Benign Prostatic Hyperplasia
Which information should the nurse include in the discharge instructions for a client who has undergone prostate surgery? (Select all that apply.) A. Activity B. Bleeding C. Bowel movements D. Sexual intercourse E. Clothing restrictions
A,B,C,D
The nurse is providing care to a client who is diagnosed with mild benign prostatic hyperplasia (BPH) who is experiencing urinary retention. Which goal is the most appropriate for this client? A. The client lists over-the-counter medications to be avoided. B. The client will increase fluid intake to at least 2-3 liters daily. C. The client will use a T-binder or scrotal support properly. D. The client will voice an understanding of the importance of the use of antiembolic stockings and compression devices.
A
The nurse is providing care to a client who is diagnosed with mild benign prostatic hyperplasia (BPH). Which lifestyle change is appropriate for this client? A. Urinating at first urge B. Increasing caffeine intake C. Using over-the-counter antihistamines D. Increasing alcohol intake
A
The community health nurse discusses preventive care guidelines for benign prostatic hyperplasia (BPH) with a community group. At which age should the nurse recommend assessment for benign prostatic hyperplasia (BPH) to begin? A40 B 50 C 60 D 30
A (Men over the age of 40 should be assessed for possible BPH and screened for prostate cancer if risk factors are present. Assessment includes a health history, physical assessment, and diagnostic tests.)
The nurse is providing teaching to an older patient and his wife about nonpharmacologic therapies they can implement for his mild benign prostatic hyperplasia (BPH). Which is an appropriate lifestyle change for the nurse to include? A "Avoid drinking fluids within 2 hours of bedtime." B "Hold urine as long as possible." C "Drink warm caffeinated beverages." D "Avoid sexual activity."
A (Patients with mild BPH may have symptom improvements by avoiding drinking fluids within 2 hours of bedtime, urinating at the first urge, avoiding alcohol and caffeine, exercising regularly, reducing stress, and other measures. Avoiding sexual activity is not an appropriate lifestyle change recommended for individuals with BPH. Additional Learning)
A client with mild benign prostatic hyperplasia (BPH) tells the nurse that he prefers to do things "naturally" and doesn't want to take medication for his condition. Which lifestyle change should the nurse recommend? (Select all that apply.) A. Reducing stress B. Avoiding alcohol and caffeine C. Avoiding drinking fluids within 2 hours of bedtime D. Exercising regularly, including pelvic floor exercises E. Increasing dietary intake of foods high in potassium
A, B, C, D
Which elements of a health history for a client with benign prostatic hyperplasia (BPH) should be documented? (Select all that apply.) A. Pain B. Hematuria C. Risk factors D. Sexual orientation E. Urinary elimination patterns
A, B, C, E
Which instruction should the nurse include to promote healing for a client being discharged post-prostate surgery? (Select all that apply.) A. Avoid strenuous activity and heavy lifting. B. Drink fruit juices and take stool softeners as ordered. C. Use NSAIDs for pain relief every 4-6 hours as needed. D. Avoid sexual activity for at least 6 weeks after surgery. E. Restrict driving time to less than half an hour at a time.
A, B, D
A client is diagnosed with benign prostatic hyperplasia (BPH). Which topics are appropriate for the nurse to include in the teaching session related to the client's condition? Select all that apply. A. Self-care B. Pharmacologic approaches to treatment C. Permanent urinary catheterization D. Nutrition E. Surgical approaches to treatment
A, B, D, E
The nurse is providing discharge instructions to a postoperative client who is being discharged home with an indwelling urinary catheter. Which information should the nurse include in discharge teaching? (Select all that apply.) A. Empty the leg bag every 3-4 hours. B. Avoid strapping on the leg bag too tightly. C. Place powder around the bag to prevent odor. D. Place a soft cloth between the leg bag and thigh. E. Change from a daytime leg bag to a larger drainage bag at night.
