Benign Prostatic Hyperplasia (BPH) Practice Questions (Test #5, Fall 2020)

The client asks, "What does an elevated PSA test mean?" On which scientific rationale should the nurse base the response? 1. An elevated PSA can result from several different causes. 2. An elevated PSA can be only from prostate cancer. 3. An elevated PSA can be diagnostic for testicular cancer. 4. An elevated PSA is the only test used to diagnose BPH.

1 1. An elevated PSA can be from urinary retention, BPH, prostate cancer, or prostate infarct. 2. An elevated PSA does not indicate only prostate cancer. 3. PSA does not diagnose testicular cancer. 4. An elevated PSA and digital examination are used in combination to diagnose BPH or prostate cancer. TEST-TAKING HINT: Answer options "2" and "4" have the word "only"; an absolute word should cause the test taker to eliminate them as possible answers. Options with words such as "always," "never," and "only" are usually incorrect.

The client diagnosed with moderate BPH is being treated with tamsulosin. Which intervention should the nurse implement? 1. Check the client's blood pressure. 2. Send a urinalysis to the laboratory. 3. Determine if the client has nocturia. 4. Plan a scheduled voiding pattern.

1 1. The alpha-adrenergic agonist tamsulosin (Flomax) is used to treat hyperplasia of the prostate and was originally developed to treat high blood pressure. The client may develop hypotension when taking these medications. This side effect makes them useful for clients who are also hypertensive. 2. The medication is not given for UTIs, so there is no need for a urinalysis to be done when administering this medication. 3. The client has symptoms of BPH, which could include nocturia, but this is not pertinent when administering the medication. 4. This is an intervention that assists clients who have incontinence, not BPH.

Which intervention should the nurse include when preparing a teaching plan for the client with chronic prostatitis? 1. Sit in a warm sitz bath for 10 to 20 minutes several times daily. 2. Sit in the chair with the feet elevated for two (2) hours daily. 3. Drink at least 3,000 mL of oral fluids, especially tea and coffee, daily. 4. Stop broad-spectrum antibiotics as soon as the symptoms subside

1 1. The client should sit in a warm sitz bath for 10 to 20 minutes several times each day to provide comfort and assist with healing. 2. Clients should avoid sitting for extended periods because it increases the pressure. 3. Oral fluids should be consumed to satisfy thirst but not to push fluids to dilute the medication levels in the bladder. 4. Broad-spectrum antibiotics are administered for 10 to 14 days and should not be stopped until all medications are taken by the client. TEST-TAKING HINT: The test taker must know basic concepts when answering questions; this includes the need for the client to take all prescribed antibiotics. If the test taker is unsure of option "3," drinking plenty of tea and coffee should indicate this is an incorrect answer because these are high in caffeine

The nurse is administering morning medications. Which combination of medications should the nurse question administering? 1. Terazosin and captopril. 2. Finasteride and digoxin. 3. Tamsulosin and metformin. 4. Serenoa repens and metoprolol.

1 1. The major adverse effect of terazosin (Hytrin) is hypotension. Most blood pressure lowering medications can also cause hypotension. The nurse would question administering two medications that can cause the client to become dizzy upon standing, possibly resulting in a fall. The medications that shrink the prostate gland were originally developed to treat high blood pressure. This is a safety issue. 2. Finasteride (Proscar) does not cause hypotension and does not interact with digoxin. The nurse would not question administering these medications. 3. Tamsulosin (Flomax) is an alpha1- adrenergic agonist, but does not cause hypotension. Metformin (Glucophage), a biguanide, does not interact with Tamsulosin (Flomax). The nurse would not question administering these medications. 4. Serenoa repens (saw palmetto) has fewer side effects than most prescription medications that treat BPH and it does not cause hypotension or interact with metoprolol (Toprol XL). The nurse would not question administering these medications. MEDICATION MEMORY JOGGER: If the test taker did not know these medications, an alpha blocker usually will have some effect on the cardiovascular system and an angiotensin converting enzyme (ACE) inhibitor is used to treat high blood pressure. Most blood pressure medications can cause orthostatic hypotension. Two medications that can cause similar side effects would be questioned.

