NR 511 Week 7 Quiz 7, NEW, Best Reviewed Document: NR
511: Differential Diagnosis and Primary Care Practicum
Chamberlain college of Nursing
Section 1: Erectile Dysfunction & Male Sexual Health
Question 1 [Verified Source]
A patient is being treated for erectile dysfunction. The patient is morbidly obese
and is also being treated for a coagulopathy. Which of the following medications
would be contraindicated?
A. Subcutaneous pellet testosterone (Testopel)
B. Topical testosterone (AndroGel)
C. Alprostadil (Caverject)
D. Sildenafil (Viagra)
Correct Answer: C
Rationale: The vasoactive injectable alprostadil (Caverject) should not be
used in patients with sickle cell anemia, coagulopathy, severe cardiovascular
disease, myeloma, leukemia, morbid obesity, or penile deformity, fibrosis, or
implants. This patient has both morbid obesity and a coagulopathy, making
alprostadil contraindicated .
Question 2 [Verified Source]
A 51-year-old male requests a prescription for sildenafil (Viagra). He says that the
only medication he takes is isosorbide mononitrate (Monoket) oral tablets and that
he has diabetes which is controlled with diet alone. What should the nurse
practitioner tell him?
A. "I'd better refer you to a urologist."
B. "Let's try a sample and see how you do."
C. "Because of your history of diabetes, we can't use it."
,D. "Viagra is contraindicated with isosorbide mononitrate; let's discuss other
options."
Correct Answer: D
Rationale: Sexual stimulation leads to the release of nitric oxide in the corpus
cavernosum of the penis, and sildenafil (Viagra) potentiates that release. There is a
double hypotensive effect between sildenafil and a nitric oxide donor such as
isosorbide mononitrate (Monoket, Imdur, Ismo). Therefore, the use of sildenafil
with Monoket is contraindicated due to the risk of severe hypotension .
Question 3 [Verified Source]
A 54-year-old male is complaining of erectile dysfunction. He also has a condition
that has reduced arterial blood flow to his penis. The most common cause of this
condition is:
A. Diabetes mellitus
B. Multiple sclerosis
C. Parkinson disease
D. Epilepsy
Correct Answer: A
Rationale: About 50% of men who have had diabetes for longer than 6 years
develop erectile dysfunction to some extent as a result of pathological changes in
the vascular wall that lead to a reduction of arterial blood flow to the penis.
Diabetes mellitus is the most common cause of vasculogenic erectile dysfunction .
Question 4 [Verified Source]
A 58-year-old male has been diagnosed with erectile dysfunction and says that a
friend told him about a method that uses a constricting ring around the base of the
penis. What is he referring to?
,A. Surgery
B. Intracavernous injection therapy
C. Urethral suppositories
D. An external vacuum device
Correct Answer: D
Rationale: An external vacuum device is a viable method for alleviating
erectile dysfunction regardless of the cause. It involves placing a plastic cylinder
around the penis, using a vacuum pump for cavernosal engorgement, and applying
a constricting ring at the base of the penis to maintain the erection .
Question 5 [Verified Source]
What simple test can a clinician suggest to determine if a male patient's erectile
dysfunction is organic or stress-related?
A. Nocturnal Penile Tumescence and Rigidity (NPTR) test
B. Penile Doppler ultrasound
C. Serum testosterone level
D. Corporal cavernosometry
Correct Answer: A
Rationale: The Nocturnal Penile Tumescence and Rigidity (NPTR) test is a
simple test that the client can do at home to determine if he has the ability to have
a nocturnal erection. If nocturnal erections occur, an organic cause of erectile
dysfunction is less likely, and psychogenic causes should be considered .
Question 6
A 62-year-old man with a history of hypertension and hyperlipidemia presents with
a 6-month history of difficulty achieving and maintaining an erection. He takes
hydrochlorothiazide and atorvastatin. Which medication class is most likely
contributing to his erectile dysfunction?
, A. Thiazide diuretics
B. Beta blockers
C. Statins
D. ACE inhibitors
Correct Answer: B
Rationale: Beta blockers are well-known to be associated with erectile
dysfunction. They can reduce cardiac output and interfere with the hemodynamic
mechanisms necessary for erection. Thiazide diuretics may also contribute but beta
blockers have a stronger association. Statins and ACE inhibitors are not typically
first-line offenders .
Question 7 (SATA)
A 55-year-old man is being evaluated for erectile dysfunction. Which of the
following are risk factors for organic erectile dysfunction? Select all that apply.
A. Diabetes mellitus
B. Cigarette smoking
C. Hyperlipidemia
D. Regular aerobic exercise
E. Pelvic radiation therapy
Correct Answers: A, B, C, E
Rationale: Organic erectile dysfunction is associated with vascular risk
factors (diabetes, hypertension, hyperlipidemia, smoking), neurological conditions,
pelvic surgery or radiation, and medication use. Regular aerobic exercise is
protective, not a risk factor .
Question 8
A 68-year-old man presents with erectile dysfunction. He has a history of
Peyronie's disease. Which treatment option would be contraindicated?