A, B, D, E
The nurse is teaching a community-based group about reproductive health. Which information should the nurse include when discussing benign prostatic hyperplasia (BPH)? (Select all that apply.) A. BPH is the most common benign tumor in men. B. BPH is considered a precursor to prostate cancer. C. Almost all men will develop BPH if they live long enough. D. Caucasian American men develop symptoms of BPH later than all other races. E. Antioxidant and anti-inflammatory supplements can reduce the risk of BPH.
A, C
Which diagnostic tests should the nurse expect to be prescribed for a client with symptoms of benign prostatic hyperplasia (BPH)? (Select all that apply.) A. Urinalysis B. Urine specific gravity test C. Digital rectal examination D. Prostate-specific antigen (PSA) level E. Ultrasound or postvoid catheterization
A, C, D, E
Which risk factors should the nurse assess when performing a health history on a client for benign prostatic hyperplasia (BPH) screening? (Select all that apply.) A. Age B. Vasectomy C. Racial background D. Sexual promiscuity E. The presence of testes
A, C, E
A client is recovering from prostate surgery on a medical-surgical unit. The client will be ready for discharge within the next few days. Which teaching point is appropriate for this client? A. The client should not drive for 6 weeks after surgery. B. The client should incorporate fruit juice in his diet. C. The client should avoid heavy lifting for 2 weeks after surgery. D. The client should call the healthcare provider immediately for any bleeding.
B
The nurse is providing care to a client who is diagnosed with benign prostatic hyperplasia (BPH). The client's primary concern is burning and difficulty when urinating. Based on this data, which nursing diagnosis is the priority for this client? A. Deficient Knowledge B. Acute Pain C. Fluid Volume Overload D. Fluid Volume Deficit
B
The nurse is preparing a client for surgery for benign prostatic hyperplasia (BPH). Which clinical manifestations should the nurse expect in the client's history and physical that would support the need for surgery? (Select all that apply.) A. Nocturia B. Hematuria C. Bladder stones D. Urinary retention E. Renal insufficiency secondary to BPH
B, C, D, E
A client presents to the urologist with complaints of getting up to urinate several times a night and difficulty starting a stream of urine. After medical testing is completed, a diagnosis of benign prostatic hyperplasia (BPH) is made. After conducting teaching regarding BPH, which statement by the client indicates the need for further education? A. "There are nonsurgical treatment options available." B. "Alpha blockers can be used to control my symptoms." C. "I know I will get cancer of the prostate because of this.". D. "As my condition progresses, I may need to consider surgical management."
C
A client with benign prostatic hyperplasia (BPH) exhibits decreased bladder capability and bladder instability. Which should the nurse recognize as the cause of this condition? A. Increased prostate sensitivity to dihydrotestosterone B. Increased intra-abdominal pressure C. Hypertrophic detrusor muscle D. Development of bladder diverticula
C
The nurse is preparing a client for a transurethral needle ablation (TUNA) for benign prostatic hyperplasia (BPH). For which reason should the nurse expect that the client has selected this surgical procedure? (Select all that apply.) A. It is not expensive. B. It is easy to perform. C. It is minimally invasive. D. It does not cause impotence. E. It does not cause incontinence.
C, D, E
A client is recovering from minimally invasive surgery due to a diagnosis of benign prostatic hyperplasia (BPH). After assessing the client, the nurse expects which outcome for this client? A. Absence of pain B. Bowel continence C. No postoperative treatment D. Urinary continence
D
A client receiving an alpha-adrenergic blocker, doxazosin, for treatment of the symptoms of benign prostatic hyperplasia (BPH) calls the nurse complaining of severe dizziness. How should the nurse respond to this information? A. Tell the client that it is likely that he will need to switch to a different drug to treat the BPH symptoms. B. Ask the client to continue taking the drug, but make an appointment with the provider for follow-up. C. Inform the client that he needs to immediately quit taking the drug and see the healthcare provider. D. Inform the client that these are common adverse effects and review precautions to take while on this drug.
D
A client with BPH is experiencing urinary retention and bladder distention. The nurse understands that, without proper treatment, the client is at risk for complications such as diverticula, hydroureter, and hydronephrosis. Which issue related to the client's condition is most important to address in order to reduce the risk for these complications? A. The weak urinary stream must be strengthened. B. Bladder pain must be managed. C. Straining during urination must be avoided. D. The enlarging mass of prostatic tissue must be reduced.
