AH MALE REPRO
A client is having prostate-specific antigen (PSA) testing done. Which result would the nurse identify as abnormal?
4.6 nanograms/milliliter
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 trouble getting started when I urinate, often straining to do so."
The nurse is teaching a young adult male how to perform testicular self-examination (TSE). The nurse determines that the client has understood the instructions when he states which of the following?
"The best time to do it is once a month after I take my warm morning shower."
Which of the following should be included when teaching a client about the management of benign prostatic hyperplasia (BPH)? Select all that apply.
- Do not delay the urge to void - Schedule digital rectal exams
A client is scheduled for a transurethral resection of the prostate (TURP). Which statement demonstrates that the expected outcome of "client demonstrates understanding of the surgical procedure and aftercare" has been met?
"The surgeon is going to insert a scope through my urethra to remove a portion of the gland."
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?"
The nurse working on the postoperative unit receives a report on various clients. Based on the information provided, whom should the nurse see first?
A 67-year-old male patient recovering from a prostatectomy, with a potassium level of 4.0 mEq/L and a serum sodium level of 130 mEq/L. Vital signs are temperature 99.2°F, pulse 88, respirations 22, and blood pressure 156/92.
A nurse is caring for a 33-year-old male who has come to the clinic for a physical examination. He states that he has not had a routine physical in 5 years. During the examination, the physician finds that digital rectal examination (DRE) reveals "stoney" hardening in the posterior lobe of the prostate gland that is not mobile. The nurse recognizes that the observation typically indicates what?
A sign for early prostate cancer
A patient has returned to the floor after undergoing a transurethral resection of the prostate (TURP). The patient has a continuous bladder irrigation system in place. The patient tells you he is experiencing bladder spasms and asks what you can do to relieve his discomfort. What is the most appropriate nursing action to relieve the discomfort of the patient?
Administer a smooth-muscle relaxant as ordered (antispasmodics)
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 (Tamsulisin) & 5-ARI (Finasteride)
The nurse is leading a workshop on sexual health for men. The nurse should teach participants that psychogenic causes of erectile dysfunction include what? Select all that apply.
Anxiety, depression, fatigue *Recommend psychotherapy
Bright red bleeding following prostate surgery indicates which of the following?
Arterial bleed
Which treatment involves implantation of interstitial radioactive seeds under anesthesia to treat prostate cancer?
Brachytherapy
A patient has just returned to the floor following a transurethral resection of the prostate. A triple-lumen indwelling urinary catheter has been inserted for continuous bladder irrigation. What, in addition to balloon inflation, are the functions of the three lumens?
Continuous inflow and outflow of irrigation solution
A client reports experiencing nocturia. The nurse obtains a thorough history including current signs and symptoms. What would the client likely include when describing the symptoms?
Decrease in the force of urinary stream
A client with erectile dysfunction has been prescribed a PDE5 inhibitor. What would the nurse include in the client education?
Depending on the drug, most are taken "on demand" 15 minutes, 1/2 hour, to 1 hour before sexual activity.
Which of the following would the nurse expect to be done to assess the size of the prostate?
Digital rectal examination
A patient experiences hypotension, lethargy, and muscle spasms while receiving bladder irrigations after a transurethral resection of the prostate (TURP). What is the first action the nurse should take?
Discontinue irrigations
Which of the following may result if prostate cancer invades the urethra or bladder?
Hematuria Symptoms related to metastases include backache, hip pain, perineal and rectal discomfort, anemia, weight loss, weakness, nausea, and oliguria.
After teaching a group of students about erectile dysfunction, the instructor determines that the teaching was successful when the students identify which of the following as true?
Erectile dysfunction may be due to testosterone insufficiency.
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)
In a client with benign prostatic hyperplasia (BPH), which assessment finding provides the best indication of urinary retention?
Frequency
A nurse is teaching a 53-year-old man about prostate cancer. What information should the nurse provide to best facilitate the early identification of prostate cancer?
Have a DRE and prostate-specific antigen (PSA) test done yearly.
Which component of client teaching helps the nurse assist a client following treatment for cancer of the prostate gland to manage and minimize the possibility of a recurrence of the primary cancer or metastasis?
Have regular prostate-specific antigen (PSA) levels tested and repeat lymph node biopsies.
Which of the following is an immediate danger after a prostate surgery?
Hemorrhagic shock
A 65-year-old man complains to his health care provider that, when he urinates, he has to start and stop several times over a period of minutes in order to fully empty his bladder. The nurse is aware that this is not uncommon in men over the age of 60. This "double voiding" is directly related to which of the following?
