iggy 67 & 68

Which instructions will the nurse teach a client after an open retroperitoneal lymph node dis-section (RPLND) for testicular cancer? Select all that apply. A. Do not lift anything that weighs over 15 lbs. B. Limit intake of fluids to 1000 to 1200 mL per day. C. Do not drive a car until the health care provider allows it. D. Perform monthly testicular self-examination on the remaining testicle. E. Report fever, drainage, or increasing tenderness around the incision. F. Avoid climbing stairs during the first week after surgery.

ACDE

Which questions will the nurse ask a client to determine the presence of signs and symptoms of benign prostatic hyperplasia (BPH)? Select all that apply. A. "Have you noticed a sensation of incomplete bladder emptying?" B. "Have you recently experienced a testicular or bladder infection?" C. "Have you noticed dribbling or leaking after you finish urination?" D. "How many times do you have to get up during the night to urinate?" E. "Have you noticed blood at the start or at the end of urination?" F. "Have you noticed increased force or size of your urine stream?"

ACDE

To which common sites does the nurse expect metastasis when a client has prostate cancer? Select all that apply. A. Liver B. Pancreas C. Lungs D. Lumbar spine E. Kidneys F. Bones of the pelvis

ACDF

Which criteria will the nurse assess in a client with benign prostatic hyperplasia that indicate the need for a surgical treatment? Select all that apply. A. Hydronephrosis B. Acute urinary tract infection unresponsive to first-line antibiotics C. Hematuria D. Chronic urinary tract infection secondary to residual urine in bladder E. Recurrent kidney stones F. Acute urinary retention due to obstruction

ACDF

What physical changes will the nurse teach a client to expect when undergoing estrogen therapy for male-to-female (MtF) transition? Select all that apply. A. Decreased testicular size B. Increased libido (sex drive) C. Reduced muscle mass D. Increased erectile function E. Softening of skin F. Increased body hair growth

ACE

Which laboratory tests does the nurse expect to be ordered to screen for prostate cancer in a client with benign prostatic hyperplasia (BPH)? Select all that apply. A. Urinalysis and urine culture B. Complete blood count (CBC) C. Prostate-specific antigen (PSA) D. Blood urea nitrogen (BUN) E. Serum acid phosphatase F. Serum creatinine

CE

What does the nurse teach an older client with prostate cancer who is scheduled to have a digital rectal examination (DRE) and a prostate-specific antigen (PSA) test? A. The PSA laboratory test is drawn before the DRE. B. The DRE is completed 2 weeks before the PSA. C. The PSA is reviewed first because DRE may not be necessary. D. Both tests can be completed at the client's convenience.

A

What will the nurse do first when a natal male client who appears to be female has an order for placement of a urinary indwelling catheter for hourly urine output measurement? A. Introduce himself or herself, ask how the client prefers to be addressed, verify the client's identity by checking the name band, and explain the procedure. B. Respectfully address the client by the name on the chart and armband, then perform catheter insertion for a male client. C. Inspect the genitalia and adapt the catheter insertion as appropriate while avoiding the use of gender-specific language. D. Politely leave and obtain advice from the charge nurse about whether to treat the client as male or female.

A

Which recommendations will nurses follow to create a safe, welcoming environment for LGBTQ client care? Select all that apply. A. Designating unisex or single-stall restrooms B. Making waiting rooms inclusive of LGBTQ clients and families C. Not limiting gender options on medical forms to "male" and "female" D. Ensuring that visitation policies are equitable for families of LGBTQ clients E. Reflecting the client's choice of terminology in communication and documentation F. Including gender-neutral language on all medical forms and documents

ABCDEF

After a transrectal ultrasound with biopsy for prostate cancer, what instructions will the nurse provide the client? Select all that apply. A. Report fever, chills, bloody urine, and any difficulty voiding. B. The biopsy will diagnose if you have prostate cancer. C. Drink plenty of fluids during the first 24 hours. D. Expect to see bright red bleeding at first. E. Report any pink color in the urine to the health care provider. F. Avoid strenuous physical activity.

ABCF

Which increased health risks will the nurse monitor for when a transgender client is prescribed estrogen therapy? Select all that apply. A. Elevated blood glucose B. Fluid retention C. Hypotension D. Estrogen-dependent cancer E. Kidney disease F. Venous thromboembolism

ABDF

Which potential causes of organic erectile dys-function does the nurse assess for in a client? Select all that apply. A. Kidney disease B. Diverticulitis C. Thyroid disorders D. Obesity E. Diabetes mellitus F. Penile trauma

ACEF

What action will the advanced practice nurse take after performing a digital rectal examina-tion on a client with benign prostatic hyperplasia (BPH)? A. Instruct the client to remain in a supine position with knees bent. B. Massage the prostate to obtain a fluid sample for possible prostatitis. C. Use a sterile cotton-tipped applicator for a sample from the penis for possible infection. D. Administer pain medication to relieve the discomfort from the examination.