D
A client with benign prostatic hyperplasia is noted to have a smaller prostate in his physical examination. He states he is planning on having surgery that will minimize the risk of postoperative retrograde ejaculation, but he cannot remember what it is called. Which procedure should the nurse suspect? A. Prostatic urethral lift B. Transurethral needle ablation C. Laser surgery D. Transurethral incision of the prostate
D
The client admitted with benign prostatic hyperplasia (BPH) is prescribed an alpha-adrenergic blocker, prazosin (Minipress), for the treatment of BPH. When providing care to this client, which assessment is a priority related to this medication? A. Respiratory rate B. Pain rating C. Temperature D. Blood pressure
D
A patient post-transurethral resection of the prostate (TURP) is receiving a continuous bladder irrigation (CBI). How should the nurse titrate the flow rate for the patient? A. Rate of flow should be maintained to keep the output light pink or colorless. B. Rate of flow should be maintained at a rate based upon patient comfort. C. Rate of flow should be mainitained at a rate that keeps output between 100 and 200 mL per hour. D. Rate of flow should be maintained at the slowest rate possible to prevent catheter obstruction.
A (CBI prevents the formation of blood clots postsurgery. Flow rate should be maintained to keep the output light pink or colorless. While flow rate may be adjusted if the patient is having bladder spasms, typically, the flow rate is determined by the volume, color, and consistency of the output in the tubing and collection bag, not overall patient comfort. Flow rate is not based upon keeping output at 100-200 mL per hour; thus, this would not be an appropriate guideline. Determining the slowest rate possible to prevent obstruction is not a guideline for CBI flow rate.)
The nurse is providing teaching to a patient who has been recently diagnosed with mild benign prostatic hyperplasia (BPH). Which statement by the nurse addresses dietary changes to minimize symptoms of BPH? A. "Avoid alcohol and caffeine." B. "Drink 12-16 ounces of water several times per day." C. "Limit total daily fluid intake to 1800 mL." D. "Drink juices high in vitamin C."
A (Dietary changes that can help address symptoms of BPH include avoiding alcohol and caffeine, drinking small amounts of fluid throughout the day, and avoiding drinking fluids within 2 hours of bedtime. Drinking 12-16 ounces of water several times a day would not be recommended, nor is it necessary to limit total fluid intake. Drinking juices high in vitamin C can support urinary health but are not implicated in relation to BPH.)
The nurse evaluates teaching to a patient about an alpha-adrenergic blocker, doxazosin, prescribed for benign prostatic hyperplasia (BPH). Which statement by the patient indicates the need for further teaching? A. "It's ok to continue to take my allergy medicine as long as I limit its use." B. "I need to monitor my blood pressue daily while taking this medication." C. "I need to make sure to change position slowly to prevent dizziness." D. "This medication may help relieve obstruction and increase my urine flow."
A (Doxazosin is an alpha-adrenergic blocker and many medications for coughs, colds, or allergies may contain an adrenergic agent. Therefore, the patient should first check with the healthcare provider before taking any of these medications, and limiting use would not be appropriate. Monitoring blood pressure daily and changing positions slowly are appropriate actions when taking this medication. Doxazosin relaxes the smooth muscle of the prostate and bladder neck, helping to relieve obstruction and increase the flow of urine, so this is a correct statement.)
During discharge teaching post-prostate surgery, the patient asks when he can resume sexual intercourse. Which response by the nurse is appropriate? A. "You can resume sexual activity 6 weeks after surgery." B. "You can resume sexual activity as soon as you are able to achieve an erection." C. "You can resume sexual activity as soon as the catheter is removed." D. "You can resume sexual activity immediately."
A (In order to prevent bleeding, sexual activity should not be resumed until 6 weeks after surgery. Another teaching point for the patient and/or partner is that after resuming sex, the ejaculate will flow back into the bladder, so the patient will express little or no semen.)