Hyperplasia of the prostate gland
A patient has presented at the clinic with symptoms of benign prostatic hyperplasia. What diagnostic findings would suggest that this patient has chronic urinary retention?
Increased BUN
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
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) because it is a nitrate
A public health nurse has been asked to provide a health promotion session for men at a wellness center. What should the nurse inform the participants about testicular cancer?
It is high responsive to chemotherapy. Testicular cancer is most common among men 15 to 35 years of age and produces a painless enlargement of the testicle. Testicular cancers metastasize early but are one of the most curable solid tumors, being highly responsive to chemotherapy.
Which statement is accurate regarding sildenafil?
Its side effects include headache, flushing, and dizziness.
A patient informs the nurse that his father died of prostate cancer, so he wants to know ways in which to reduce his risk factors for developing it. What education can the nurse give to the patient to decrease modifiable risk factors?
Limit red meat and dairy products high in fat.
Which of the following would a nurse include in a teaching plan for a client with benign prostatic hyperplasia who is not yet a candidate for surgery?
Maintaining optimal bladder emptying
Which nursing assessment finding is most significant in determining the plan of care in a client with erectile dysfunction?
Medication use
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.
A patient is 24 hours postoperative following prostatectomy and the urologist has ordered continuous bladder irrigation. What color of output should the nurse expect to find in the drainage bag?
Reddish pink, light pink
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
Which is the most common type of prostate surgery?
TURP
A patient is having a DRE in the physician's office and the nurse is to assist in the examination. What can the nurse instruct the client to do to decrease the discomfort from the exam?
Take a deep breath and exhale when the physician inserts a gloved finger into the rectum.
After having transurethral resection of the prostate (TURP), a client returns to the unit with a three-way indwelling urinary catheter and continuous closed bladder irrigation. Which finding suggests that the client's catheter is occluded?
The client reports bladder spasms and the urge to void.
A patient has been prescribed sildenafil. What should the nurse teach the patient about this medication?
The drug should be taken 1 hour prior to intercourse.
Remember
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.
A man comes to the clinic complaining that he is having difficulty obtaining an erection. When reviewing the patient's history, what might the nurse note that contributes to erectile dysfunction?
The patient has a history of hypertension.
A patient has just been diagnosed with prostate cancer and is scheduled for brachytherapy next week. The patient and his wife are unsure of having the procedure because their daughter is 3 months pregnant. What is the most appropriate teaching the nurse should provide to this family?
The patient should avoid close contact with his daughter for 2 months
The client states to the nurse that he is very anxious about having prostate cancer ever since his prostate-specific antigen (PSA) test came back elevated. The client asks, "Which diagnostic test produces definitive results if cancer is present?" The nurse is most correct to state which of the following?
Tissue biopsy
Symptoms of prostate cancer
Trouble urinating Decreased force in the stream of urine difficulty urinating, urinary retention, urinary dribbling, back pain, and urinary/bladder inflammation. Blood in the urine Blood in the semen Swelling in the legs Discomfort in the pelvic area Bone pain
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.
A client underwent a transurethral resection of the prostate gland 24 hours ago and is on continuous bladder irrigation. Which nursing intervention is appropriate?
Use sterile technique when irrigating catheter
Which factor should be checked when evaluating the effectiveness of an alpha-adrenergic blocker given to a client with benign prostatic hyperplasia (BPH)?
Voiding pattern
Which client is most likely to develop prostate cancer according to a nurse working at a health screening at the local mall?
A 56-year-old African American man
The nurse is leading a workshop on sexual health for men. The nurse should teach participants that organic causes of erectile dysfunction include what? Select all that apply.
Cardiovascular disease, endocrine disease (diabetes, pituitary tumors, testosterone deficiency, hyperthyroidism, and hypothyroidism), cirrhosis, chronic renal failure, genitourinary conditions (radical pelvic surgery), hematologic conditions (Hodgkin disease, leukemia), neurologic disorders (neuropathies, parkinsonism, spinal cord injury, multiple sclerosis), trauma to the pelvic or genital area, alcohol, smoking, medications, and drug abuse
During a routine office visit, a client mentions difficulty maintaining an erection. While reviewing the client's medical history, the nurse notes the client's medication history. Which medication would the nurse interpret as a potential cause of erectile dysfunction? Select all that apply.
ClonidineLorazepamNadololFluoxetine
A nurse is providing care for a patient who has recently been admitted to the postsurgical unit from PACU following a transuretheral resection of the prostate. The nurse is aware of the nursing diagnosis of Risk for Imbalanced Fluid Volume. In order to assess for this risk, the nurse should prioritize what action?
Closely monitoring input and output of bladder irrigation system
