A 54-year-old diabetic patient has come to the urology clinic ...

[haleyc112]

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

Question 2

A male college student has arrived at the student clinic complaining of tingling, itching, and pains in his groin.
 
  Upon inspection, the nurse notices some pustules and vesicles. While taking a detailed sexual history, the nurse should ask which of the following questions to rule out further complications?
  A)
  Do you get cold sores very often?
  B)
  Do you have pain when you urinate or have difficulty starting the stream?
  C)
  Have you noticed excessive swelling in your scrotum the last few days?
  D)
  Have you been experiencing flank pain and bloody urine?

[triiciiaa]

Answer to Question 1

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.

Answer to Question 2

Ans:
B

Feedback:

The initial symptoms of primary genital herpes infections include tingling, itching, and pain in the genital area, followed by eruption of small pustules and vesicles. In men, the infection can cause urethritis and lesions of the penis and scrotum. Urethritis is characterized by pain with urination and difficulty starting the stream. Cold sores are not related to genital herpes. Swelling of the scrotum is common in epididymitis, while flank pain and bloody urine are associated primarily with kidney stone formation.

[haleyc112]

Excellent

[ttt030911]

TYSM