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A 13-year-old uncircumcised male patient has been treated for phimosis and returns to the nurse practitioner for follow-up. A referral should be made to the urologist if the adolescent

A.

is unable to retract a previously retractable prepuce.

B.

complains of difficulty keeping the glans penis clean.

C.

desires to be circumcised.

D.

states that he began experiencing nocturnal erections.

Answer and Explanation

The Correct Answer is A

Rationale:
A. Inability to retract a previously retractable prepuce (paraphimosis or recurrent phimosis) after treatment may indicate an underlying structural problem and warrants referral to a urologist.
B. Difficulty maintaining hygiene is common in uncircumcised adolescents and can often be managed with education on proper cleaning techniques.
C. Desire for circumcision alone is not an urgent indication for urology referral; it can be elective.
D. Nocturnal erections are a normal physiological process in adolescent males and do not necessitate referral.


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Related Questions

Correct Answer is D

Explanation

Rationale:
A. Infection with HPV, especially high-risk strains, is strongly associated with cervical cancer.
B. Hardening of the cervix can indicate malignant changes.
C. An irregular, cauliflower-like cervical growth is a classic visual finding in cervical cancer.
D. A cervical polyp is typically benign and does not usually suggest cervical cancer, though it may cause abnormal bleeding.

Correct Answer is C

Explanation

Rationale:
A. The Sickledex test is a rapid screening tool for sickle hemoglobin but cannot definitively diagnose sickle cell disease.
B. A complete blood count (CBC) may show anemia or other hematologic abnormalities but cannot confirm the specific hemoglobin type.
C. Hemoglobin electrophoresis is the definitive test to diagnose sickle cell disease. It identifies the specific types of hemoglobin present (e.g., HbS, HbA, HbF) and distinguishes between sickle cell trait and sickle cell disease.
D. The sickle cell solubility test can indicate the presence of HbS but cannot differentiate between trait and disease and is therefore not diagnostic.

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