59: Assessment & Mgmt - Male Reproductive Disorders
A patient is diagnosed with prostatitis. Which of the following is the most commonly isolated organism that will be present in this patient's laboratory results? Staphylococcus aureus Proteus Escherichia coli Pseudomonas
Escherichia coli Explanation: E. coli is the most commonly isolated organism with prostatitis. Microorganisms are usually carried to the prostate from the urethra.
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? Apply a scrotal support Prepare the client for surgery Apply a dressing over the scrotum Prepare the client for circumcision
Prepare the client for surgery Explanation: For the client with torsion, immediate surgery is necessary to prevent atropy of the spermatic cord and preserve fertility. Analgesics would be given preoperatively. Postoperatively, a scrotal support is applied and dressings are inspected for drainage. Circumcision is done to relieve phimosis or paraphimosis.
A nurse is obtaining a male client's health history before performing a physical examination. Which information would most likely not be obtained? age of first ejaculate contraceptive practices pain during sexual intercourse premature ejaculation or other concerns of a sexual nature
age of first ejaculate Explanation: Age of first ejaculate would most likely not be asked. Premature ejaculation or other concerns of a sexual nature, pain during sexual intercourse, and contraceptive practices would most likely be included in the health history.
A client has an edematous glans penis, pain, and an extremely constricted foreskin. What treatment would the physician likely prescribe? circumcision narcotic analgesics increased hygienic measures scrotal support
circumcision Explanation: Circumcision is recommended to relieve phimosis and paraphimosis permanently.
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." "It should begin in men over age 50." "It should be performed in high-risk males over age 30." "It should begin at age 40."
"It should begin in adolescence." Explanation: TSE should begin during adolescence.
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? Increased libido Deepening of voice Breast tenderness Enhanced potency
Breast tenderness Explanation: Feminizing side effects occur with hormone therapy. The client's voice may become higher, hair and fat distribution may change, and breasts may become tender and enlarged. Libido and potency also are diminished.
Which age-related change affects the male reproductive system? Increased prostate secretion Decreased plasma testosterone levels Testes become soft Increased patency
Decreased plasma testosterone levels Explanation: Changes in gonadal function include a decline in plasma testosterone levels and reduced production of progesterone. The testes become smaller and more firm.
Which nursing assessment finding is most significant in determining the plan of care in a client with erectile dysfunction? Age Medication use Sexual history Undescended testicle
Medication use Explanation: Certain medications such as antihypertensive drugs, antidepressants, narcotics, etc. can cause sexual dysfunction in men. Impotence is not a normal part of aging. Undescended testicle is not indicative of ED. Sexual history is not indicative of ED.
Which of the following is the most common organism implicated in prostatitis? Escherichia coli Staphylococcus aureus Streptococcus Methicillin-resistant Staphylococcus aureus
Escherichia coli Explanation: Escherichia coli is the most commonly isolated organism implicated in prostatitis. Microorganisms are usually carried to the prostate from the urethra. Staphylococcus aureus, Streptococcus, and methicillin-resistant Staphylococcus aureus are not the most common organism implications in prostatitis.
Which of the following may result if prostate cancer invades the urethra or bladder? Hematuria Backache Hip pain Rectal discomfort
Hematuria Explanation: Hematuria may result if the cancer invades the urethra or bladder. Symptoms related to metastases include backache, hip pain, perineal and rectal discomfort, anemia, weight loss, weakness, nausea, and oliguria.
When assessing a client with benign prostatic hyperplasia, which of the following would the nurse expect the client to report as the initial complaint? Dark brown urine Increased effort to void Narrowing of urinary stream Nocturia
Increased effort to void Explanation: The symptoms of BPH appear gradually. At first, the client notices that it takes more effort to void. Eventually, the urinary stream narrows and has decreased force. The bladder empties incompletely. As residual urine accumulates, the client has an urge to void more often and nocturia occurs.
The nurse is providing care to a client who has had a transurethral resection of the prostate. The client has a three-way catheter drainage system in place for continuous bladder irrigation. The nurse anticipates that the catheter may be removed when the urine appears as which of the following? Reddish-pink with numerous clots Dark amber with copious mucous Light yellow and clear Light pink with few red streaks
Light yellow and clear Explanation: Typically a three-way catheter drainage system is removed when the urine appears clear and amber (light yellow). Reddish-pink urine with clots usually occurs in the immediate postoperative period. Eventually the urine becomes light pink within 24 hours after surgery. Dark amber urine suggests concentrated urine commonly associated with dehydration.