Which statement indicates discharge teaching has been effective for the client who is postoperative TURP? 1. "I will call the surgeon if I experience any difficulty urinating." 2. "I will take my Proscar daily, the same as before my surgery." 3. "I will continue restricting my oral fluid intake." 4. "I will take my pain medication routinely even if I do not hurt."

1 1. This indicates the teaching is effective. 2. Clients do not need to take Proscar postoperatively. 3. There is no reason to restrict the client's fluid intake. 4. Pain medication should be taken as needed. TEST-TAKING HINT: If the test taker is not sure of the correct answer, selecting an option addressing notifying a health-care provider is usually an appropriate choice

An adult male client has been unable to void for the past 12 hours. The best method for the nurse to use when assessing for bladder distention in a male client is to check for: 1.A rounded swelling above the pubis. 2.Dullness in the lower left quadrant. 3.Rebound tenderness below the symphysis. 4.Urine discharge from the urethral meatus.

1 The best way to assess for a distended bladder in either a male or female client is to check for a rounded swelling above the pubis. This swelling represents the distended bladder rising above the pubis into the abdominal cavity. Dullness does not indicate a distended bladder. The client might experience tenderness or pressure above the symphysis. No urine discharge is expected; the urine flow is blocked by the enlarged prostate

The primary reason for taping an indwelling catheter laterally to the thigh of a male client is to: 1.Eliminate pressure at the penoscrotal angle. 2.Prevent the catheter from kinking in the urethra. 3.Prevent accidental catheter removal. 4.Allow the client to turn without kinking the catheter.

1 The primary reason for taping an indwelling catheter to a male client so that the penis is held in a lateral position is to prevent pressure at the penoscrotal angle. Prolonged pressure at the penoscrotal angle can cause a ureterocutaneous fistula.

The client who has had a TURP is reporting bladder spasms. The HCP prescribed a belladonna and opiate (B&O) suppository. Which interventions should the nurse implement when administering this medication? Select all that apply. 1. Obtain the correct dose of the medication. 2. Lubricate the suppository with K-Y jelly. 3. Wash hands and don nonsterile gloves. 4. Check the client's armband for allergies. 5. Ask the client to lie on the left side

1,2,3,4,5 1. B&O suppositories come in 15A (1/2 grain) and 16A (1 grain) formulations. When obtaining the medication from the narcotic cabinet, the nurse should obtain the correct dose for the client. B&O suppositories are used to reduce bladder spasms for clients who have had bladder surgery. 2. Lubricating the suppository decreases the pain for the client when inserting the suppository. 3. Adhering to Standard Precautions is always an appropriate nursing intervention when caring for the client. 4. The nurse should check the armband before opening the medication and preparing to administer it. 5. The large intestine/rectum lies on the left side of the body, so placing the client on the left side makes insertion easier and reduces the chance of a ruptured bowel

When caring for a client with a history of benign prostatic hypertrophy (BPH), the nurse should do which of the following? Select all that apply. 1.Provide privacy and time for the client to void. 2.Monitor intake and output. 3.Catheterize the client for postvoid residual urine. 4.Ask the client if he has urinary retention. 5.Test the urine for hematuria.

1,2,4,5 Because of the history of BPH, the nurse should provide privacy and time for the client to void. The nurse should also monitor intake and output, assess the client for urinary retention, and test the urine for hematuria. It is not necessary to catheterize the client.

The client returned from surgery after having a TURP and has a P 110, R 24, BP 90/40, and cool and clammy skin. Which interventions should the nurse implement? Select all that apply. 1. Assess the urine in the continuous irrigation drainage bag. 2. Decrease the irrigation fluid in the continuous irrigation catheter. 3. Lower the head of the bed while raising the foot of the bed. 4. Contact the surgeon to give an update on the client's condition. 5. Check the client's postoperative creatinine and BUN.

