59 mens reproductive health
A client comes to the clinic reporting urinary symptoms. Which statement would most likely alert the nurse to suspect benign prostatic hyperplasia (BPH)? "I've had a fever and noticed I've been running to the bathroom more often." "I'm waking up at night to urinate and I've noticed some burning, too." "I've had trouble getting started when I urinate, often straining to do so." "I've had some pain in my lower abdomen lately and felt a bit sick to my stomach."
"I've had trouble getting started when I urinate, often straining to do so." Explanation: Symptoms that might alert the nurse to BPH include difficulty initiating urination and abdominal straining with urination. Although fever, urinary frequency, nocturia, pelvic pain, nausea, vomiting, and fatigue may be noted, they also may suggest other conditions such as urinary tract infection. Fever, nausea, vomiting, and fatigue are general symptoms that can accompany many conditions.
Which of the following is inconsistent with a digital rectal examination (DRE)? Recommended for men older than 40 years of age Assists in screening for cancer of prostate gland Enables examiner to assess size, shape, and consistency of prostate gland Can reveal a hydrocele
Can reveal a hydrocele Explanation: The DRE is recommended as part of the regular health checkup for every man older than 50 years of age. It is a screening for cancer of the prostate gland. It enables the examiner to assess the size, shape, and consistency of the prostate gland.
Which of the following patient populations have the highest risk for developing testicular cancer? Caucasian American African American Asian American Mexican American
Caucasian American Explanation: Caucasian American men have a five times greater risk than that of African American men and more than double the risk of Asian American men.
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) Tamsulosin (Flomax) Terazosin (Hytrin) Oxybutynin chloride (Ditropan)
Finasteride (Proscar) Explanation: Finasteride (Proscar) inhibits the conversion of testosterone depriving the gland of dihydrotestosterone (more potent type of testosterone), which stimulates prostatic growth. Tamsulosin (Flomax) and terazosin (Hytrin) work by reducing the tone of smooth muscle in the bladder neck and prostate gland but have little effect on reducing prostate size. Oxybutynin chloride (Ditropan) is antimuscarinic, antispasmodic drug used for treatment of overactive bladder.
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? Reports of increased libido Muscle overgrowth Gynecomastia Nipple retraction
Gynecomastia Explanation: Adverse effects associated with leuprolide, a luteinizing hormone-releasing hormone agonist, are related to hypogonadism and include vasomotor flushing, loss of libido, decreased bone density, anemia, fatigue, increased fat mass, decreased muscle mass, gynecomastia, and mastodynia (breast/nipple tenderness).
Which nursing assessment finding is most significant in determining the plan of care in a client with erectile dysfunction? Age Medication use Sexual history Undescended testicle
Medication use Explanation: Certain medications such as antihypertensive drugs, antidepressants, narcotics, etc. can cause sexual dysfunction in men. Impotence is not a normal part of aging. Undescended testicle is not indicative of ED. Sexual history is not indicative of ED.
The nurse is providing instruction for testicular self-examination to a group of young adolescents. Which is the most correct examination technique? Palpate both testicles simultaneously for comparison. Palpate each testicle separately, following a warm shower. Palpate the front of the testicle first, where most tumors are found. Palpate for a soft, round shape with normal ridges on the testicles.
Palpate each testicle separately, following a warm shower. Explanation: It is best to examine and palpate each testicle following a warm shower, when the testes are relaxed and not retracted. Because one testicle is normally larger and hangs lower, comparing the two sides is not indicated. Both testes should be oval in shape, smooth, and firm without masses or tenderness. Most tumors are located on the lateral aspect of the testicles.
Nursing students are reviewing information about the male reproductive system and normal age-related changes. They demonstrate understanding of the topic when they identify which of the following as occurring? Secretions of the prostate gland increase. Testes become heavier in weight. Spematogenesis drops significantly Plasma testosterone levels decrease.
Plasma testosterone levels decrease. Explanation: With aging, plasma testosterone levels decrease, prostatic secretions increase, testes decrease in weight, and spermatogenesis continues.