Which of the following nursing assessment findings would be most significant in determining sterility in a male client? Uncircumcised penis Recurrent urinary tract infections (UTI) Multiple sex partners Mumps at age 15 years
Mumps at age 15 years Explanation: Viral mumps infection that occurs after puberty can be the cause of orchitis, which may result in testicular atrophy and sterility. Uncircumcised penis, UTIs, and number of sex partners are not indicated with sterility.
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? Erection of the penis Unclean glans Painful swelling Nausea and vomiting
Painful swelling Explanation: Paraphimosis results in strangulation of the glans penis from inability to replace the retracted foreskin. The strangulation results in painful swelling of the glans. Erection of the penis in the presence of phimosis can cause pain but is not a result of retracted foreskin. Nausea and vomiting are not indicated with retraction of foreskin.
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 urine in the drainage bag appears red to pink. The client reports bladder spasms and the urge to void. The normal saline irrigant is infusing at a rate of 50 drops/minute. About 1,000 ml of irrigant have been instilled; 1,200 ml of drainage have been returned.
The client reports bladder spasms and the urge to void. Explanation: Reports of bladder spasms and the urge to void suggest that a blood clot may be occluding the catheter. After TURP, urine normally appears red to pink, and normal saline irrigant usually is infused at a rate of 40 to 60 drops/minute or according to facility protocol. The amount of returned fluid (1,200 ml) should correspond to the amount of instilled fluid, plus the client's urine output (1,000 ml + 200 ml), which reflects catheter patency.
Several male clients are scheduled to come to the clinic for an annual physical examination. The nurse would expect to prepare which client for a digital rectal examination (DRE)? A 34-year-old man with a history of hypertension A 52-year-old man in good health A 40-year-old man with a history of asthma A 48-year-old man with a history of type 2 diabetes
A 52-year-old man in good health Explanation: DRE is used to screen for prostate cancer and is recommended annually for every man older than 50 years or those 45 years old at high risk (African-American men and men with a strong family history of prostate cancer). Therefore, a DRE would be most likely for the 52-year-old client. A DRE would not necessarily be done for the other clients, even with their history of other underlying conditions.
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? Erectile dysfunction Prostatitis Cryptorchidism Priaprism
Cryptorchidism Explanation: Structural abnormalities include cryptorchidism, torsion of the spermatic cord, phimosis, paraphimosis, hydrocele, spermatocele, and varicocele. Erectile dysfunction and priaprism are erection disorders. Prostatitis is an infectious disorder.
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 IV 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 Counter-balancing the I.V. pole Attaching the infusion set to an infusion pump Collecting a urine specimen before beginning irrigation
Evaluating patency of the drainage lumen Explanation: The nurse should evaluate patency of the drainage tubing before leaving the client's room. If the lumen is obstructed, the solution infuses into the bladder but isn't eliminated through the drainage tubing, a situation that may cause client injury. Balancing the pole is important; however, the nurse would have had to address this issue immediately after hanging the 2 L bag. Using an I.V. pump isn't necessary for continuous bladder irrigation. Unless specifically ordered, obtaining a urine specimen before beginning continuous bladder irrigation isn't necessary.
Which term refers to the surgical removal of one or both testes? Orchiectomy Circumcision Vasectomy Hydrocelectomy
Orchiectomy Explanation: Orchiectomy is required when the testicle(s) has been damaged. Circumcision is excision of the foreskin, or prepuce, of the glans penis. Vasectomy is ligation and transection of part of the vas deferens to prevent the passage of sperm from the testes. Hydrocelectomy describes the surgical repair of a hydrocele, a collection of fluid in the tunica vaginalis.
A client is to undergo a TURP for BPH. Which statement is accurate with regard to a TURP? A TURP causes erectile dysfunction. It is done on an outpatient basis. Urethral strictures are more frequent for TURP than for nontransurethral procedures. There is no danger of retrograde ejaculation.
Urethral strictures are more frequent for TURP than for nontransurethral procedures. Explanation: Urethral strictures are more frequent for TURP than with nontransurethral procedures. TURP rarely causes erectile dysfunction. It requires an overnight stay. There is danger of retrograde ejaculation.
Following a vasectomy, which is the most important instruction to provide to the client? Wear a scrotal support until swelling is resolved. Use a Tylenol as needed for discomfort. Use another form of birth control until further notice. Take a day or two to rest and recuperate from the procedure.
Use another form of birth control until further notice. Explanation: It may take up to 10 ejaculations to clear sperm and prevent impregnation. The client should be instructed to use another form of reliable birth control until a sperm count proves sterility has occurred. Use of Tylenol, scrotal support, and rest are all helpful during the initial recovery period.
