A 78-Year-Old Man Comes to the Office for a Regularly

question 127

Multiple Choice

A 78-year-old man comes to the office for a regularly scheduled review of his chronic medical problems.  The patient has hypertension, coronary artery disease, and type 2 diabetes mellitus, for which he takes metformin, atorvastatin, lisinopril, and nitroglycerin as needed for chest pain.  He takes his medications as prescribed and follows diet and exercise instructions.  During the discussion, he hesitates, laughs nervously, and says, "I can't get an erection anymore, and my wife says I have to ask you about getting the 'blue pill.'"  Which of the following is the most appropriate response to this patient's concern?

• A)"I can see that you feel uncomfortable talking about this.  It can be a sensitive subject for some men."
• B)"I can understand your concern, but at your age, we hesitate to start too many medications."
• C)"Medications for erectile dysfunction have significant side effects.  I would not pursue them unless you feel it is important."
• D)"This is a very common problem for men as they age.  It is good that you mentioned it."
• E)"We can try medication for erectile dysfunction, but it may not be effective at your age."

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Definitions:

Extinction

In behavioral psychology, the process through which a learned response is diminished or diminishes over time following the removal of reinforcement.

Extinction

In behavioral psychology, the gradual weakening and eventual disappearance of a conditioned response when the conditioned stimulus is no longer paired with the unconditioned stimulus.

Non-associative Learning

A form of learning in which an organism becomes more (or less) responsive to a repeated stimulus over time, without the need for association between different stimuli.

Cognitive Model

A framework used in cognitive psychology and cognitive therapy that describes how thoughts, feelings, and behaviors interact and influence mental health and behavior.