The student nurse studying the male reproductive tract demonstrates understanding of the pathway testicular secretions take when they exit the penis by selecting which of the following answer options? Epididymis, ejaculatory duct, vas deferens, penis Seminiferous tubules, epididymis, vas deferens, ejaculatory duct Vas deferens, epididymis, ejaculatory duct, urethra Seminiferous tubules, urethra, ejaculatory duct, penis
Seminiferous tubules, epididymis, vas deferens, ejaculatory duct
Which of the following should be included as part of the home care instructions for a patient with epididymitis and orchitis? Take prescribed antibiotics Undertake lifting exercises Apply ice to area after scrotal swelling subsides Resume sexual intercourse
Take prescribed antibiotics Explanation: Home care for a patient with epididymitis and orchitis includes instructions to continue administering prescribed antibiotics, and to take sitz baths, apply local heat after scrotal swelling subsides, avoid lifting, and to refrain from sexual intercourse until symptoms are relieved.
A patient comes to the emergency department and tells the nurse, "I took a pill to help me perform and then passed out." The nurse is assessing the patient and finds a nitroglycerin patch on his back. What is the first intervention the nurse must perform? Take the patient's blood pressure. Ask the patient to obtain a urine specimen. Start an IV. Administer atropine 0.5 mg.
Take the patient's blood pressure. Explanation: Based on the patient's comments, he is most likely taking a phosphodiesterase type 5 (PDE-5) inhibitor, which is an oral medication used to treat erectile dysfunction. The most common side effects of this medication include headache, flushing, dyspepsia, diarrhea, nasal congestion, and lightheadedness. These agents are contraindicated in men who take organic nitrates (e.g., isosorbide [Isordil], nitroglycerin), because taken together, these medications can cause side effects such as severe hypotension.
An 80-year-old client is being seen by the urologist because of erectile dysfunction. This client has a history of hypertension and heart disease. Which of the following would be the most likely cause of his erectile dysfunction? All options are correct. Hypertension medication Atherosclerosis Depression
All options are correct.
Which of the following would the nurse expect to find when assessing a client with phimosis? Severe edema accompanied by chronic inflammation at the glans penis Difficulty cleaning under the foreskin Painful swelling of the glans penis and prepuce Urinary retention accompanied by burning sensations in the urinary tract
Difficulty cleaning under the foreskin Explanation: Clients with phimosis report pain with erection and intercourse and difficulty cleaning under the foreskin. Clients with paraphimosis experience painful swelling of the glans. If the condition continues, severe edema and urinary retention may occur.
A client with a penile implant is to be informed about the possible complications after discharge. Which of the following are complications that occur due to a midsized implant, pressure, or friction of the implanted cylinders? Erosion of penile or urethral tissue Migration of the cylinders, pump, and reservoir Erosion of scrotal, bowel, or bladder tissue Malfunction of the device
Erosion of penile or urethral tissue Explanation: Erosion of penile or urethral tissue may occur from a midsized implant, pressure, and friction of the implanted cylinders, which is evidenced by seeing the implant through the skin. Migration of the cylinders, pump, and reservoir is a possible complication but not due to a midsized implant, pressure, or friction of the implanted cylinders. Malfunction of the device can occur with migration, accidental trauma such as a fall, or aggressive or improper use of the device.
Which of the following is not a definition of erectile dysfunction? The inability to achieve an erection after sexual activity The inability to achieve an erection The inability to achieve or maintain an erection that is sufficiently rigid for sexual activity The inability to sustain erection for a satisfactory period of time
The inability to achieve an erection after sexual activity Explanation: The ability to achieve an erection after sexual activity varies and depends on the man's age, health, and sexual excitement. This statement is included in the definition of erectile dysfunction. Additionally, there must be multiple or persistent incidences of failed erection for the disorder to be considered pathologic.
The nurse is providing preoperative care to a client who is to undergo a radical prostatectomy for prostate cancer. The client's plan of care includes the nursing diagnosis of "anxiety related to surgery and its outcome." Which of the following would be most appropriate for the nurse to do? Tell the client that prostate cancer is very curable if caught early. Inform the client that risk of recurrence is decreased with this type of surgery. Ensure privacy when discussing sensitive or embarrassing sexual issues. Allow the client to assume a passive role in the preparation.