A urologist suspects that a client might have prostate cancer. Which test would be used to make a diagnosis of cancer? tissue biopsy prostate-specific antigen cystoscopy digital rectal examination
tissue biopsy Explanation: A needle biopsy of prostatic tissue is obtained to diagnose a definitive cancer of the prostate. The PSA assay is a blood test that, when elevated, may correspond with prostate cancer. However, an elevated PSA does not always indicate a malignancy; it may indicate benign disease or other factors such as an enlarged prostate gland, older age, prostatitis, recent ejaculation, and other innocuous causes. Cytoscopy involves a cystoscope inserted into the urinary meatus to inspect the bladder, prostate, and urethra. This aids in evaluating the degree of encroachment by the prostate on the urethra. A digital rectal examination is performed to assess the prostate for size as well as evidence of tumor.
A client comes to the emergency department reporting severe testicular pain that started about 1 hour ago. Examination reveals a thickened spermatic cord, an elevated testis, and testicular tenderness. The nurse would interpret these findings to suggest which of the following? Epididymitis Testicular torsion Orchitis Testicular cancer
Testicular torsion Explanation: Testicular torsion is manifested by sudent pain in the testicle, usually developing over 1 to 2 hours, accompanied by swelling of the scrotum, testicular tenderness, elevated testis, thickened spermatic cord, and a swollen, painful scrotum. Epididymitis is manifested by low-grade fever, chills, and heaviness in the affected testicle developing over 1 to 2 days. Orchitis is manifested by fever, pain, tenederness in one or both testicles, testicular swelling, penile discharge, blood in the semen, and leukocytosis. It is common after an episode of mumps. Testicular cancer is manifested by a lump or mass on the testicle and usually painless enlargement of the testis that appears gradually.
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) Annual digital rectal examination (DRE) after age 35 years Annual prostate-specific antigen (PSA) testing after age 40 years Transrectal ultrasound every 5 years after age 50 years
Monthly testicular self-examination (TSE) Explanation: Screening typically includes monthly TSE starting in adolescence and annual DRE for men older than 50 years. PSA testing along with DRE are used to screen for prostate cancer in men with at least a 10-year life expectancy and for men at high risk, including those with a storng family history of prostate cancer and of African-American ethnicity. Transrectal ultrasound is performed in clients with abnormalities detected by DRE and in those with elevated PSA levels.
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 is unrelated to anxiety or depression. Erectile dysfunction is primarily a normal response to aging. Erectile dysfunction may be due to testosterone insufficiency. Erectile dysfunction rarely occurs in clients with diabetes mellitus.
Erectile dysfunction may be due to testosterone insufficiency. Explanation: Common causes of erectile dysfunction include neurologic disorder like spinal cord injury, perineal trauma, testosterone insufficiency, side effects of drug therapy such as antihypertensives or antidepressants, atherosclerosis, hypertension, and complications of diabetes mellitus. Erectile dysfunction may be related to anxiety or depression. It is not a normal aspect of aging.
The nurse is providing instruction for testicular self-examination to a group of young adolescents. Which is the most correct examination technique? Palpate both testicles simultaneously for comparison. Palpate each testicle separately, following a warm shower. Palpate the front of the testicle first, where most tumors are found. Palpate for a soft, round shape with normal ridges on the testicles.
Palpate each testicle separately, following a warm shower. Explanation: It is best to examine and palpate each testicle following a warm shower, when the testes are relaxed and not retracted. Because one testicle is normally larger and hangs lower, comparing the two sides is not indicated. Both testes should be oval in shape, smooth, and firm without masses or tenderness. Most tumors are located on the lateral aspect of the testicles.
A nurse is teaching a client about a circumision. Which external reproductive structure is removed by circumcision? Prepuce Glans Corpora cavernosa Mons pubis
Prepuce Explanation: In an uncircumcised male, the prepuce, sometimes referred to as the foreskin, that covers the glans is removed by cicumcision. The glans is the rounded head of the penis. The corpora cavernosa is erectile tissue. The mons pubis is fatty tissue near the pubic bones.
The nurse is preparing a presentation for an older adult group of males at a senior center. Which of the following would the nurse expect to include when describing the effects of aging on the male reproductive system? The volume and viscosity of seminal fluid increase with age. Men retain the ability to fertilize ova irrespective of age. There is a gradual increase in sperm and testosterone production. The scrotum becomes less pendulous and becomes firm.