A patient diagnosed with benign prostatic hyperplasia (BPH) asks the nurse, "What does hyperplasia mean?" Which response by the nurse is accurate? A. "There has been a increase in the number of cells in your prostate that have formed nodules." B. "There has been an increase in the size of individual cells in your prostate." C. "The cells that make up your prostate have changed to a different type." D. "There is an increase in the activity of your cells that make up the prostate."
A (BPH begins as small nodules in the periurethral glands (inner layers of the prostate) due to hyperplasia, an increase in the number of cells. Hypertrophy refers to an increase in the size of individual cells, which also contribute to the problem of BPH, but for a different reason than hyperplasia. It is not an increase in cell differentiation or cell activity.)
The nurse caring for a client 24-hours post-transurethral resection of the prostate (TURP) should assess for which complication? (Select all that apply.) A. Hemorrhage B. Hypotension C. Hypertension D. Large blood clots E. Decreased urinary output
A, B, D, E
A client has been prescribed a 5-alpha reductase inhibitor, dutasteride (Avodart), for benign prostatic hyperplasia (BPH). Which potential adverse effect should the nurse include in the teaching for this medication? (Select all that apply.) A. Impotence B. Gynecomastia C. Decreased libido D. Renal insufficiency E. Decreased volume of ejaculate
A, C, E
Which clinical manifestations should the nurse expect to observe when assessing a client with benign prostatic hyperplasia (BPH)? (Select all that apply.) A. Hesitancy B. Frequency C. Incontinence D. Incomplete emptying E. Weak or intermittent urinary stream
A, D, E
A client who has just undergone transurethral resection of the prostate (TURP) has developed TURP syndrome. Which finding during the nursing assessment support this diagnosis? (Select all that apply.) A. Confusion B. Hypotension C. Hypertension D. Hyponatremia E. Decreased hematocrit
A,C,D,E
The nurse is caring for a client diagnosed with benign prostatic hyperplasia (BPH) who is experiencing an increase in symptoms. Which statement by the client would best explain the source of the increased symptoms? A. "I have decreased oral intake at night." B. "I am using an over-the-counter cold medication for a cold." C. "I am drinking very little caffeine." D. "I recently had a vasectomy."
B
The nurse is caring for a middle-aged male client who is experiencing urinary retention. The client asks the nurse if it is possible that he is experiencing benign prostatic hyperplasia (BPH). During the client history, the client reports that he is of Japanese descent. Which response by the nurse is the most appropriate? A. "No, you are not old enough to have BPH." B. "You are considered low-risk for BPH." C. "Where did you get an idea that you might have BPH?" D. "Your symptoms are not consistent with BPH."
B
Which statement most accurately describes why benign prostatic hyperplasia is more common in older men than in younger men? A. An increase in androgen production occurs with age, and increased androgens trigger prostatic growth. B. Hyperplasia of stromal and epithelial cells in the prostate gland occurs over a long period of time. C. A decrease in estrogen levels occurs over time and results in an increase in the size of the individual cells within the prostate. D. Frequency of urinary tract infections increases with age, and frequent UTIs contribute to changes in the prostate.
B
Which statement by the nurse supports self-care behavior to help prevent benign prostatic hyperplasia (BPH)? A. "Avoid or limit alcohol and caffeine intake." B. "Maintain a healthy lifestyle that includes exercise and maintenance of a healthy weight." C. "Use antioxidant and anti-inflammatory supplements daily." D. "Begin having routine prostate-specific antigen (PSA) levels tested at age 40."
B (A recent study has supported a possible connection between metabolic syndrome and BPH; therefore, encouraging the patient to live a healthy lifestyle would be the best advice to provide. Avoiding alcohol and caffeine can be helpful for individuals diagnosed with BPH but this has not been suggested as a way to prevent BPH. Antioxidant and anti-inflammatory supplements have not been supported as effective in preventing BPH. Having routine PSA levels tested will not prevent development of BPH.)
