Prostate Cancer
What is the primary location of prostate cancer? Peripheral zone of prostate gland Neck of the urethra Lower portion of the bowel Prostate capsule
A Almost all prostate cancers are adenocarcinomas that develop in the peripheral zones of the prostate gland. This location increases the risk of spreading to the prostate capsule. Despite the location of the prostate gland, metastasis to the bowel is uncommon.
The nurse is assisting the healthcare provider with a physical examination of a client suspected of having cancer of the prostate. Which finding would support the diagnosis of prostate cancer? Palpable mass felt on digital rectal exam (DRE) Postvoid residual of 150 mL Hypoactive bowel sounds Cancer cells found in the urine
A A DRE is done to palpate the prostate and should be done as part of a physical examination to assess prostate size, symmetry, firmness, and nodules. Digital rectal examination reveals a prostate that is nodular and fixed in position.
The nurse is caring for a client who reports nausea and a sudden onset of acute perineal and back pain. The client reports a history of prostate cancer in his family. Which diagnostic test does the nurse anticipate for this client? Digital rectal examination WBC count and urine drug screen Urinalysis with differential X-ray and biopsy
A Bone pain can indicate metastasis. A digital rectal examine (DRE) may reveal a prostate that is nodular and fixed, indicating cancer. Along with the client's symptoms and history, the DRE is the only one of these tests that relates.
The nurse is preparing a poster on prostate cancer for display at a health fair. Which information should the nurse include on the display? (Select all that apply.) Prostate cancer is the second leading cause of death in North America. There is a reduced incidence of prostate cancer in men who take large amounts of vitamin A. Prostate cancer is the most common type of cancer among men. When prostate cancer is confined to the prostate, the 5-year survival rate is 100%. Prostate cancer occurs more often in Black men.
A, C, D, E Prostate cancer is the most common type of cancer among men and is the second leading cause of death in North America. When confined to the prostate, the 5-year survival rate is 100%. If the cancer spreads regionally, the survival rate is 95% after 5 years. This disease occurs more often in African American men at a rate greater than 60% higher than those seen in White men. Asians and Native Americans have the lowest incidence of prostate cancer. Taking large amounts of vitamin A does not reduce the incidence of prostate cancer.
Your client has been diagnosed with prostate cancer and had radiation therapy for treatment. What home care instruction would you provide the client? Increase exercise as tolerated Wear a condom Sleep with two pillows Watch for urinary tract infections
B The client with prostate cancer has different home care planning based on the type of treatment received. The client with radiation therapy would watch for radiation damage to others and sleep in a room alone for a week after treatment. He would also avoid close contact with pregnant women, infants, and children, and wear condoms during sexual contact because ejaculate may be discolored.
The nurse is interviewing a client admitted with a diagnosis of prostate cancer and questions the client regarding his symptoms. Which symptoms, if experienced by the client, support the diagnosis? (Select all that apply.) Polyuria Reduction in urinary stream Frequent urination Dysuria Nocturia
B, C, D, E Rationale Dysuria is painful or difficult urination that occurs because of prostatic cancer. As the tumor grows, it can compress the urethra, leading to urinary obstruction. The tumor may metastasize directly into the seminal vesicles or bladder or may spread via the lymphatic and venous systems. Other manifestations of prostate cancer include hematuria, nocturia, increased urinary frequency, reduction in urinary stream, and abnormal prostate on digital rectal exam. Polyuria is not a symptom of prostate cancer.
The nurse knows that treatment of prostate cancer depends on the stage of disease when the client was diagnosed. Which treatment would the nurse expect for a 60-year-old client recently diagnosed with a small benign tumor of the prostate following a DRE? (Select all that apply.) Radiation Watchful waiting Brachytherapy Medication Surgery
B, D The treatment of prostate cancer depends on the stage of the disease when the client is diagnosed. Watchful waiting may be the treatment of choice for the client with a slow-growing tumor or the client who is older and has a limited life expectancy. Medication may also be used to treat this client. Surgery, radiation, and brachytherapy are reserved for treating clients with aggressive forms of prostate cancer.
Mr. Allen, a truck driver, has been diagnosed with prostate cancer and asks about sexual function. What instruction, related to sexual function, should you provide to help him? "Be sure to take iron supplements." "Symptoms of impotence will subside eventually." "Therapy may affect sexual function, so make sure to talk about any issues with your partner." "Restrict fluids so you won't have to go to the bathroom often or during sex."
C For the client with prostate cancer, nursing interventions are aimed at facilitating urinary elimination, improving communication related to sexual function, and promoting effective pain management. The nurse teaches the client about the actual or potential effects of therapy on sexual function and encourages the client to discuss sexual function without anxiety or discomfort.
Mr. Giles is a 38-year-old African American man who has been diagnosed with prostate cancer. He states, "I thought prostate cancer was an 'old man's' disease; how did I get it?" What is your best explanation to Mr. Giles? "You have had kidney stones in the past and this leads to cancer." "Your test results show you had a terrible virus last season." "This disease occurs more often in African American men at a rate greater than 60% higher than those seen in White men." "You have had recurrent urinary tract infections."
C Prostate cancer is the most common type of cancer among men and is the second leading cause of death in North America. This is a disease primarily of older men with approximately one in eight age 70 years and older. This disease occurs more often in African American men at a rate greater than 60% higher than those seen in White men. Asians and Native Americans have the lowest incidence of prostate cancer.
Mr. Wright is a 75-year old who has been diagnosed with prostate cancer. He asks you why the doctor is not being aggressive with his treatment. What is your best response to Mr. Wright? "You're too old for surgery." "A radical prostatectomy is the next step; he's just waiting for the surgeon's availability." "Your tumor is growing slowly, so right now we just watch it." "You may need to change doctors."