Men retain the ability to fertilize ova irrespective of age. Explanation: As men age, they retain the ability to fertilize ova even though there is a gradual decrease in sperm and testosterone production. Along with decreased sperm production, the volume and viscosity of seminal fluid decrease with age. A loss of muscular tone causes the scrotum to become more pendulous.
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: testosterone therapy during childhood. sexually transmitted disease. early onset of puberty. cryptorchidism.
cryptorchidism. Explanation: Cryptorchidism (failure of one or both testes to descend into the scrotum) appears to play a role in testicular cancer, even when corrected surgically. Other significant history findings for testicular cancer include mumps orchitis, inguinal hernia during childhood, and maternal use of diethylstilbestrol or other estrogen-progestin combinations during pregnancy. Testosterone therapy during childhood, sexually transmitted disease, and early onset of puberty aren't risk factors for testicular cancer.
The obstructive and irritative symptom complex caused by benign prostatic hypertrophy is called prostatitis. prostatism. prostaglandin. prostatectomy.
prostatism. Explanation: Symptoms of prostatism include increased frequency of urination, nocturia, urgency, dribbling, and a sensation that the bladder has not completely emptied. Prostatitis is an inflammation of the prostate gland. Prostaglandins are physiologically active substances present in tissues with vasodilator properties. Prostatectomy refers to the surgical removal of the prostate gland.
A nurse is instructing a client in testicular self-examination. Which client statement indicates the need for additional teaching? "I should do this exam at least once a week." "A good place to do this is when I'm showering." "It's normal for one testis to be larger than the other." "My thumb goes on top and my index and middle fingers go under the testis."
"I should do this exam at least once a week." Explanation: Testicular self-examination is performed monthly, preferably when warm, such as in the shower. The client should place his thumb on top and his middle and index fingers under the testis. It is normal for one testis to be larger than the other.
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? "I'll have to stay in the hospital for about 3 to 4 days after the surgery." "I'll have a small incision on my lower abdomen after the procedure." "The surgeon is going to remove the entire prostate gland." "The surgeon is going to insert a scope through my urethra to remove a portion of the gland."
"The surgeon is going to insert a scope through my urethra to remove a portion of the gland." Explanation: TURP involves the surgical removal of the inner portion of the gland through an endoscope inserted through the urethra. There is no external skin incision. Typically, the procedure is performed in an outpatient setting but may require an overnight hospital stay.
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? "What concerns you most about having surgery?" "Your surgeon has performed this surgery many times." "How does your family feel about this decision?" "This surgery can cure you of cancer."
"What concerns you most about having surgery?" Explanation: Being sympathetic and encouraging the client to express his concerns is a therapeutic response. This client may have concerns about the complications associated with the surgery and/or need additional information on newest techniques that improve outcomes. Explaining that the surgeon is competent does not address the concerns of this client. Family feelings are secondary to the concerns or the client. A cure of cancer is never a guarantee with any surgery.
A male client has undergone a semen analysis for evaluation of fertility. The nurse understands that a sperm count of which of the following would suggest infertility? 100 million /mL 75 million/mL 50 million/mL 18 million/mL
18 million/mL Explanation: A sperm count of fewer than 20 million spermatozoa per milliliter results in infertility. Normal sperm count ranges on average from 60 to 100 million /mL.
A client is having prostate-specific antigen (PSA) testing done. Which result would the nurse identify as abnormal? 2.7 nanograms/milliliter 3.2 nanograms/milliliter 3.8 nanograms/milliliter 4.6 nanograms/milliliter
4.6 nanograms/milliliter Explanation: Normal prostate-specific antigen (PSA) levels are less than 4.0 nanograms/milliliter (ng/mL). A level of 4.6 ng/mL would be considered abnormal.
Which client would the nurse identify as being at highest risk for the development of testicular cancer? A 45-year-old white male with a history of hypertension A 25-year-old male with a history of cryptorchidism A 39-year-old African American male who is HIV-negative A 75-year-old white male with erectile dysfunction
A 25-year-old male with a history of cryptorchidism Explanation: Testicular cancer is most common in between 15 and 34 years of age and is the leading cause of cancer deaths in men between 25 to 34 years of age. Its incidence is higher in Caucasians and men with a history of cryptorchidism. Other clients at risk are those with a family history of the disease, those who are HIV-positive or have developed AIDS, and those who already have had cancer in one testicle.
Which client is most likely to develop prostate cancer according to a nurse working at a health screening at the local mall? A 35-year-old African American man A 60-year-old Asian American man A 17-year-old Caucasian man A 56-year-old African American man
A 56-year-old African American man Explanation: Age over 40 and African American race are both risk factors for prostate cancer. Age younger than 40 and Asian heritage reduce the risk of prostate cancer.