1,3,4 1. The nurse should assess the drain postoperatively. 2. The client is hemorrhaging, so the nurse should increase the irrigation fluid to clear the red urine, not decrease the rate. 3. The head of the bed should be lowered and the foot should be elevated to shunt blood to the central circulating system. 4. The surgeon needs to be notified of the change in condition. 5. These laboratory values assess kidney function, not the circulatory system, so this is not an appropriate intervention. TEST-TAKING HINT: When the test taker reads vital signs with the blood pressure decreased and the pulse and respiratory rate elevated, the test taker should recognize the signs and symptoms of shock.

The nurse should instruct the client who is being discharged to home 3 days after transurethral resection of the prostate (TURP) to do which of the following? Select all that apply. 1.Drink at least 3,000 mL water per day. 2.Increase calorie intake by eating six small meals a day. 3.Report bright red bleeding to the health care provider. 4.Take deep breaths and cough every 2 hours. 5.Report a temperature over 99°F (37.2°C).

1,3,5 The nurse should instruct the client to drink a large amount of fluids (about 3,000 mL/day) to keep the urine clear. The urine should be almost without color. About 2 weeks after TURP, when desiccated tissue is sloughed out, a secondary hemorrhage could occur. The client should be instructed to call the surgeon or go to the emergency department if at any time the urine turns bright red. The nurse should also instruct the client to report signs of infection such as a temperature over 99°F (37.2°C). The client is not specifically at risk for nutritional problems after TURP and can resume a diet as tolerated. The client is not specifically at risk for airway problems because the procedure is done under spinal anesthesia and the client does not need to take deep breaths and cough.

The nurse observes red urine and several large clots in the tubing of the normal saline continuous irrigation catheter for the client who is one (1) day postoperative TURP. Which intervention should the nurse implement? 1. Remove the indwelling catheter. 2. Titrate the NS irrigation to run faster. 3. Administer protamine sulfate IVP. 4. Administer vitamin K slowly.

2 1. The indwelling catheter should not be removed because doing so may result in edema, which, in turn, may obstruct the urethra and not allow the client to urinate. 2. Increasing the irrigation fluid will flush out the clots and blood. 3. Protamine is the reversal agent for heparin, an anticoagulant. 4. Vitamin K is the reversal agent for the anticoagulant warfarin (Coumadin). TEST-TAKING HINT: The test taker should eliminate options "3" and "4" because both are medications and the problem is with continuous irrigation, which does not require medications.

The male client reports urinary frequency and nocturia and tells the nurse he is taking the herbal supplement saw palmetto. Which statement is the nurse's best response? 1. "Use of saw palmetto is an old wives' tale." 2. "This herb does help shrink the prostate tissue." 3. "Have you noticed any itching or rashes?" 4. "Saw palmetto has been known to cause cancer."

2 1. There is documented evidence that this herb effectively treats BPH. Its use is not a folk remedy without a sound basis. 2. Research has proven the efficacy of saw palmetto in treating BPH. The exact mechanism of action is unknown, but the herb does shrink prostate tissue, resulting in relief of urinary obstructive symptoms. 3. The client reported that he has been taking the herb. The time to discuss allergies is before or shortly after initiation of a medication. 4. Research indicates that saw palmetto is as effective as finasteride (Proscar), but has fewer side effects. It is considered a safe and effective treatment for BPH. There is no evidence that the herb causes cancer.

