Chapter 59: Assessment and Management of Problems Related to Male Reproductive Processes

The nurse is providing instruction for testicular self-examination to a group of young adolescents. Which is the most correct examination technique?

Palpate each testicle separately, following a warm shower.

The nurse is preparing a discharge teaching plan for a client who has had a prostatectomy. Which of the following would be appropriate to include?

Performing perineal exercises frequently throughout the day

Erectile dysfunction would not be characterized as the inability to:

achieve an erection after sexual activity.

Which client would the nurse identify as being at highest risk for the development of testicular cancer?

A 25-year-old male with a history of cryptorchidism

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

A patient has demonstrated interest in obtaining a penile implant. What should the patient consider prior to making this decision? (Select all that apply.)

ADLs Social activities Expectations of the patient and his partner

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 demonstrating the technique for performing a testicular self examination (TSE) to a group of men for a company health fair. One of the men asks the nurse at what age a man should begin performing TSE. What is the best answer by the nurse?

"It should begin in adolescence."

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."

The nurse is reviewing the medical record of a client who has been diagnosed with prostate cancer. The nurse notes that the Gleason score was used to grade the cancer. Which total score would the nurse interpret as indicating a highly aggressive cancer?

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A client is being seen by an urologist for perineal pain, low back pain, fever lasting 5 days, and painful urination. The physician confirms a diagnosis of prostatitis and orders treatment. During client education, which recommendation does the nurse make?

All options are correct.

A client is undergoing treatment for prostate cancer. He has chemotherapy sessions regularly. However, of late he is showing symptoms of food allergy and loss of appetite. He has lost considerable weight as a result. Which is an appropriate nursing task in this situation?

Ask the client to keep a diet diary.

Which treatment involves implantation of interstitial radioactive seeds under anesthesia to treat prostate cancer?

Brachytherapy

A client with Stage IV prostate cancer is to receive hormone therapy. The nurse would inform the client about possible adverse effects including which of the following?

Breast tenderness

Which is inconsistent with a digital rectal examination (DRE)?

Can reveal a hydrocele

After teaching a group of student about structural abnormalities of the male reproductive system, the instructor determines that the teaching was successful when the students identify which of the following as an example?

Cryptorchidism

Which term refers to a failure of one or both or both of the testes to descend into the scrotum?

Cryptorchidism

Which assessment finding is most important in determining which client has a higher risk for developing testicular cancer?

Cryptorchidism as an infant

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 the irrigations.

A patient is planning to use a negative-pressure (vacuum) device to maintain and sustain an erection. What should the nurse caution the patient about with the use of this device?

Do not leave the constricting band in place for longer than 1 hour to avoid penile injury.

A nurse is caring for a client admitted to the unit with a seizure disorder. The client seems upset and asks the nurse, "What will they do to me? I'm scared of the tests and of what they'll find out." The nurse should focus her teaching plans on which diagnostic tests?

EEG, blood cultures, and neuroimaging studies

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.

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.

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

The nurse is preparing a presentation for a local community group about prostate cancer and possible dietary risk factors. Which of the following would the nurse most likely include?

High-fat diet

Which of the following should nurses teach all men, especially those who have had cryptorchidism?

How to perform a testicular self-examination.

Which nursing assessment finding is most significant in determining the plan of care in a client with erectile dysfunction?

Medication use

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?

Ibuprofen

When assessing a client with benign prostatic hypertrophy, which of the following would the nurse expect the client to report as the initial complaint?

Increased effort to void

The nurse is preparing a presentation for a men's community group about health promotion. Which of the following would the nurse include as a current recommendation for screening?

Monthly testicular self-examination (TSE)

Which term refers to the surgical removal of one or both testes?

Orchiectomy

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?

Painful swelling

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?

Plasma testosterone levels decrease.

A client comes to the Emergency Department complaining of sudden sharp testicular pain. Further examination reveals torsion of the spermatic cord. Which of the following would the nurse expect to do next?

Prepare the client for surgery

Which of the following is the obstructive and irritative symptom complex caused by benign prostatic hypertrophy?

Prostatism

A nurse is discussing the importance of testicular self-examination with a client who had cryptorchidism. What should the nurse exclude from the discussion?

Regular testicular self-examinations should be performed by all men.

Which of the following herbal remedies is used to treat symptoms of benign prostatic hypertrophy (BPH)?

Saw palmetto

A client expresses concerns about future reproduction after a surgery to correct the cancer of the testes. For this client, treatment proceeded without first collecting and storing sperm. Which alternative should the nurse suggest to the client?

Suggest donor insemination or adoption

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.

Which should be included as part of the home care instructions for a client with epididymitis and orchitis?

Take prescribed antibiotics.

Students preparing for a test are reviewing the structure and function of the male reproductive system. They demonstrate understading of the material when they identify which of the following as the site of spermatogenesis?

Testes

A nurse is teaching a male client to perform monthly testicular self-examinations. Which point is appropriate to make?

Testicular cancer is a highly curable type of cancer.

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.

When developing an educational program for a group of adolescents about sexually transmitted infections (STIs), what should the nurse inform the group about the single greatest risk factor for contracting an STI?

The number of sexual partners

A client with benign prostatic hyperplasia doesn't respond to medical treatment and is admitted to the facility for prostate gland removal. Before providing preoperative and postoperative instructions to the client, the nurse asks the surgeon which prostatectomy procedure will be done. What is the most widely used procedure for prostate gland removal?

Transurethral resection of the prostate (TURP)

Following a vasectomy, which is the most important instruction to provide to the client?

Use another form of birth control until further notice.

Which assessment finding would create the greatest risk to a client ordered a phosphodiesterase (PDE5) inhibitor such as sildenafil (Viagra)?

Use of nitrates

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

A triple-lumen indwelling urinary catheter is inserted for continuous bladder irrigation following a transurethral resection of the prostate. In addition to balloon inflation, the functions of the three lumens include:

continuous inflow and outflow of irrigation solution.

A client is undergoing a diagnostic workup for suspected testicular cancer. When obtaining the client's history, the nurse checks for known risk factors for this type of cancer. Testicular cancer has been linked to:

cryptorchidism.

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 must be sure to use a condom for 2 weeks after implantation and then it will no longer be necessary."

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.

Bright red bleeding following prostate surgery indicates which of the following?

Arterial bleed

Which of the following would a nurse include in the teaching plan for a client who has had surgery for cancer of the testes?

Consuming a well-balanced diet with adequate fluids.

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.

A client is scheduled for a transurethral rescection 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 patient is suspected to have prostate cancer related to observed clinical symptoms. What definitive test can the nurse assist with to confirm a diagnosis of prostate cancer?

Prostate biopsy

A client is diagnosed with stage II cancer of the prostate. The nurse interprets this as indicating which of the following?

Tumor is confined to the prostate gland.

A client with a history of hypertension and heart disease is being seen by the urologist because of erectile dysfunction. What would be the most likely cause of the client's erectile dysfunction?

All options are correct.