Which of these statements is most appropriate when the nurse is obtaining a genitourinary history from an older man?

Correct Answer: A

Rationale: The correct answer is A because it pertains to a common genitourinary issue in older men, nocturia. Nocturnal emissions (choice B) are not typically relevant in this context. Testicular self-examination (choice C) is more appropriate for younger men, and asking about unwanted touching (choice D) is not relevant to obtaining a genitourinary history. Asking about nocturia can provide valuable information about potential prostate issues, urinary tract infections, or other conditions commonly affecting older men.

Correct Answer: C

Rationale: Step 1: Define priapism - Priapism is a prolonged, painful erection of the penis without sexual stimulation. Step 2: Link to the drug side effect - The question mentions a potential side effect of an erectile dysfunction drug, which is priapism. Step 3: Eliminate other choices - Orchitis is inflammation of the testicle, stricture is a narrowing of a tube or passage, and phimosis is the inability to retract the foreskin. These do not match the description of priapism. Step 4: Conclusion - The correct answer is C because it directly aligns with the described side effect and the other choices do not.

Correct Answer: C

Rationale: The correct answer is C: antidiuretic hormone. Antidiuretic hormone (ADH) regulates water reabsorption in the kidneys by increasing permeability of the collecting ducts to water. This allows for reabsorption of more water back into the bloodstream, reducing urine output and maintaining water balance. Renin, angiotensin, and aldosterone are involved in regulating blood pressure and electrolyte balance, not specifically water reabsorption. Therefore, ADH is the main regulator of water reabsorption in the body.

Correct Answer: A

Rationale: The correct answer is A: Urethral meatus and vaginal orifice. The vestibule is the area between the labia minora where the urethral meatus and vaginal orifice are located. This is important for the nurse to observe during an examination to assess the patient's genital health. Choice B is incorrect because the vestibular (Bartholin) glands are not typically visible in the vestibule during an examination. Choice C is incorrect because the paraurethral (Skene) glands are not typically visible in the vestibule either. Choice D is incorrect because it combines the paraurethral (Skene) and vestibular (Bartholin) glands, which are not typically visible in the vestibule during examination.

Correct Answer: A

Rationale: The correct answer is A: Menstrual history, because it is generally nonthreatening. Starting with the menstrual history is appropriate as it is a common and noninvasive topic that can help build rapport and make the patient feel more comfortable. It also provides important insights into the patient's overall health and reproductive system. By addressing this topic first, the nurse can establish a foundation for a more in-depth discussion of other aspects of the patient's gynecologic health. Summary of other choices: B: Obstetric history is not the most appropriate to start with as it may not be relevant for all patients during an annual gynecologic examination. C: Urinary system history may not be the most relevant starting point for a routine gynecologic exam and may not be as nonthreatening as discussing menstrual history. D: Sexual history, while important, may be more sensitive and personal for some patients, making it less suitable as an initial topic for building rapport and establishing trust.