A patient diagnosed with benign prostatic hyperplasia (BPH) states to the nurse, "I don't understand why I have this condition. What has caused it?" In the nurse's explanation, which hormone should be presented as the primary mediator of prostatic growth? A. Progesterone B. Dihydrotestosterone C. Testosterone D. Estrogen
B (The androgen that mediates prostatic growth at all ages is dihydrotestosterone (DHT), which is formed in the prostate from testosterone. Estrogen, which is produced in small amounts in men, seems to sensitize the prostate to DHT. Increasing estrogen levels associated with aging or a relative increase in estrogen related to testosterone levels contributes to prostatic hyperplasia. Testosterone and progesterone do not mediate growth of the prostate gland.)
The nurse has provided discharge teaching to a patient on urinary catheter care following surgery for benign prostatic hyperplasia (BPH). Which statement by the patient indicates correct understanding? A."I can still expect to see large blood clots fairly frequently; if I do, I need to increase fluid intake." B. "If I see a change in the color or consistency of my urine and if I note an odor, I should let my healthcare provider know." C. "I can use my leg bag for urine collection as long as I empty it every 3 to 4 hours." D. "I need to make sure the leg bag is secured very tightly to my leg to prevent shifting and possible urine reflux."
B (The patient stating the need to contact the healthcare provider regarding any changes in urine color and consistency or an odor indicates correct understanding of catheter care upon discharge. The patient should not expect to see large blood clots upon discharge; these should be reported to the healthcare provider. At night, a larger bag suspended from the bed frame, not the leg bag, should be used to prevent urine reflux. The leg bag should not be secured very tightly to the leg, because this can decrease venous return and increase the risk from thrombophlebitis or embolic complications.)
An older adult patient with benign prostatic hyperplasia (BPH) tells the nurse that he has been prescribed a tricyclic antidepressant by his counselor. How should the nurse respond? A. "Unfortunately, all antidepressants can increase prostate enlargement and should be avoided." B. "Tricyclic antidepressants can worsen the symptoms of BPH; thus, a different antidepressant may need to be considered." C. "Antidepressants, particularly tricyclic antidepressants, can cause increases in prostate-specific antigen levels." D. "Tricyclic antidepressants activate alpha-adrenergic receptors in the bladder neck, further restricting urine flow."
B (Tricyclic antidepressants should be avoided because they have anticholinergic side effects and therefore can increase urinary frequency, worsening the symptoms of BPH. The statement that all antidepressants increase BPH symptoms is not a valid statement. Antidepressants do not cause increases in PSA levels, nor do they activate alpha-adrenergic receptors.)
A patient 6 hours postsurgery for a transurethral resection of the prostate (TURP) complains of symptoms indicating to the nurse that he may be experiencing bladder spasms. Which medication should the nurse anticipate administering? A. Oral doxazosin B. Rectal belladonna and opium suppositories C. Oral finasteride D. Intravenous morphine
B (Belladonna and opium suppositories are used to relieve bladder spasms. Doxazosin is an alpha-adrenergic blocker used to address symptoms of benign prostatic hyperplasia (BPH). Finasteride is a 5-alpha reductase inhibitor used to address symptoms of BPH. Morphine is an opioid pain reliever that would not directly address bladder spasms. previous)
The nurse is providing care to a client who is diagnosed with benign prostatic hyperplasia (BPH). Which items in the client's health history indicate a risk factor for this diagnosis? Select all that apply. A. Diet high in milk B. 70 years of age. C. Excessive exercise D. Decreased fluid intake E. African American ethnicity
B, E
The nurse is conducting a seminar on benign prostatic hyperplasia (BPH) for older men. Which statement is accurate in describing the pathophysiologic change of the aging prostate that contributes to the development of BPH? A. "Testosterone levels decrease, thereby decreasing inhibition of prostate growth." B. "The prostate increases the production of dihydrotestosterone." C. "The prostate becomes more sensitive to available dihydrotestosterone." D. "Estrogen levels decrease, contributing to prostatic hyperplasia."
C
A patient presents with complaints of increasing symptoms related to previously diagnosed benign prostatic hyperplasia (BPH). Which diagnostic test should the nurse anticipate being ordered to assess urinary function? A. Urinalysis B. Blood creatinine levels C. Bladder ultrasound to measure residual urine D. Prostate-specific antigen (PSA) levels
C (An ultrasound to assess residual urine can be used to determine urinary function. A urinalysis can be used to determine issues secondary to the BPH such as infection. Blood creatinine levels are used to assess for kidney damage. PSA levels are obtained to rule out prostate cancer.)
