Chapter 55 Clients W/Male Reproductive Disorders
30. A 50-year-old is diagnosed with stage II prostate cancer. The client is upset and verbalizes that he would rather die than have any surgery. Which is the best response by the nurse? A) "What concerns you most about having surgery?" B) "Your surgeon has performed this surgery many times." C) "How does your family feel about this decision?" D) "This surgery can cure you of cancer."
Ans: A
A client is diagnosed with stage II cancer of the prostate. The nurse interprets this as indicating which of the following? A) Cancer is small with no symptoms. B) Tumor is confined to the prostate gland. C) Tumor has spread beyond the prostrate. D) Tumor has expanded to the bladder.
Ans: B
A client is receiving chemotherapy as adjuvant therapy in the management of testicular cancer. The nurse also notes that the client is ordered filgrastim (Neupogen) and knows that the client is at greatest risk for which assessment finding? A) Increased bruising B) Fever C) Pale color D) Decreased energy
Ans: B
A young client is admitted with torsion of the spermatic cord. Which is the most appropriate action to be taken by the nurse? A) Elevate the scrotum. B) Keep the client NPO. C) Monitor vital signs for cardiac changes. D) Avoid the use of analgesics.
Ans: B
The surgeon has ordered belladonna and opium (B and O) suppositories for the management of a postoperative prostatectomy client who is receiving continuous bladder irrigation. Which of the following symptoms would indicate to the nurse the need for administration of this drug? Select all that apply. A) Increased blood in the catheter tubing B) Slowed or stopped infusion rate C) Increased bladder pressure and pain D) Increased speed of infusion rate E) Signs of urinary retention F) Increased force of urinary stream
Ans: B, C
Which of the following should be included when teaching a client about the management of benign prostatic hyperplasia (BPH)? Select all that apply. A) Moderate use of alcohol is useful for bladder relaxation. B) Do not delay the urge to void. C) Low-dose Benadryl will promote restful sleep. D) Prolonged exposure to heat increases bladder spasms. E) Painless hematuria is a common symptom of BPH. F) Schedule digital rectal exams.
Ans: B, F
A client who is diagnosed with stage II prostate cancer asks the nurse if a transurethral resection of the prostate (TURP) can be done for this disorder. Which is the best response by the nurse? A) "A TURP is a viable option. Let's talk to the surgeon." B) "Stage II means the cancer has already spread from the prostate gland." C) "A TURP is a removal of only a portion of the prostate gland." D) "You have the right to choose which ever surgery you feel is best for you."
Ans: C
A client with a normal prostate-specific antigen (PSA) level is reporting painful urination and the presence of blood in urine and semen. The nurse understands that the best option for management of this client includes which of the following? A) Wait-and-see approach B) Continue to monitor PSA levels. C) Further evaluation D) Treat the symptoms.
Ans: C
A client with erectile dysfunction has opted to self-administer a urethral suppository as a means to produce an erection. Which of the following agents would most likely be used? A) Sildenafil B) Vardenafil C) Alprostadil D) Papaverine
Ans: C
A client is diagnosed with prostatitis. Which of the following is the most important teaching point for the management of this disorder? A) Avoid tub baths. B) Avoid sexual activity. C) Limit fluid intake. D) Avoid prolonged sitting.
Ans: D
A client with history of type 2 diabetes mellitus and coronary artery disease has been diagnosed with stage III prostate cancer and opts for treatment with diethylstilbestrol (DES). Which is the most important nursing assessment finding in this client? A) Nausea and vomiting B) Progression of the malignancy C) Breast enlargement D) Elevated blood sugar
Ans: D
Which of the following nursing assessment findings would be most significant in determining sterility in a male client? A) Uncircumcised penis B) Recurrent urinary tract infections (UTI) C) Multiple sex partners D) Mumps at age 15 years
Ans: D
A client comes to the outpatient clinic for information on a vasectomy. Which instruction should be included by the nurse? A) Vasectomies should be considered a permanent means of birth control. B) Following surgery, sexual intercourse should be avoided for 3 months. C) Postoperative discomfort can be relieved with use of warm sitz baths. D) Vasectomy can result in permanent impotence.
Ans: A
A hydrocele is suspected in a client with scrotal edema. Which assessment technique would the nurse anticipate to be done first? A) Transillumination of the scrotum B) Palpate for presence of testicle C) Examine for soft tissue swelling D) Assess for collect-on of blood in the scrotum
Ans: A
In a client with benign prostatic hyperplasia (BPH), which assessment finding provides the best indication of urinary retention? A) Frequency B) Urgency C) Hesitancy D) Dribbling
Ans: A
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? A) Finasteride (Proscar) B) Tamsulosin (Flomax) C) Terazosin (Hytrin) D) Oxybutynin chloride (Ditropan)
Ans: A
Which of the following recommendations would a nurse advocate during infancy and childhood to help reduce potential adult complications such as orchitis? A) Ensure immunizations against infectious diseases such as mumps. B) Engage in activities and exercises that minimize heavy lifting. C) Encourage the consumption of foods that are rich in fat and starch. D) Urge the limited intake of foods and fluids containing caffeine.