B

What is the nurse's best action when assessing a client after open radical prostatectomy and finding scrotal and penile swelling? A. Notify the health care provider and monitor for inability to urinate. B. Elevate the scrotum and penis, then apply ice to the area intermittently. C. Assist the client to increase mobility by using early ambulation. D. Observe the urethral meatus for redness, discharge, and abnormal output.

B

When the nurse interviews a transgender client, which statement is of greatest concern for failure to cope with major life stressors? A. "I smoke two to three packs of cigarettes every day." B. "I've tried to commit suicide four times in my life." C. "When I feel really down, I drink and use marijuana." D. "Last night I went to a bar and picked up a stranger for sex."

B

Which common serum tumor markers does the nurse expect will be ordered to confirm a client's suspected diagnosis of testicular cancer? Select all that apply. A. Early prostate cancer antigen (EPCA-2) B. Lactate dehydrogenase (LDH) C. Alpha-fetoprotein (AFP) D. Beta human chorionic gonadotropin (hCG) E. BRCA1 mutation F. Glutathione S-transferase (GST P1)

BCD

Which behavioral modification instructions will the nurse teach a client with benign prostatic hyperplasia (BPH)? Select all that apply. A. Take diuretics to increase urine output. B. Limit alcohol intake. C. Avoid caffeine containing beverages. D. Do not consume large amounts of fluid in a short time. E. Avoid sexual intercourse. F. Avoid taking antihistamine drugs.

BCDF

Which information will the nurse include when teaching a client who had a vaginoplasty about self-care management? Select all that apply. A. Do not take baths (submerged in water) for 8 months after surgery. B. Avoid tobacco or smoking for at least a month after surgery to promote healing. C. Carefully follow the prescribed individualized dilator protocol. D. Do not have sexual intercourse until at least 3 months after surgery. E. Avoid swimming or bike riding for 3 weeks. F. Take acetaminophen as prescribed for pain control at home.

BCDF

Based on the guidelines from the World Professional Association for Transgender Health (WPATH), which clients meet the criteria for gender-affirming hormonal therapy? Select all that apply. A. 16-year-old who has experienced gender dysphoria since early childhood B. 30-year-old with gender dysphoria and no physical or mental health problems C. 40-year-old who would like to temporarily try being a member of the opposite sex D. 45-year-old with gender dysphoria since grade school and well-controlled hypertension E. 62-year-old with known history of gender dysphoria and symptoms of dementia F. 65-year-old lesbian with history of multiple suicide attempts

BD

What does the nurse practitioner suspect when performing an examination on a young male client and finding a testicular lump that is hard and painless? A. Prostate cancer B. Epididymitis C. Testicular cancer D. Erectile dysfunction

C

What question will the nurse ask first when a client's medical record states that he has gender dysphoria? A. "Do you think of yourself as male or female?" B. "Are you seeking interventions for sex reassignment?" C. "How do you prefer to be addressed?" D. "What issues of sexuality would you like to talk about?"

C

Which action does the nurse teach a client with BPH to perform that can help relieve obstructive symptoms? A. Urinate before going to bed and immediately upon waking. B. Consume fluids regularly throughout the day. C. Increase the frequency of sexual intercourse. D. Urinate forcefully after drinking a large glass of water.

C

In which circumstance will the nurse make a clinical judgment to forgo extensive questioning about a client's gender identity? A. The client is dressed like a man and wants information about hormones that feminize the body. B. The client has recurrent urinary tract infections despite compliance with the medication treatment regime. C. The client appears to be male but requests a pelvic examination by a female health care provider. D. The client requires treatment for a severely sprained ankle sustained during a soccer game.

D

Which client does the nurse recognize has the highest risk for development of prostate cancer? A. 45-year-old Asian American with a history of benign prostatic hyperplasia B. 55-year-old Hispanic American who practices poor dietary intake C. 65-year-old Caucasian American with two cousins who developed prostate cancer D. 75-year-old African American whose father and brother developed prostate cancer

D

Which laboratory result will the nurse monitor to prevent harm when a client on estrogen therapy is also prescribed spironolactone? A. Blood glucose level B. Platelet count C. White blood cell count D. Serum potassium level

D

Which question will the nurse ask a client to determine whether the drug tamsulosin is achieving the desired therapeutic effect? A. "Do you have a green or yellow discharge from your penis?" B. "Are you having any problems achieving an erection?" C. "Does your urine have a strong odor or appear cloudy?" D. "Are you continuing to have difficulty passing urine?"