The client is one (1) day postoperative TURP. Which task should the nurse delegate to the UAP? 1. Increase the irrigation fluid to clear clots from the tubing. 2. Elevate the scrotum on a towel roll for support. 3. Change the dressing on the first postoperative day. 4. Teach the client how to care for the continuous irrigation catheter

2 1. This intervention requires analysis and should not be delegated. 2. Elevating the scrotum on a towel for support is a task that can be delegated to the UAP. 3. The surgeon changes the first dressing; therefore, this cannot be delegated. A TURP does not have a dressing. 4. The nurse is responsible for teaching. TEST-TAKING HINT: Teaching, assessing, evaluating, and intervening for clients who are unstable cannot be delegated to an unlicensed assistive personnel (UAP).

The nurse is caring for a client with a TURP. Which expected outcome indicates the client's condition is improving? 1. The client is using the maximum amount allowed by the PCA pump. 2. The client's bladder spasms are relieved by medication. 3. The client's scrotum is swollen and tender with movement. 4. The client has passed a large, hard, brown stool this morning.

2 1. Using the maximum amount of medication does not indicate the client is achieving pain management. 2. Bladder spasms are common, but being relieved with medication indicates the condition is improving. 3. Scrotal edema and tenderness do not indicate improvement. 4. Clients are administered laxatives or stool softeners to prevent constipation, which could cause increased pressure. TEST-TAKING HINT: The stem asks which option indicates the client is improving. Needing maximum medication (option "1") and scrotal edema (option "3") do not indicate the client is getting better. A bowel movement has nothing to do with the prostate

In discussing home care with a client after transurethral resection of the prostate (TURP), the nurse should teach the male client that dribbling of urine: 1.Can be a chronic problem. 2.Can persist for several months. 3.Is an abnormal sign that requires intervention. 4.Is a sign of healing within the prostate

2 Dribbling of urine can occur for several months after TURP. The client should be informed that this is expected and is not an abnormal sign. The nurse should teach the client perineal exercises to strengthen sphincter tone. The client may need to use pads for temporary incontinence. The client should be reassured that continence will return in a few months and will not be a chronic problem. Dribbling is not a sign of healing, but is related to the trauma of surgery

The primary reason for lubricating the urinary catheter generously before inserting the catheter into a male client is that this technique helps reduce: 1.Spasms at the orifice of the bladder. 2.Friction along the urethra when the catheter is being inserted. 3.The number of organisms gaining entrance to the bladder. 4.The formation of encrustations that may occur at the end of the catheter

2 Liberal lubrication of the catheter before catheterization of a male reduces friction along the urethra and irritation and trauma to urethral tissues. Because the male urethra is tortuous, a liberal amount of lubrication is advised to ease catheter passage. The female urethra is not tortuous, and, although the catheter should be lubricated before insertion, less lubricant is necessary. Lubrication of the catheter will not decrease spasms. The nurse should use sterile technique to prevent introducing organisms. Crusts will not form immediately. Irrigating the catheter as needed will prevent clot and crust formation.

The nurse should specifically assess a client with prostatic hypertrophy for which of the following? 1.Voiding at less frequent intervals. 2.Difficulty starting the flow of urine. 3.Painful urination. 4.Increased force of the urine stream.

2 Signs and symptoms of prostatic hypertrophy include difficulty starting the flow of urine, urinary frequency and hesitancy, decreased force of the urine stream, interruptions in the urine stream when voiding, and nocturia. The prostate gland surrounds the urethra, and these symptoms are all attributed to obstruction of the urethra resulting from prostatic hypertrophy. Nocturia from incomplete emptying of the bladder is common. Straining and urine retention are usually the symptoms that prompt the client to seek care. Painful urination is generally not a symptom of prostatic hypertrophy.