While performing a health history, the patient tells the nurse that he has benign prostatic hyperplasia (BPH). Which assessment finding in the health history supports this diagnosis? A. Elevated white blood cell (WBC) count B. Fever C. Nocturia D. Decreased time to void
C (Clinical manifestations of BPH include a weak urinary stream, increased time to void, hesitancy, incomplete bladder emptying, postvoid dribbling, frequency, urgency, incontinence, nocturia, dysuria, and bladder pain. Fever, decreased time to void, and an elevated WBC count are not signs of BPH.)
The nurse completes a health history for a patient diagnosed with mild benign prostatic hyperplasia (BPH). Which behavior noted during the assessment should the nurse discourage the patient from continuing? A. Use of cranberry-based supplements B. Urinating whenever he feels the urge to do so C. Drinking one to two beers daily D. Drinking small amounts of fluid throughout the day
C (Patients with mild BPH should avoid the use of alcohol; thus, the nurse should encourage the patient to avoid drinking beer. Alcohol is a bladder stimulant that can cause urinary incontinence. While evidence does not support an affect from cranberry-based supplements related to BPH, it is also not harmful and would not need to be avoided. Urinating upon the first urge to do so and drinking fluids in small amounts throughout the day are recommended activities for patients with mild BPH.)
A 40-year-old patient states he is hoping to prevent the development of benign prostatic hyperplasia (BPH). Which statment by the nurse is accurate based on recent evidence? A. "Moderate alcohol consumption has been correlated with a later occurrence of BPH." B. "BPH appears to be less prevalent in men who use dietary supplements containing antioxidant and anti-inflammatory properties." C."Living an overall healthy lifestyle can help prevent metabolic syndrome that has recently been connected to BPH."" D. "Exposure to various chemicals, particularly in occupational settings, has been correlated to development of BPH."
C (Recent evidence has suggested a connection between metabolic syndrome and BPH, thus encouraging men to live an overall healthy lifestyle to prevent metabolic syndrome. This may, in turn, help to prevent BPH. Other than this recent suggested connection, there is no known prevention for BPH; thus, statements indicating a relationship between dietary supplements, moderate alcohol use, and occupational chemical exposures are not valid.)
A patient recently diagnosed with benign prostatic hyperplasia (BPH) is told he can no longer take the decongestant medication he has routinely used for the sniffles. He asks the nurse why he should avoid this medication. Which response by the nurse is accurate? A. "This medication causes an increased risk of bladder cancer." B. "This medication causes an accelerated growth of the prostate." C."This medication causes urinary retention." D. "This medication may lead to impotence."
C (Several classes of medications can precipitate urinary retention in men with BPH, including anticholinergics and over-the-counter medications for the common cold, such as decongestants. These medications do not lead to impotence, growth of the prostate, or increased risk of bladder cancer.)
A 50-year-old man asks the nurse during a routine visit about risk factors for development of benign prostatic hyperplasia (BPH), because several relatives have been diagnosed with BPH. Which response by the nurse provides accurate information? A. "A history of hydrocele increases the risk of BPH in later years." B. "Genetics plays a strong role in development of BPH; thus, your risk would be higher." C. "There are two main risk factors for BPH; age and presence of testosterone." D. "There really are no known risk factors for BPH; it is just a result of the aging process."
C (The two main risk factors for developing BPH are age and the presence of testosterone; thus, this would be the most accurate response to the question. Neither genetics nor history of hydrocele are implicated as risk factors for development of BPH. Stating that there are no risk factors would not be an accurate statement.)
