexual history d. All of the above A pt comes to the office c/o constipation. The pt lists all of the following meds. Which drug could be responsible for the constipation? a. Multivitamin b. Magnesium hydroxide c. Pepto-Bismol d. Ibuprofen