A patient tells the primary care NP that he has difficulty getting and maintaining an erection. The NP's initial response should be to:
a. prescribe sildenafil (Viagra).
b. perform a medication history.
c. evaluate his cardiovascular status.
d. order a papaverine injection test to screen for erectile dysfunction.
B
Because the use of multiple medications is associated with a higher prevalence of erectile dysfunction, a medication history should be performed first to see if any medications have sexual side effects. A cardiovascular evaluation may be assessed next. Papaverine injection tests are useful screening tools after a thorough history has been performed. Medications are prescribed only after a diagnosis is determined and other causes have been ruled out.
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