Ans: A
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? A) Maintaining optimal bladder emptying B) Using appropriate coping to allay anxiety C) Performing deep breathing exercises periodically D) Doing leg exercises at least daily
Ans: A
The nurse is providing instruction for testicular self-examination to a group of young adolescents. Which is the most correct examination technique? A) Palpate both testicles simultaneously for comparison. B) Palpate each testicle separately, following a warm shower. C) Palpate the front of the testicle first, where most tumors are found. D) Palpate for a soft, round shape with normal ridges on the testicles.
Ans: B
Which nursing assessment finding is most significant in determining the plan of care in a client with erectile dysfunction? A) Age B) Medication use C) Sexual history D) Undescended testicle
Ans: B
Following a vasectomy, which is the most important instruction to provide to the client? A) Wear a scrotal support until swelling is resolved. B) Use a Tylenol as needed for discomfort. C) Use another form a birth control until further notice. D) Take a day or two to rest and recuperate from the procedure.
Ans: C
Following morning hygiene of an elderly client, the nurse is unable to replace the retracted foreskin of the penis. Which is the most likely outcome? A) Erection of the penis B) Unclean glans C) Painful swelling D) Nausea and vomiting
Ans: C
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? A) Spironolactone B) Cimetidine C) Ibuprofen D) Methyldopa
Ans: C
The nurse knows that the safest treatment for erectile dysfunction in a client with coronary artery disease (CAD) includes which of the following medications? A) Sildenafil (Viagra) B) Tadalafil (Cialis) C) Apomorphine (Uprima) D) Vardenafil (Levitra)
Ans: C
Which assessment finding is most important in determining which client has a higher risk for developing testicular cancer? A) Previous sexually transmitted infection (STI) B) Low sperm count C) Cryptorchidism as an infant D) Family history of cancer
Ans: C
A client is scheduled for a pump-type implanted penile prosthesis. Which client statement would indicate the need for additional teaching? A) "The reservoir is filled with saline solution." B) "The penis will appear longer than usual." C) "Surgery is required for placing the implant." D) "The implant is pumped when sexual activity is desired."
Ans: B
A client with erectile dysfunction who had a penile implant inserted has been taught how to identify malfunction of the device. Which of the following if stated by the client as indicative of malfunction would indicate to the nurse that the client has understood the teaching? A) Erosion of penile or urethral tissue B) Underinflation or bulging of the cylinders during inflation C) Erosion of scrotal, bowel, or bladder tissue D) Migration of the cylinders, pump, or reservoir from their intended location
Ans: B
Which pharmacologic agents pose the greatest risk for urinary retention in a client with benign prostatic hyperplasia (BPH)? A) Muscle relaxers B) Antihypertensives C) Nitrates D) Antihistamines
Ans: D
Which of the following would be most important to include in a teaching plan for a client who has had a vasectomy? A) Using a reliable method of contraception for several weeks B) Applying warm compresses to the scrotum for the first 24 hours C) Taking a prescribed opioid analgesic for pain relief D) Resuming sexual activity in 24 to 48 hours
Ans: A
Which of the following should nurses teach all men, especially those who have had cryptorchidism? A) Need for blood tests to measure serum acid phosphatase levels B) Importance of regular monitoring of prostate-specific antigen (PSA) levels C) Need to undergo a baseline and follow up lymph node biopsies D) How to perform a testicular self-examination
Ans: D
Immediately following a transurethral resection of the prostate (TURP), which is the best method to determine if active bleeding is occurring? A) Assess hemoglobin and hematocrit. B) Assess blood in catheter collection bag. C) Assess catheter tubing. D) Assess blood pressure and pulse.
Ans: C
The client with prostatitis presents with low back pain, dysuria, and unusual sensation following ejaculation. Which of the following treatments will the nurse anticipate being ordered for this client? A) Analgesics B) Sitz baths C) Antibiotics D) Abstinence
Ans: C
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? A) Staphylococcus B) Streptococcus C) Escherichia coli D) Paramyxovirus
Ans: C F
Which assessment finding would create the greatest risk to a client ordered a phosphodiesterase (PDE5) inhibitor such as sildenafil (Viagra)? A) Use of nitrates B) History of hypertension C) Type 2 diabetes D) Use of diuretics
Ans: A
After examination, a client is found to have a prostatic nodule and is scheduled for prostatic-specific antigen (PSA) testing. When reviewing the results, which of the following would indicate that the nodule is malignant? A) 4 ng/mL B) 7 ng/mL C) 9 ng/mL D) 12 ng/mL
Ans: D
