A 32-year-old male appears with a rapid onset of unilateral scrotal pain radiating up to the groin and flank. The nurse practitioner is trying to differentiate between epididymitis and testicular torsion. Which test should be the provider’s first choice?
Question 1 A 32-year-old male appears with a rapid onset of unilateral scrotal pain radiating up to the groin and flank. The nurse practitioner is trying to differentiate between epididymitis and testicular torsion. Which test should be the provider’s first choice?
Technetium scan.
X-ray.
Ultrasound.
Physical examination.
Question 2 A male patient presents to the clinic for evaluation of infertility. Subjectively, the patient complains of pain and fullness of the testes and states, “My testicles feel like a bag of worms.” On physical examination, the nurse practitioner notes tortuous veins posterior to and above the testes that extend up into the external inguinal ring. Based on the preceding assessment, the nurse practitioner refers the patient to urology with a diagnosis of:
Hydrocele.
Urethritis.
Varicocele.
Orchitis.
Question 3 A patient’s chief complaint is pain and heaviness in the scrotum. The nurse practitioner notes swelling of the testes, along with warm scrotal skin. Which of the following diagnoses is most probable?
Testicular torsion.
Orchitis.
Cryptorchidism.
Epididymitis.
Question 4 A 15-year-old male comes to the clinic in acute distress with “belly pain.” When obtaining his history, the nurse practitioner (NP) finds that he fell off his bike this morning and has vomited. Upon closer examination, the NP determines the belly pain to be left-sided groin pain or pain in his left testicle. He is afebrile and reports no dysuria. Which of the following diagnoses is most likely?
Testicular torsion.
Epididymitis.
Varicocele.
Hydrocele.
Question 5 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?
Alprostadil (Caverject).
Topical testosterone (AndroGel).
Subcutaneous pellet testosterone (Testopel).
Sildenafil (Viagra).
Question 6 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?
“Because of your history of diabetes, we can’t use it.”
“I’d better refer you to a urologist.”
“Let’s try a sample and see how you do.”
“Viagra is contraindicated with isosorbide mononitrate; let’s discuss other options.”
Question 7 A 52-year-old male patient is in a new relationship and is not sure whether his erectile dysfunction is organic or is caused by stress about his performance. What simple test could the clinician suggest to determine if he has the ability to have an erection?
Serum prostate-specific antigen (PSA).
Intracavernous injection.
Penile duplex ultrasonography.
Nocturnal penile tumescence and rigidity (NPTR) test.
Question 8 A 72-year-old unmarried, sexually active man, presents to the clinic with complaints of hesitancy, urgency, and occasional uncontrolled dribbling. Although the nurse practitioner suspects benign prostatic hyperplasia, what else should the differential diagnosis include?
Detrusor hyperreflexia.
Urethral stricture.
Antihistamine use.
Renal calculi.
Question 9 A 72-year-old male presents to the office for follow-up of several episodes of orthostatic hypotension. After obtaining a review of systems and a digital rectal examination, it also appears that he has benign prostatic hyperplasia (BPH) with lower urinary tract symptoms. The nurse practitioner reviews his recent ultrasound evaluation, which reports a prostate volume of over 40 mL, and the results of the American Urological Association (AUA) symptom index for BPH, which shows his score to be 12. Based on the preceding information and the patient’s desire for noninvasive medical therapy, what management should he be offered?
Doxazosin (Cardura).
Phenoxybenzamine (Dibenzyline).
Prazosin (Minipress).
Finasteride (Proscar).
Question 10 A 62-year-old male has a low International Prostate Symptom Score for lower urinary tract symptoms associated with his benign prostatic hyperplasia (BPH). The nurse practitioner should recommend:
Balloon dilation.
Immediate referral to urology.
No treatment at this time.
Starting an alpha blocker.
Question 11 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?
Urethral suppositories.
Surgery.
An external vacuum device.
Intracavernous injection therapy.
Question 12 Regular testicular self-exams have not been studied enough to show if they lower the risk of dying from testicular cancer. This is why the American Cancer Society and other agencies do not have a recommendation about regular testicular self-exams for all men. Still, some practitioners do recommend that all men examine their testicles monthly after reaching puberty. In teaching a patient how to do a testicular self-examination, which of the following should the clinician advise?
“Make sure your hands are dry to create friction.”
“Examine your testicles when you are cold because this makes them more sensitive.”
“If you feel firmness above and behind the testicle, make an appointment.”
“Make an appointment if you note any hard lumps directly on the testicle, regardless of whether they are tender.”
Question 13 A 32-year-old male presents with complaints of a scrotal mass; however, the scrotum is so edematous that it is difficult to assess. How would the nurse practitioner (NP) best determine whether the condition is a hernia or a hydrocele?
Bowel sounds may be heard over a hernia.
With a hydrocele, a bulge appears on straining.
The NP can transilluminate a hernia.
The NP can always return a hernia’s contents to the abdominal cavity.
Question 14 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:
Parkinson disease.
Diabetes mellitus.
Multiple sclerosis.
Epilepsy.
Question 15 A 63-year-old man presents to your office with hematuria, hesitancy, and dribbling. Digital rectal examination (DRE) reveals a smooth, moderately enlarged prostate. The client’s prostate-specific antigen (PSA) is 1.2. What is the most appropriate management strategy at this time?
Recommending saw palmetto extract.
Referring the client to urology.
Prescribing an alpha-adrenergic blocker.
Prescribing an antibiotic.
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