Many older men with prostatic hypertrophy do not seek medical attention until urinary obstruction is almost complete. One reason for this delay in seeking attention is that these men may: 1.Feel too self-conscious to seek help when reproductive organs are involved. 2.Expect that it is normal to have to live with some urinary problems as they grow older. 3.Fear that sexual indiscretions in earlier life may be the cause of their problem. 4.Have little discomfort in relation to the amount of pathology because responses to pain stimuli fade with age

2 Some older men tend to believe it is normal to live with urinary problems. As a result, these men often overlook symptoms and simply attribute them to aging. As part of preventive care for men older than age 40, the yearly physical examination should include palpation of the prostate via rectal examination. Prostate-specific antigen screening also is done annually to determine elevations or increasing trends in elevations. The nurse should teach male clients the value of early detection and adequate follow-up for the prostate.

A physician has prescribed amoxicillin (Ampicillin) 100 PO b.i.d. The nurse should teach the client to do which of the following? Select all that apply. 1.Drink 300 to 500 mL of fluids daily. 2.Void frequently, at least every 2 to 3 hours. 3.Take time to empty the bladder completely. 4.Take the last dose of the antibiotic for the day at bedtime. 5.Take the antibiotic with or without food.

2, 3, 4, 5. Ampicillin may be given with or without food, but the nurse should instruct the client to obtain an adequate fluid intake (2,500 to 3,000 mL) to promote urinary output and to flush out bacteria from the urinary tract. The nurse should also encourage the client to void frequently (every 2 to 3 hours) and empty the bladder completely. Taking the antibiotic at bedtime, after emptying the bladder, helps to ensure an adequate concentration of the drug during the overnight period.

The client diagnosed with BPH has had a TURP. The client is reporting lower abdominal pain. Which interventions should the nurse implement? Rank in order of performance. 1. Administer the prescribed morphine by slow IV push. 2. Check the urinary catheter for drainage and clots. 3. Determine if the client has a hard, rigid abdomen. 4. Adjust the saline irrigation to flush the bladder. 5. Dilute the morphine with several milliliters of normal saline.

2, 4, 3, 5, 1 The most obvious reason for a client post-TURP to be having lower abdominal pain is that the bladder has blood clots that need to be flushed out. Clots that are not flushed from the bladder result in bladder spasms. Assessing the urinary drainage would be the first step. 4. The next step is to adjust the rate of the irrigation to ensure adequate drainage of blood and clots from the bladder. 3. Before administering a narcotic analgesic the nurse should rule out complication. Assessing for peritonitis (hard, rigid abdomen) is the next step in this situation. 5. Morphine and most other narcotic medications require a very slow IV rate, around 5 minutes, according to the manufacturer's recommendations. The morphine is dispensed in 1-mL tubex syringes or vials. It is difficult to maintain a steady, slow administration of the medication with only 1 mL over 5 minutes. If the medication is diluted to a total volume of 10 mL, then the nurse can administer the medication at a rate of 1 mL every 30 seconds. Dilution causes less pain for the client and helps decrease irritation to the vein. 1. The final step in this sequence is to actually administer the analgesic.

Which is the scientific rationale for administering dutasteride to a client diagnosed with BPH? 1. The medication elevates male testosterone levels and decreases impotence. 2. Dutasteride causes a rapid reduction in the size of the prostate and relief of symptoms. 3. The medication decreases the mechanical obstruction of the urethra by the prostate. 4. Dutasteride is as fast as surgery in reducing the obstructive symptoms of BPH.

3 1. Testosterone is converted to dihydrotestosterone (DHT) in the prostate. The 5-alpha-reductase inhibitors reduce DHT, but not testosterone. With a reduction in DHT, the prostate tissue shrinks. The 5-alpha-reductase inhibitors do not elevate testosterone, nor do they improve impotence problems. 2. The 5-alpha-reductase inhibitors require 6 to 12 months for therapeutic relief of symptoms of BPH to occur. 3. The 5-alpha-reductase inhibitors, such as dutasteride (Avodart), work by reducing the size of the prostate gland, resulting in a relief of the obstructive symptoms of urgency, frequency, difficulty initiating a urine stream, and nocturia. 4. Surgery provides faster relief of symptoms after recovery has taken place. Dutasteride (Avodart) requires a lengthy time period for therapeutic effects of the medications and may not provide adequate relief of symptoms if the client has severe BPH.

