Chapter 50: Assessment of Reproductive System Lewis: MedicalSurgical Nursing, 10th Edition

Which question should the nurse ask when assessing a 60-yr-old patient who has a history of benign prostatic hyperplasia (BPH)? a. "Have you noticed any unusual discharge from your penis?" b. "Has there been any change in your sex life in the past year?" c. "Has there been a decrease in the force of your urinary stream?" d. "Have you been experiencing any difficulty in achieving an erection?" - ANS: C Enlargement of the prostate blocks the urethra, leading to urinary changes such as a decrease in the force of the urinary stream. The other questions address possible problems with infection or sexual difficulties, but they would not be helpful in determining whether there were functional changes caused by BPH. DIF: Cognitive Level: Apply (application) REF: 1194 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity After a 26-yr-old patient has been treated for pelvic inflammatory disease, the nurse will plan to teach about the a. use of hormone therapy (HT). b. potential complication of infertility. c. irregularities in the menstrual cycle. d. changes in secondary sex characteristics. - ANS: B Pelvic inflammatory disease may cause scarring of the fallopian tubes and result in difficulty in fertilization or implantation of the fertilized egg. Because ovarian function is not affected, the patient will not require HT, have irregular menstrual cycles, or experience changes in secondary sex characteristics. DIF: Cognitive Level: Apply (application) REF: 1194 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity A 68-yr-old male patient tells the nurse that he is worried because he does not respond to sexual stimulation the same way he did when he was younger. Which is the nurse's best response to the patient's concern? a. "Interest in sex frequently decreases as men get older." b. "Many men need additional sexual stimulation with aging." c. "Erectile dysfunction is a common problem with older men." d. "Tell me more about how your sexual response has changed." - ANS: D The initial response by the nurse should be further assessment of the problem. The other statements by the nurse are accurate but may not respond to the patient's concerns. DIF: Cognitive Level: Analyze (analysis) REF: 1191 TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity The nurse is providing teaching by telephone to a patient who is scheduled for a pelvic examination and Pap test next week. The nurse instructs the patient that she should a. not have sexual intercourse the day before the Pap test. b. shower, but not take a tub bath, before the examination. c. avoid douching for at least 24 hours before the examination. d. schedule to have the Pap test just after her menstrual period. - ANS: C Because the results of a Pap test may be affected by douching, the patient should not douche before the examination. The examination may be scheduled without regard to the menstrual