Nursing Management: Patients With Male Reproductive Disorders
A 58-year-old patient has been diagnosed with acute prostatitis after seeking care for severe perineal pain. The patient's severe leukocytosis has prompted the care team to admit him to the medical unit of the hospital for treatment. The nurse should anticipate that this patient's treatment regimen will include which of the following?
Administration of IV antibiotics
A patient is diagnosed with prostatitis. Which of the following is the most commonly isolated organism that will be present in this patient's laboratory results?
Escherichia coli
The nurse is preparing a presentation for a local community group about prostate cancer and possible dietary risk factors. Which of the following would the nurse most likely include?
High-fat diet
A patient comes to the clinic with complaints of inability to sustain an erection and is prescribed a PDE-5 inhibitor, sildenafil (Viagra). What medication should the nurse caution the patient about taking with this medication?
Isosorbide (Isordil)
The nurse is providing instruction for testicular self-examination to a group of young adolescents. Which is the most correct examination technique?
Palpate each testicle separately, following a warm shower.
Which of the following herbal remedies is used to treat symptoms of benign prostatic hypertrophy (BPH)?
Saw palmetto
A 55-year-old Asian man has a PSA level of 4.8 ng/mL. Based on the client's PSA level, which assessment question does the nurse need to ask?
"When was the last time you experienced ejaculation?"
A client is having prostate-specific antigen (PSA) testing done. Which result would the nurse identify as abnormal?
4.6 nanograms/milliliter
A patient is 62 years old and weighs 176 pounds. Post prostatectomy, the nurse assesses hourly urine outputs. Select the measurement that would require notification of the health care provider.
25 mL/hr
A nurse is conducting a health promotion class for a group of younger middle-aged men. When discussing the need for a digital rectal exam, the nurse would recommend this exam for every man over age:
50
The nurse is reviewing the medical record of a client who has been diagnosed with prostate cancer. The nurse notes that the Gleason score was used to grade the cancer. Which total score would the nurse interpret as indicating a highly aggressive cancer?
9
Several male clients are scheduled to come to the clinic for an annual physical examination. The nurse would expect to prepare which client for a digital rectal examination (DRE)?
A 52-year-old man in good health
Medical management of BPH includes pharmacologic therapy. Which of the following medications would the nurse expect the health care provider to prescribe for this diagnosis?
Alpha-adrenergic blocker
A client is undergoing treatment for prostate cancer. He has chemotherapy sessions regularly. However, of late he is showing symptoms of food allergy and loss of appetite. He has lost considerable weight as a result. Which is an appropriate nursing task in this situation?
Ask the client to keep a diet diary.
Which treatment involves implantation of interstitial radioactive seeds under anesthesia to treat prostate cancer?
Brachytherapy
A client who comes to the clinic complaining of perineal pain, dysuria and fever is diagnosed with prostatitis. The nurse understands that which of the following organisms would be the most likely cause?
Escherichia coli
Which of the following is the most common organism implicated in prostatitis?
Escherichia coli
The client with benign prostatic hyperplasia (BPH) is considering use of medication in the management of symptoms. Which of the following drugs reduces the size of the prostate without lowering circulating levels of testosterone?
Finasteride (Proscar)
Which of the following may result if prostate cancer invades the urethra or bladder?
Hematuria
Which of the following is an immediate danger after a prostate surgery?
Hemorrhagic shock
Which of the following should nurses teach all men, especially those who have had cryptorchidism?
How to perform a testicular self-examination.
When assessing a client with benign prostatic hyperplasia, which of the following would the nurse expect the client to report as the initial complaint?
Increased effort to void
After a radical prostatectomy for prostate cancer, a client has an indwelling catheter removed. The client then begins to have periods of incontinence. During the postoperative period, which intervention should be implemented first?
Kegel exercises
The nurse is caring for a patient who had a transurethral resection of the prostate (TURP). The health care provider has ordered continuous bladder irrigation, and the patient is now around 20 hours postoperative. During the nurse's shift assessment, what color urine would the nurse expect to find in the drainage bag?
Light pink
The nurse is preparing a presentation for a men's community group about health promotion. Which of the following would the nurse include as a current recommendation for screening?
Monthly testicular self-examination (TSE)
Which of the following nursing assessment findings would be most significant in determining sterility in a male client?
Mumps at age 15 years
Which statement should be included in the teaching plan for a client prescribed sildenafil?
Only one tablet of the prescribed dose should be taken each day.
Which is an age-related change affecting the male reproductive system?
Plasma testosterone levels decrease.
A 29-year-old patient has just been told that he has testicular cancer and needs to have surgery. The surgery is scheduled for the following week. That afternoon, the patient calls the nurse and tells her he wants to cancel the surgery because he thinks he might be better off dead. The nurse asks him why he feels that way. The patient states "My wife won't want to have sex with me anymore. He says he feels like he's spoiled a happy, satisfying sex life with his wife and he starts to cry. Based on these statements, which nursing diagnosis would be most appropriate for creating a plan of care for this patient?
Situational low self-esteem
Which should be included as part of the home care instructions for a client with epididymitis and orchitis?
Take prescribed antibiotics.
A 30-year-old patient is receiving analgesics and antibiotics for the treatment of epididymitis. The patient normally leads an active lifestyle and is concerned about the effect that his recovery will have on his routines. What should the nurse teach the patient about lifestyle modifications during his recovery?
The patient should avoid lifting and sexual activity until his infection is resolved.
Which instruction regarding future sexual activity should a nurse give a client with a vasectomy?
Use a reliable method of contraception until the physician ensures that sperm no longer are present
Following a vasectomy, which is the most important instruction to provide to the client?
Use another form of birth control until further notice.