The client who is postoperative TURP asks the nurse, "When will I know if I will be able to have sex after my TURP?" Which response is most appropriate by the nurse? 1. "You seem anxious about your surgery." 2. "Tell me about your fears of impotency." 3. "Potency can return in six (6) to eight (8) weeks." 4. "Did you ask your doctor about your concern?"

3 1. The client wants information and the nurse should provide facts. 2. The client wants information and the nurse should provide facts. 3. This is usually the length of time clients need to wait prior to having sexual intercourse; this is the information the client wants to know. 4. The client may need to talk with his surgeon, but it should be after the nurse answers the client's question. TEST-TAKING HINT: The client is asking for factual information and the nurse should provide this information. Options "1" and "2" are therapeutic responses addressing feelings, and option "4" is passing the buck—the nurse can discuss this with the client.

The client diagnosed with mild benign prostatic hypertrophy (BPH) is prescribed finasteride to relieve symptoms of urinary frequency. Which intervention should the clinic nurse implement? 1. Tell the client to drink at least 8 to 10 glasses of water a day. 2. Schedule an appointment with the HCP for a 1-week follow-up examination. 3. Have the laboratory draw a prostate-specific antigen level. 4. Give the client a urinal to measure his daily output of urine.

3 1. The client's intake of water will not affect the medication. Drinking this much water each day until the medication has had an opportunity to shrink the enlarged prostate tissue could cause the client to have a diffi cult time emptying an uncomfortably full bladder. 2. The medication takes 6 to 12 months to have a full effect. There is no reason for the client to be seen in 1 week. 3. Finasteride (Proscar), a 5-alphareductase inhibitor, decreases serum prostate-specific antigen (PSA) levels. The client should have a PSA level drawn before beginning finasteride and a level drawn after 6 months. If the PSA level does not drop, the client should be assessed for cancer of the prostate. 4. Clients do not need to measure their urine outputs daily.

A client with benign prostatic hypertrophy (BPH) is being treated with terazosin (Hytrin) 2 mg at bedtime. The nurse should monitor the client's: 1.Urine nitrites. 2.White blood cell count. 3.Blood pressure. 4.Pulse.

3 If paralysis of vasomotor nerves in the upper spinal cord occurs when spinal anesthesia is used, the client is likely to develop respiratory paralysis. Artificial ventilation is required until the effects of the anesthesia subside. Seizures, cardiac arrest, and renal shutdown are not likely results of spinal anesthesia.

The nurse is reviewing the medication history of a client with benign prostatic hypertrophy (BPH). Which medication will likely aggravate BPH? 1.Metformin (Glucophage). 2.Buspirone (BuSpar). 3.Inhaled ipratropium (Atrovent). 4.Ophthalmic timolol (Timoptic)

3 Ipratropium is a bronchodilator, and its anticholinergic effects can aggravate urine retention. Metformin and buspirone do not affect the urinary system; timolol does not have a systemic effect.

When emptying the client's bladder during a urinary catheterization, the nurse should allow the urine to drain from the bladder slowly to prevent: 1.Renal failure. 2.Abdominal cramping. 3.Possible shock. 4.Atrophy of bladder musculature

3 Rapid emptying of an overdistended bladder may cause hypotension and shock due to the sudden change of pressure within the abdominal viscera. The nurse should empty the bladder slowly. Removal of urine from the bladder does not cause renal failure. The client may experience cramping, but the primary concern is the potential for shock. Bladder muscles will not atrophy because of a catheterization.

A client with benign prostatic hypertrophy (BPH) has an elevated prostate-specific antigen (PSA) level. The nurse should: 1.Instruct the client to request having a colonoscopy before coming to conclusions about the PSA results. 2.Instruct the client that a urologist will monitor the PSA level biannually when elevated. 3.Determine if the prostatic palpation was done before or after the blood sample was drawn. 4.Ask the client if he emptied his bladder before the blood sample was obtained.