Which surgical option for treating benign prostatic hyperplasia (BPH) utilizes low-level radio frequency through twin needles to burn away a region of the enlarged prostate? A. Balloon urethroplasty B. Transurethral resection of the prostate (TURP) C. Transurethral needle ablation (TUNA) D. Laser surgery
C (Transurethral needle ablation (TUNA) utilizes low-level radio frequency through twin needles to burn away a region of the enlarged prostate. Transurethral resection of the prostate (TURP) is performed with the use of a wire loop resectoscope to remove prostate tissue and perform electrocautery through the urethra (see image below). In laser surgery, a cystoscope is passed through the urethra and used to vaporize prostatic tissue with short bursts of energy. Balloon urethroplasty is done by inserting a balloon-tipped catheter into the urethra and inflating it to widen the narrowed portion.)
A patient diagnosed with mild benign prostatic hyperplasia (BPH) asks, "What can I do to relieve symptoms of BPH?" Which response by the nurse provides appropriate self-care interventions? A. "Only use over-the-counter antihistamines for a cold, and avoid decongestants." B. "Restrict fluid intake to decrease urinary frequency." C. "Exercise regularly, including pelvic floor exercises." D. "Limit alcohol intake to three to four drinks per week."
C (Exercising regularly, including pelvic floor exercises, can be a helpful lifestyle change for men diagnosed with mild BPH. Fluid intake does not need to be restricted. Over-the-counter decongestants and antihistamines should be avoided because they can precipitate urinary retention. Use of alcohol should be avoided because it can cause urinary incontinence.)
A client with benign prostatic hyperplasia (BPH) asks the nurse if there are medications that can be used to prevent the need for surgery. Which response by the nurse is accurate? A. "There are medications, but most of them have serious adverse effects." B. "There are two classes of medications available for BPH, but they only address lower urinary tract symptoms and do not shrink the prostate." C. "There are some medications available, but ultimately they just delay the need for surgery for a short time." D. "Yes, there are medications that can help control BPH symptoms and reduce the need for surgery."
D
The home care nurse is making an initial follow-up visit to a client discharged post-perineal prostatectomy. Which behavior reported by the client post-suture removal should be a cause for concern? A. Fluid intake of 2000-3000 mL per day B. Daily sitz baths C. Perineal irrigations with sterile normal saline after bowel movements D. Use of enemas to address constipation
D
The nurse is providing care to a client in the healthcare clinic. The client's brother was recently diagnosed with benign prostatic hyperplasia (BPH), and the client wants to know if he is also at risk. Which item in the client's history increases the risk for BPH? A. Testicle removal due to cancer B. Decreased levels of progesterone C. 35 years of age D. Increased levels of estrogen
D
The nurse is providing follow-up care for a client was recently diagnosed with benign prostatic hyperplasia (BPH). Which nursing diagnosis is the priority for the nurse to include in the client's plan of care? A. Diarrhea B. Chronic Pain C. Constipation D. Impaired Urinary Elimination
D
The nurse is assessing a patient for symptoms of benign prostatic hyperplasia (BPH). Which factor in the patient's health history should the nurse consider? A. More than one sexual partner B. Smoking history C. Sedentary lifestyle D. Age
D (Age is the most common risk factor for BPH. Almost all men will develop BPH if they live long enough. Race may play a role, because African American and Latino men develop BPH earlier than Caucasian Americans, but Asian American men develop it later. Smoking, sexual history, and a sedentary lifestyle are not risk factors for developing BPH.)
The ultrasound of a patient with benign prostratic hyperplasia (BPH) reveals an accumulation of urine in the renal pelvis. Which complication of untreated BPH should the nurse suspect this patient is experiencing? A. Renal insufficiency B. Hydroureter C. Infection D. Hydronephrosis
D (An accumulation of urine in the renal pelvis reflects development of hydronephrosis, which can occur if the enlarging mass of BPH is not reduced. Infection, hydroureter, and renal insufficiency are also possible complications but are not characterized by an accumulation of urine in the renal pelvis.)
A patient with benign prostatic hyperplasia (BPH) is scheduled for minimally invasive surgery for his condition. He asks the nurse, "What's the worst that can happen if I don't have the procedure?" The nurse should consider which complication in response to the patient? A. Impotence B. Detrusor hypertrophy C. Diverticula D. Varicocele
D (Several complications may occur if the mass is not reduced in size. One significant complication relates to the pressure resulting from urinary retention. This causes the development of diverticula, which are saclike outward projections of mucosa protruding through the muscular layer of the bladder wall. Infection resulting from the retained urine and in the diverticula can ascend from the bladder to the kidney. Detrusor hypertrophy occurs in BPH to try to compensate for increased resistance to urine flow, but it is not a complication of the mass. Impotence is not a factor. Varicocele refers to dilated and twisted veins of the testis; it is not due to untreated BPH.)