Ensure privacy when discussing sensitive or embarrassing sexual issues. Explanation: To help reduce anxiety, the nurse should provide clear explanations about the events before, during, and after surgery, reinforcing information already provided by the surgeon. In addition, the nurse should establish a trusting relationship and allow the client to ask questions and verbalize his feelings related to the diagnosis, surgery, and outcomes. Because the surgery involves reproductive issues that the client may find sensitive or embarrassing, the nurse needs to ensure the client's privacy when discussing any of these issues. Telling the client that the cancer is very curable and informing him of a lower risk of recurrence would give the client false reassurance. In addition, anxiety could be increased, especially if the client's cancer is not at an early stage. Regardless of the diagnosis, clients need to participate in their care to foster autonomy and feelings of control over the situation.
A patient is having brachytherapy for the treatment of prostate cancer and asks the nurse if he can have sexual intercourse after radiation therapy is completed. What is the best response by the nurse? "You most likely will not be able to have sexual intercourse after radiation therapy." "You must be sure to use a condom for 2 weeks after implantation and then it will no longer be necessary." "There are no restrictions to sexual activity during radiation." "You must use a condom for at least 6 months after beginning radiation therapy."
"You must be sure to use a condom for 2 weeks after implantation and then it will no longer be necessary." Explanation: Two major forms of radiation therapy are used to treat cancer of the prostate: teletherapy (external) and brachytherapy (internal). Brachytherapy (internal implants) involves the implantation of interstitial radioactive seeds under anesthesia. Radiation safety guidelines include straining urine for seeds and using a condom during sexual intercourse for 2 weeks after implantation to catch any seeds that pass through the urethra.
A client diagnosed with epididymitis is being discharged from the Emergency Department. Which of the following would be most important for the nurse to include as part of the client's discharge teaching? "Apply ice to the top of your scrotum to help reduce the swelling." "Engage in sexual intercourse frequently to help drain the area." "If you have a fever, call the physician so he can order an antibiotic right away." "Keep your scrotum elevated on a folded towel until the swelling goes down."
"Keep your scrotum elevated on a folded towel until the swelling goes down." Explanation: The scrotum is elevated with a folded towel, four tail bandage, or adhesive tape across the upper thighs to relieve pain by lessening the weight of the testes. Ice is applied under the scrotum not on top or leaning against it. Sexual intercourse is to be avoided until symptoms are relieved. Antibiotics are typically prescribed as part of the initial treatment, not when the client develops a fever.
A group of students are reviewing information about the classifications of testicular cancer. The students demonstrate understanding of the information when they describe which of the following? Nongerminal tumors are the most common type of testicular tumor. Seminomas are typically fast growing tumors. Choriocarcinoma is an example of a nonseminoma. Prostate cancer is the most common cause of secondary testicular tumors.
Choriocarcinoma is an example of a nonseminoma. Explanation: Testicular tumors are classified as germinal or nongerminal. Germinal tumors are futher classified as seminomas (slow-growing forms usually found in men in their 30s and 40s) and nonseminomas (more common and grow more rapidly). Nonseminomas inlcude choricarcinomas, embryonal carcinomas, teratomas, and yolk sac tumors. Nongerminal tumors account for less than 10% of testicular cancers. Lymphoma is the most common cause of secondary testicular cancer.
Which of the following recommendations would a nurse advocate during infancy and childhood to help reduce potential adult complications such as orchitis? Ensure immunizations against infectious diseases such as mumps. Engage in activities and exercises that minimize heavy lifting. Encourage the consumption of foods that are rich in fat and starch. Urge the limited intake of foods and fluids containing caffeine.
Ensure immunizations against infectious diseases such as mumps. Explanation: Nurses should advocate for infant and childhood immunizations against infectious diseases such as mumps to reduce potential adult complications such as orchitis. Minimizing activities involving heavy lifting or urging limited intake of caffeine have no effect on the potential for adult complications such as orchitis. The nurse should encourage foods that are low in fat and starch; however, this also would have no effect on the potential for orchitis
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 I.V. 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 Counter-balancing the I.V. pole Attaching the infusion set to an infusion pump Collecting a urine specimen before beginning irrigation
Evaluating patency of the drainage lumen Explanation: The nurse should evaluate patency of the drainage tubing before leaving the client's room. If the lumen is obstructed, the solution infuses into the bladder but isn't eliminated through the drainage tubing, a situation that may cause client injury. Balancing the pole is important; however, the nurse would have had to address this issue immediately after hanging the 2 L bag. Using an I.V. pump isn't necessary for continuous bladder irrigation. Unless specifically ordered, obtaining a urine specimen before beginning continuous bladder irrigation isn't necessary