511: Differential Diagnosis and Primary Care Practicum
Chamberlain college of Nursing
Section 1: Erectile Dysfunction & Male Sexual Health
Question 1 [Verified Source]
A patient is being treated for erectile dysfunction. The patient is morbidly obese
and is also being treated for a coagulopathy. Which of the following medications
would be contraindicated?
A. Subcutaneous pellet testosterone (Testopel)
B. Topical testosterone (AndroGel)
C. Alprostadil (Caverject)
D. Sildenafil (Viagra)
Correct Answer: C
Rationale: The vasoactive injectable alprostadil (Caverject) should not be
used in patients with sickle cell anemia, coagulopathy, severe cardiovascular
disease, myeloma, leukemia, morbid obesity, or penile deformity, fibrosis, or
implants. This patient has both morbid obesity and a coagulopathy, making
alprostadil contraindicated .
Question 2 [Verified Source]
A 51-year-old male requests a prescription for sildenafil (Viagra). He says that the
only medication he takes is isosorbide mononitrate (Monoket) oral tablets and that
he has diabetes which is controlled with diet alone. What should the nurse
practitioner tell him?
A. "I'd better refer you to a urologist."
B. "Let's try a sample and see how you do."
C. "Because of your history of diabetes, we can't use it."
,D. "Viagra is contraindicated with isosorbide mononitrate; let's discuss other
options."
Correct Answer: D
Rationale: Sexual stimulation leads to the release of nitric oxide in the corpus
cavernosum of the penis, and sildenafil (Viagra) potentiates that release. There is a
double hypotensive effect between sildenafil and a nitric oxide donor such as
isosorbide mononitrate (Monoket, Imdur, Ismo). Therefore, the use of sildenafil
with Monoket is contraindicated due to the risk of severe hypotension .
Question 3 [Verified Source]
A 54-year-old male is complaining of erectile dysfunction. He also has a condition
that has reduced arterial blood flow to his penis. The most common cause of this
condition is:
A. Diabetes mellitus
B. Multiple sclerosis
C. Parkinson disease
D. Epilepsy
Correct Answer: A
Rationale: About 50% of men who have had diabetes for longer than 6 years
develop erectile dysfunction to some extent as a result of pathological changes in
the vascular wall that lead to a reduction of arterial blood flow to the penis.
Diabetes mellitus is the most common cause of vasculogenic erectile dysfunction .
Question 4 [Verified Source]
A 58-year-old male has been diagnosed with erectile dysfunction and says that a
friend told him about a method that uses a constricting ring around the base of the
penis. What is he referring to?
,A. Surgery
B. Intracavernous injection therapy
C. Urethral suppositories
D. An external vacuum device
Correct Answer: D
Rationale: An external vacuum device is a viable method for alleviating
erectile dysfunction regardless of the cause. It involves placing a plastic cylinder
around the penis, using a vacuum pump for cavernosal engorgement, and applying
a constricting ring at the base of the penis to maintain the erection .
Question 5 [Verified Source]
What simple test can a clinician suggest to determine if a male patient's erectile
dysfunction is organic or stress-related?
A. Nocturnal Penile Tumescence and Rigidity (NPTR) test
B. Penile Doppler ultrasound
C. Serum testosterone level
D. Corporal cavernosometry
Correct Answer: A
Rationale: The Nocturnal Penile Tumescence and Rigidity (NPTR) test is a
simple test that the client can do at home to determine if he has the ability to have
a nocturnal erection. If nocturnal erections occur, an organic cause of erectile
dysfunction is less likely, and psychogenic causes should be considered .
Question 6
A 62-year-old man with a history of hypertension and hyperlipidemia presents with
a 6-month history of difficulty achieving and maintaining an erection. He takes
hydrochlorothiazide and atorvastatin. Which medication class is most likely
contributing to his erectile dysfunction?
, A. Thiazide diuretics
B. Beta blockers
C. Statins
D. ACE inhibitors
Correct Answer: B
Rationale: Beta blockers are well-known to be associated with erectile
dysfunction. They can reduce cardiac output and interfere with the hemodynamic
mechanisms necessary for erection. Thiazide diuretics may also contribute but beta
blockers have a stronger association. Statins and ACE inhibitors are not typically
first-line offenders .
Question 7 (SATA)
A 55-year-old man is being evaluated for erectile dysfunction. Which of the
following are risk factors for organic erectile dysfunction? Select all that apply.
A. Diabetes mellitus
B. Cigarette smoking
C. Hyperlipidemia
D. Regular aerobic exercise
E. Pelvic radiation therapy
Correct Answers: A, B, C, E
Rationale: Organic erectile dysfunction is associated with vascular risk
factors (diabetes, hypertension, hyperlipidemia, smoking), neurological conditions,
pelvic surgery or radiation, and medication use. Regular aerobic exercise is
protective, not a risk factor .
Question 8
A 68-year-old man presents with erectile dysfunction. He has a history of
Peyronie's disease. Which treatment option would be contraindicated?