Upon completion of a health history for a patient reporting urinary frequency and urgency, the patient asks, "Which diagnostic tests will be needed to determine if I have an enlarged prostate?" Which is the first test that the nurse should discuss with the patient? A. Uroflowmetry B. Prostate-specific antigen (PSA) level C. Bladder ultrasound D. Digital rectal examination (DRE)
D (The digital rectal examination is the most common diagnostic test for BPH. PSA levels are done to rule out prostate cancer, not to diagnose BPH. Bladder ultrasounds and urine flow tests are additional tests used to diagnose BPH or to identify problems associated with BPH.)
The nurse is preparing teaching for a patient-posttransurethral resection for benign prostatic hyperplasia (BPH). Which intervention should the nurse encourage the patient to implement in order to decrease the risk for urinary tract infections? A. "Empty the urinary catheter leg bag every 3-4 hours during waking hours." B. "Try to avoid voiding around the urinary catheter." C. "Start and stop the urine stream several times during each voiding after catheter removal." D "Maintain a liberal fluid intake of 2-3 L per day."
D (To help prevent a urinary tract infection, encourage the patient to maintain a liberal fluid intake of 2-3 L per day. Asking the patient to try to avoid voiding around the urinary catheter helps to prevent bladder spasms and bleeding. Starting and stopping the urine stream several times during each voiding helps improve urinary control. Emptying the urinary catheter leg bag every 3-4 hours during waking hours helps to prevent)
A patient has been scheduled for a transurethral needle ablation (TUNA) to address his benign prostatic hyperplasia (BPH). Which statement describes this surgical approach? A. A resectoscope is inserted through the urethra, and the obstructing tissue is excised with an electrocautery wire loop B. A cystoscope is used to pass a yttrium-aluminum-garnet laser fiber through the urethra into the prostate to vaporize obstructing tissue. C. Microwaves are used to heat and destroy excess prostate tissue. D. Low-level radio frequency is used through twin needles to burn away a region of the enlarged prostate.
D (Transurethral needle ablation (TUNA) utilizes low-level radio frequency through twin needles to burn away a region of the enlarged prostate. Transurethral resection of the prostate (TURP) is performed with the use of a wire loop resectoscope to remove prostate tissue and perform electrocautery through the urethra. In laser surgery (see image below), a cystoscope is passed through the urethra and used to vaporize prostatic tissue with short bursts of energy. Balloon urethroplasty is done by inserting a balloon-tipped catheter into the urethra and inflating it to widen the narrowed portion.)
The nurse is completing an assessment for a patient and suspects benign prostatic hyperplasia (BPH). Which complaint by the patient supports this diagnosis? A. Localized, nondescript back pain B. Swelling of the scrotum and testicles C. Genital pain that worsens with strenuous exercise D. Urinary hesitancy and a weak urinary stream
D (Urinary hesitancy and a weak urinary stream help support a diagnosis of BPH. Swelling of the scrotum and testicles, genital pain that worsens with strenuous exercise, and localized, nondescript back pain are not indicative of BPH.)
The nurse is completing the International Prostate Symptom Score (IPSS) scale on a patient to assess for symptoms of benign prostatic hyperplasia (BPH). Which question would the nurse ask as part of this evaluation? A. "Are you experiencing any sexual dysfunction?" B. "Do you experience burning or pain when you urinate?" C. "Do you have a parent or a sibling with BPH?" D. "Do you need to urinate within 2 hours after previously urinating?"
D (Asking if the patient needs to urinate within 2 hours after previously urinating would provide information for the IPSS scale. Questions concerning possible dysuria, family members with BPH, or possible sexual dysfunction would not provide information that could be used to complete the IPSS.)