3 Rectal and prostate examinations can increase serum PSA levels; therefore, instruct the client that a manual rectal examination is usually part of the test regimen to determine prostate changes. The prostatic palpation should be done after the blood sample is drawn. The PSA level must be monitored more often than biannually when it is elevated. Having a colonoscopy is not related to the findings of the PSA test. It is not necessary to void prior to having PSA blood levels tested.

A client, who had a transurethral resection of the prostate (TURP), has a three-way indwelling urinary catheter with continuous bladder irrigation. In which of the following circumstances should the nurse increase the flow rate of the continuous bladder irrigation? 1.When drainage is continuous but slow. 2.When drainage appears cloudy and dark yellow. 3.When drainage becomes bright red. 4.When there is no drainage of urine and irrigating solution.

3 The decision by the surgeon to insert a catheter after TURP or prostatectomy depends on the amount of bleeding that is expected after the procedure. During continuous bladder irrigation after a TURP or prostatectomy, the rate at which the solution enters the bladder should be increased when the drainage becomes brighter red. The color indicates the presence of blood. Increasing the flow of irrigating solution helps flush the catheter well so that clots do not plug it. There would be no reason to increase the flow rate when the return is continuous or when the return appears cloudy and dark yellow. Increasing the flow would be contraindicated when there is no return of urine and irrigating solution.

A nursing assistant tells the nurse, "I think the client is confused. He keeps telling me he has to void, but that isn't possible because he has a catheter in place that is draining well." Which of the following responses would be most appropriate for the nurse to make? 1."His catheter is probably plugged. I'll irrigate it." 2."That's a common problem after prostate surgery. The client only imagines the urge to void." 3."The urge to void is usually created by the large catheter, and he may be having some bladder spasms." 4."I think he may be somewhat confused."

3 The indwelling urinary catheter creates the urge to void and can also cause bladder spasms. The nurse should ensure adequate bladder emptying by monitoring urine output and characteristics. Urine output should be at least 50 mL/h. A plugged catheter, imagining the urge to void, and confusion are less likely reasons for the client's problem

Which nursing diagnosis is priority for the client who has undergone a TURP? 1. Potential for sexual dysfunction. 2. Potential for an altered body image. 3. Potential for chronic infection. 4. Potential for hemorrhage.

4 1. TURPs can cause a sexual dysfunction, but if there were a sexual dysfunction, it is not priority over a physiological problem such as hemorrhaging. 2. This is not a life-threatening problem. 3. This client has had this problem preoperatively. 4. This is a potentially life-threatening problem. TEST-TAKING HINT: A basic concept the test taker must know is, for most surgeries, the highest priority problem is hemorrhaging. Hemorrhaging is life threatening.

Which data support to the nurse the client's diagnosis of acute bacterial prostatitis? 1. Terminal dribbling. 2. Urinary frequency. 3. Stress incontinence. 4. Sudden fever and chills

4 1. Terminal dribbling is a symptom of BPH. 2. Urinary frequency is a sign of a UTI. 3. Stress incontinence occurs in women who urinate when coughing, running, or jumping. 4. Clients with acute bacterial prostatitis will frequently experience a sudden onset of fever and chills. Clients with chronic prostatitis have milder symptoms. TEST-TAKING HINT: The words "acute" and "bacterial" should cue the test taker into the specific symptoms of infection. Symptoms for any infection are fever and chills.