C The treatment of prostate cancer depends on the stage of the disease when the client is diagnosed. Watchful waiting may be the treatment of choice for the client with a slow-growing tumor or who is older with a limited life expectancy. It would be inappropriate to tell a client he was too old, that surgery will happen next, or to suggest changing doctors.
The nurse is preparing to teach the client with prostate cancer. Which intervention will facilitate urinary elimination? Assessing the intensity, location, and quality of pain Interviewing the client about pretreatment sexual function Teaching Kegel exercises Assessing the effects of incontinence on client's lifestyle
C For the client with prostate cancer, nursing interventions are aimed at facilitating urinary elimination, improving communication related to sexual function, and promoting effective pain management. Teaching Kegel exercises promotes restoration of continence, as do methods to manage stress incontinence. Referring the client to physical therapy or a continence specialist for additional measures, helps promote continence as well.
Megestrol (Megace) is a medication used to treat prostate cancer. What type of medication is megestrol? Estrogen compound Nonsteroidal antiandrogen Luteinizing hormone-releasing hormone agonist Steroidal antiandrogen
D Megestrol (Megace) is a steroidal antiandrogen medication used to treat prostate cancer.
Which nursing diagnosis is appropriate for a client with prostate cancer? Risk for painful intercourse Altered nutritional status Risk for body image disturbance Alterations in urinary elimination
D Nursing diagnoses that are appropriate for a client with prostate cancer include diagnoses that affect the genitourinary, musculoskeletal, neurologic, and general body systems in a number of ways and include: alterations in urinary elimination, risk for urinary retention, and risk for stress urinary incontinence, sexual dysfunction, and pain.
Which complementary therapy promotes wellness for a client with prostate cancer? Aspirin Cranberry juice Vitamins Fruits and vegetables
D The nurse should emphasize disease prevention and wellness promotion, advising clients to follow a recommended balanced diet of fruits and vegetables as outlined in the federal government's MyPlate.gov guidelines. Natural and over-the-counter therapies and supplements should not be presumed safe; clients should be urged to consult their healthcare provider regarding the safety and efficacy of complementary and alternative therapies prior to engaging in their use.
What is the 5-year survival rate for prostate cancer confined to the prostate? 95% 80% 85% 100%
D The 5-year survival rate for prostate cancer confined to the prostate is 100%. It is a commonly occurring cancer. If the cancer spreads, the survival rate is 95% after 5 years.
The nurse caring for a client with prostate cancer knows that which surgical treatment might be included in the client's plan of care? Urinary bladder transplant Brachytherapy Radical oophorectomy Androgen deprivation via orchiectomy
D Androgen deprivation via orchiectomy is a surgical treatment for clients with prostate cancer. A radical oophorectomy is removal of the ovaries. Brachytherapy is a radiation treatment for prostate cancer. A urinary bladder transplant is not a surgical treatment for a client with prostate cancer.
The nurse knows that which type of radiation is used for the client with prostate cancer? Radical prostatectomy Orchiectomy Steroidal antiandrogens External beam
D Bone pain can indicate metastasis. A digital rectal examine (DRE) may reveal a prostate that is nodular and fixed, indicating cancer. Along with the client's symptoms and history, the DRE is the only one of these tests that relates.
The nurse is planning care for a client going home after prostate cancer surgery. What topic should be addressed when preparing the client and family for home care? The importance of keeping appointments Radiation damage Joining a support group Manifestations of infection
D For the client with prostate cancer having a surgical procedure, the following topics should be addressed in preparing the client and his family for home care: manifestations of infection and excessive bleeding, catheter care, wound care, and pain management.
The nurse is evaluating a client with prostate cancer. Which observation by the nurse means the client has successfully achieved his goals and outcomes? The client is still incontinent of urine. The client keeps the pain of his cancer from his family. The client demonstrates urine elimination of 0.3 mL/kg/hr. The client discusses his sexual function without being embarrassed.
D For the client with prostate cancer who successfully achieves the identified client goals and outcomes, examples of nursing observations during the evaluation phase may include the following: the client reported managing pain at a tolerable level using a predetermined pain rating scale; the client discussed sexual function without anxiety or discomfort; the client listed strategies for managing urinary incontinence; and/or the client maintained adequate urine output without complications related to altered urinary elimination.
The nurse is caring for a client who is diagnosed with prostate cancer. Which symptom does the nurse anticipate this client will experience? Weight gain Blurred vision Weakness of upper extremities Nocturia
D The manifestations of prostate cancer affect the genitourinary, musculoskeletal, neurologic, and general body systems and include dysuria, hematuria, nocturia, frequent urination, reduction in urine stream, abnormal prostate on DRE, bone or joint pain, back pain, nerve pain, bilateral weakness in lower extremities, bowel/bladder dysfunction, muscle spasms, weight loss, and fatigue.
The nurse is preparing to assess a 40-year-old African American client diagnosed with prostate cancer. Which assessment is part of the health history? (Select all that apply.) The client's bladder for distention The client's prostate through DRE The client's bladder for retention The client's risk factors for prostate cancer The client's urinary elimination patterns for the last week
D, E During the assessment phase of the nursing process, the nurse collects and documents data related to the client's health history, medication regimen, and current health status. Components of the health history for a client with prostate cancer may include risk factors, urinary elimination patterns, hematuria, and pain level. Components of a physical examination include a digital rectal examination and the assessment of the bladder for distention and retention.