D

From the acronym LGBTQ, which terms will the nurse understand refer to the sexual orientation of a client? Select all that apply. A. Questioning B. Queer C. Transgender D. Bisexual E. Gay F. Lesbian

DEF

Which priority information will the nurse gather from a client who is seeking a prescrip-tion for sildenafil for erectile dysfunction? A. Medication prescription for nitrate drugs B. Presence of nocturnal or morning erections C. Use of any illicit drugs or substances D. Dietary consumption of proteins each day

A

Which statement made to the nurse by a client most accurately describes self-identification as transgender? A. "Since childhood I have always felt like I was born in the wrong body." B. "I have always been attracted to other women and they are attracted to me." C. "I think women are more amazing and influential and I prefer to be viewed as a woman." D. "I enjoy wearing women's clothes because they are pretty and feel so nice."

A

Which technique is best when the nurse assesses an obese client who reports symptoms associated with benign prostatic hyperplasia? A. Instructing the client to urinate, then using the bedside ultrasound bladder scanner B. Applying gentle pressure to the bladder to elicit urgency, then instructing the client to void C. Having the client drink several large glasses of water, then percussing the bladder D. Instructing the client to undress from the waist down, then inspecting and palpating the bladder

A

Which nursing actions are included in the care of a client who had a transurethral resection of the prostate (TURP)? Select all that apply. A. Helping the client out of the bed to the chair as soon as permitted to prevent complications of immobility B. Using normal saline solution for the intermittent bladder irrigant unless otherwise prescribed C. Monitoring and documenting the color, consistency, and amount of urine output D. Providing a safe environment for the client because of temporary changes in mental status E. Assessing the client for reports of severe bladder spasms with decreased urinary output F. Checking the drainage tubing frequently for external obstructions such as kinks, and internal obstructions such as blood clots

ABCDEF

Which nursing actions are included in the pre-operative care of a male-to-female (MtF) client who will undergo a vaginoplasty? Select all that apply. A. Give nothing by mouth for 24 hours prior to surgery. B. Administer an enema and laxatives as prescribed. C. Instruct the client to ambulate because positioning for surgery will be prolonged. D. Monitor for and report hematocrit and hemoglobin level results. E. Administer preoperative antimicrobials to minimize infection. F. Monitor and record the drainage from the Jackson-Pratt drain.

BDE

Which diagnostic procedure does the nurse expect the health care provider to order to test a client with an enlarged bladder, for bladder outlet obstruction? A. Bladder ultrasound scan B. Urodynamic pressure-flow study C. Computed tomography scan D. Transrectal ultrasound

B

Which finding does the nurse assess to determine that a female-to-male (FtM) client prescribed testosterone is having the desired effect? A. Client reports breast tenderness. B. Nurse observes increased body hair. C. Client reports decreased sex drive. D. Nurse observes average sized male penis

B

What is the nurse's best action after inadvertently making an error when addressing a transgender client by not using their preferred name or pronoun? A. Apologize and explain that working with transgender clients is a new experience. B. Assume that the client is used to this type of error and continue providing care. C. Self-correct and continue providing care rather than making a prolonged apology. D. Observe the client's nonverbal behavior to determine whether the error was noticed.

C

Which client report indicates to the nurse that one of the most serious complications of vaginoplasty has occurred? A. Burning sensation during urination B. Urinary incontinence when sneezing C. Leakage of stool from the vagina D. Tenderness and bruising of the labia

C

Which instruction will the nurse provide to a client who is taking a phosphodiesterase-5 (PDE5) inhibitor drug for erectile dysfunction? A. If one pill does not work, wait an hour and take a second pill. B. Use relaxation techniques before and after taking this drug. C. Abstain from alcohol use before sexual intercourse. D. Do not perform heavy lifting while using this medication.

C

Which laboratory test suggests to the nurse that a client with prostate cancer has metastasis to the bone? A. Decreased alpha-fetoprotein B. Increased blood urea nitrogen (BUN) C. Elevated serum alkaline phosphatase D. Decreased serum creatinine

C

Which symptom does the nurse most likely expect when admitting a client diagnosed with benign prostatic hyperplasia (BPH)? A. Erectile dysfunction B. Pain in the scrotum C. Difficulty passing urine D. Constipation

C

What is the nurse's best response when a client who had a vasectomy asks when sexual inter-course can be safely resumed? A. "Your surgeon will discuss the timing and will tell you when it is safe to have sex again." B. "It depends on how much swelling, pain, and bruising you experience after the surgery." C. "Just to be safe, you should probably wait at least 6 months or more before having sex." D. "Sexual intercourse should be avoided for at least 1 week after your surgery."

D