The client diagnosed with BPH and congestive heart failure (CHF) is receiving furosemide daily. Which information provided by the UAP best indicates to the nurse the medication is effective? 1. The UAP recorded the intake as 350 mL and the output as 450 mL. 2. The UAP stated that the client ambulated to the bathroom without dyspnea. 3. The UAP emptied a moderate amount of urine from the bedside commode. 4. The UAP reported that the client lost 1 pound of weight from the day before

4 1. The client's intake and output measurements are important, but even accurate intake and output recordings cannot measure for insensible losses. An output of 100 mL over the intake may or may not be considered adequate to determine effectiveness of a diuretic. 2. Ambulating to the bathroom without dyspnea is an indicator that the client is not experiencing pulmonary complications related to excess fluid volume, but it is not the best indicator of the effectiveness of a diuretic. 3. Terminology such as small, moderate, and large are not objective words. To quantify the results the nurse should use objective data—in this situation, numbers. This would provide an accurate comparison of data to determine the effectiveness of the medication. 4. The most reliable method of determining changes in fluid-volume status is to weigh a client in the same type of clothing at the same time each day. One liter (1,000 mL) is approximately 0.9 kg (or 2 pounds). This client has lost approximately 500 mL more fluid than was taken in

Which intervention is priority for a pregnant nurse when administering dutasteride to a client diagnosed with BPH? 1. Use goggles for personal eye protection. 2. Protect the nurse's mucosa from contact with liquid. 3. Ask a male nurse to administer the medication. 4. Wear gloves while administering the medication

4 1. The medication is manufactured in a pill form. The nurse does not need eye protection to prevent exposure. 2. The nurse's mucosa should not be exposed to the medication because it comes only in pill form. 3. The nurse can administer dutasteride safely using the appropriate personal protective equipment. The nurse should not ask for another nurse to administer the medication. 4. Dutasteride (Avodart) is used to treat BPH and is considered a category X medication, which will cause harm to a developing fetus. The medication can be absorbed through the skin. The nurse should wear gloves when administering the medication. Men should not donate blood for at least 6 months after discontinuing the medication to avoid administration of the medication to a pregnant client through the transfusion. MEDICATION MEMORY JOGGER: The nurse must remember that some medications can cause harm when administering the medication. A nurse who is pregnant must be cautious.

The client with a TURP who has a continuous irrigation catheter complains of the need to urinate. Which intervention should the nurse implement first? 1. Call the surgeon to inform the HCP of the client's complaint. 2. Administer the client a narcotic medication for pain. 3. Explain to the client this sensation happens frequently. 4. Assess the continuous irrigation catheter for patency.

4 1. The nurse should not call a surgeon until all assessment is completed. 2. A pain medication should not be administered until the cause of the problem is determined and all complications are ruled out. 3. Telling a client that what he is experiencing is expected without assessing the situation is dangerous. 4. The nurse should always assess any complaint before dismissing it as a commonly occurring problem. TEST-TAKING HINT: When the question requires the test taker to decide which intervention should be first, assessment is usually first. If the test taker has no idea which intervention is correct, the test taker should choose assessment.

A client is to receive belladonna and opium suppositories, as needed, postoperatively after transurethral resection of the prostate (TURP). The nurse should give the client these drugs when he demonstrates signs of: 1.A urinary tract infection. 2.Urine retention. 3.Frequent urination. 4.Pain from bladder spasms.

4 Belladonna and opium suppositories are prescribed and administered to reduce bladder spasms that cause pain after TURP. Bladder spasms frequently accompany urologic procedures. Antispasmodics offer relief by eliminating or reducing spasms. Antimicrobial drugs are used to treat an infection. Belladonna and opium do not relieve urine retention or urinary frequency

A client is scheduled to undergo transurethral resection of the prostate. The procedure is to be done under spinal anesthesia. Postoperatively, the nurse should assess the client for: 1.Seizures. 2.Cardiac arrest. 3.Renal shutdown. 4.Respiratory paralysis.

4 If paralysis of vasomotor nerves in the upper spinal cord occurs when spinal anesthesia is used, the client is likely to develop respiratory paralysis. Artificial ventilation is required until the effects of the anesthesia subside. Seizures, cardiac arrest, and renal shutdown are not likely results of spinal anesthesia