Which assessment finding would create the greatest risk to a client ordered a phosphodiesterase inhibitor such as sildenafil?
Use of nitrates
A client has an edematous glans penis, pain, and an extremely constricted foreskin. What treatment would the physician likely prescribe?
circumcision
Which cancer ranks second as the cause of death in American men?
prostate
After teaching a group of student about structural abnormalities of the male reproductive system, the instructor determines that the teaching was successful when the students identify which of the following as an example?
Cryptorchidism
The nurse is providing care to a client who has had a transurethral resection of the prostate. The client has a three-way catheter drainage system in place for continuous bladder irrigation. The nurse anticipates that the catheter may be removed when the urine appears as which of the following?
Light yellow and clear
Which nursing assessment finding is most significant in determining the plan of care in a client with erectile dysfunction?
Medication use
A nurse is reviewing a journal article about benign prostatic hyperplasia and possible risk factors associated with this condition. Which factor would the nurse most likely find as playing a role in increasing a man's risk for this condition? Select all that apply.
Smoking Hypertension Diabetes
A client is ordered continuous bladder irrigation at a rate of 60 gtt/minute. The nurse hangs a 2 L bag of sterile solution with tubing on a three-legged IV pole. She then attaches the tubing to the client's three-way urinary catheter, adjusts the flow rate, and leaves the room. Which important procedural step did the nurse fail to follow?
Evaluating patency of the drainage lumen
The physician orders an alpha-adrenergic blocker for a client with benign prostatic hyperplasia. The nurse understands that this drug acts to achieve which of the following?
Relieve urinary symptoms
The nurse is demonstrating the technique for performing a testicular self examination (TSE) to a group of men for a company health fair. One of the men asks the nurse at what age a man should begin performing TSE. What is the best answer by the nurse?
"It should begin in adolescence."
A nurse is instructing a client in testicular self-examination. Which client statement indicates the need for additional teaching?
"I should do this exam at least once a week."
After teaching about self-care measures to a client who has been diagnosed with prostatitis, the nurse determines that the teaching was successful when the client states which of the following?
"I should avoid fluids like coffee and tea."
A client with erectile dysfunction is being treated with alprostadil urethral suppository. After teaching the client about this treatment, the nurse determines that additional education is needed based on which client statement?
"I should inject the medication about 20 minutes before intercourse."
A nurse is working in an oncology treatment center. Which clinical manifestation when reported by a client would the nurse know may be related to metastasis from prostate cancer?
Constant hip aching and discomfort
Which nursing assessment finding is most significant in determining the plan of care in a client with erectile dysfunction?A patient is planning to use a negative-pressure (vacuum) device to maintain and sustain an erection. What should the nurse caution the patient about with the use of this device?
Do not leave the constricting band in place for longer than 1 hour to avoid penile injury.
A 61-year-old man's elevated prostate screening antigen (PSA) levels and abnormal digital rectal examination (DRE) results prompted his care provider to refer him for treatment. The patient has subsequently been diagnosed with prostate cancer and is scheduled for surgery. The nurse should recognize that this patient's plan of nursing care should include interventions to address what potential long-term complication of prostate surgery?
Erectile dysfunction
A client is receiving leuprolide as part of his treatment for prostate cancer. The nurse would be alert for which of the following as a possible adverse effect?
Gynecomastia
The nurse is obtaining a medication history from a client who is reporting erectile dysfunction. Which medication would the nurse identify as being least likely to contribute to the client's condition?
Ibuprofen
A health care provider prescribed a luteinizing hormone-releasing hormone (LHRH) agonist to suppress testicular androgen and treat prostate cancer. Which medication is the primary drug of choice?
Lupron
A 59-year-old African American man has opted for hormonal androgen deprivation therapy (ADT) to treat his prostate cancer. Which surgical procedures is the client most likely to undergo?
Orchiectomy
Which term refers to the surgical removal of one or both testes?
Orchiectomy
A patient with an indwelling catheter after a radical prostatectomy is having bladder spasms. What medication prescribed by the physician can the nurse administer to help alleviate the discomfort?
Oxybutynin (Ditropan)
A client comes to the emergency department complaining of sudden, sharp testicular pain. Further examination reveals torsion of the spermatic cord. Which of the following would the nurse expect to do next?
Prepare the client for surgery
A client expresses concerns about future reproduction after a surgery to correct the cancer of the testes. For this client, treatment proceeded without first collecting and storing sperm. Which alternative should the nurse suggest to the client?
Suggest donor insemination or adoption
A nurse is teaching a male client to perform monthly testicular self-examinations. Which point is appropriate to make?
Testicular cancer is a highly curable type of cancer.
A public health nurse is teaching a health class for the male students at the local high school and has been asked about testicular cancer. What points would be appropriate to emphasize?
Testicular cancer is a highly curable type of cancer.
A client comes to the emergency department reporting severe testicular pain that started about 1 hour ago. Examination reveals a thickened spermatic cord, an elevated testis, and testicular tenderness. The nurse would interpret these findings to suggest which of the following?
Testicular torsion
Which of the following is the only definitive test that can determine if cancer of the testis is present?
Tissue biopsy
A client with benign prostatic hyperplasia doesn't respond to medical treatment and is admitted to the facility for prostate gland removal. Before providing preoperative and postoperative instructions to the client, the nurse asks the surgeon which prostatectomy procedure will be done. What is the most widely used procedure for prostate gland removal?
Transurethral resection of the prostate (TURP)
A client is to undergo a TURP for BPH. Which statement is accurate with regard to a TURP?
Urethral strictures are more frequent for TURP than for nontransurethral procedures.
Which of the following would be most important to include in a teaching plan for a client who has had a vasectomy?
Using a reliable method of contraception for several weeks.