Which cancer ranks second as the cause of death in American men? prostate testicular skin penis
Correct response: prostate Explanation: Prostatic cancer is second to skin cancer in frequency among American men. It ranks second as the cause of deaths from cancer. Cancer of the testes is a malignancy seen in men between 18 and 40 years of age. Although this cancer is relatively rare, accounting for approximately 1% of cancers in men, it is the most common type in men between 15 and 34 years of age and is the leading cause of cancer deaths in men between 25 and 34 years of age. Skin cancer ranks first in frequency among American men. Penile cancer is rare and occurs more often in men who are uncircumcised.
Which term refers to a failure of one or both or both of the testes to descend into the scrotum? Cryptorchidism Hydrocele Varicocele Phimosis
Cryptorchidism Explanation: Cryptorchidism is the failure of one or both of the testes to descend into the scrotum. Hydrocele is a collection of fluid, generally in the tunica vaginalis of the testes. Varicocele is an abnormal dilation of the veins of the pampiniform venous plexus in the scrotum. Phimosis is a condition in which the foreskin is constricted so that is cannot be retracted over the glans.
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. Increase the rate of the IV fluids. Administer a unit of packed red blood cells. Prepare the patient for an ECG.
Discontinue the irrigations. Explanation: Transurethral resection syndrome is a rare but potentially serious complication of TURP. Symptoms include lethargy, hypotension, and muscle spasms. The first action the nurse should take is to discontinue irrigation. The other interventions listed are not appropriate.
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 use the device while taking nitrates. Do not leave the constricting band in place for longer than 1 hour to avoid penile injury. Watch for erosion of the prosthesis through the skin. Watch for the development of infection.
Do not leave the constricting band in place for longer than 1 hour to avoid penile injury. Explanation: Negative-pressure (vacuum) devices may also be used to induce an erection. A plastic cylinder is placed over the flaccid penis, and negative pressure is applied. When an erection is attained, a constriction band is placed around the base of the penis to maintain the erection. To avoid penile injury, the patient is instructed not to leave the constricting band in place for longer than 1 hour.
A 48-year-old man recently diagnosed with benign prostatic hyperplasia (BPH) reports consuming <i>Serenoa repens</i> (saw palmetto berry). The nurse needs to intervene if the physician orders which treatment? Terazosin Finasteride Sipuleucel-T Ketoconazole
Finasteride Explanation: Serenoa repens (saw palmetto berry) should not be used with finasteride. Terazosin is an alpha-adrenergic blocker and can be taken with Serenoa repens. Sipuleucel-T is a therapeutic cancer vaccine. Ketoconazole is an adrenal-ablating drug used to inhibit cytochrome P450 enzymes.
The nurse is obtaining a health history from a 58-year-old client stating that he is having difficulty obtaining an erection during sexual activity. The client asks how an "erectile medication" works and if there are any side effects to the medication. The nurse explains the action of the medication and directions for use and warns of which side effect related to the client's history? Asthma with beta-adrenergic inhaler use Hypotension with nitrate use Chronic pain with narcotic use Arthritis with corticosteroid use
Hypotension with nitrate use Explanation: Due to the action of the medication on the smooth muscles and blood vessels, clients are advised not to take medications to treat erectile dysfunction when also prescribed a nitrate drug for chest pain or heart problems. Combining medication could result in a serious drop in blood pressure. Although all disease processes and medication therapy should be screened for interactions, hypotension with nitrate use the most serious side effects.
Which statement is accurate regarding sildenafil? It can be taken twice daily for increased effect. The medication should be taken right before intercourse. Its side effects include headache, flushing, and dizziness. Sexual stimulation is not needed to produce an erection.
Its side effects include headache, flushing, and dizziness. Explanation: Side effects of sildenafil include headache, flushing, and dizziness. Is should be taken 30 minutes to 4 hours before intercourse. Taking this medication more than once a day will not have an increased effect. The client will have no erection if stimulation does not occur.
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? Secretions of the prostate gland increase. Testes become heavier in weight. Spematogenesis drops significantly Plasma testosterone levels decrease.
Plasma testosterone levels decrease. Explanation: With aging, plasma testosterone levels decrease, prostatic secretions increase, testes decrease in weight, and spermatogenesis continues.
A 57-year-old Caucasian man is being treated in the outpatient community center. The client reports that most nights he wakes up twice to urinate. In addition, he reports occasional blood in his urine. The client's laboratory tests reveal a PSA level of 3.8 ng/mL and a white blood cell (WBC) count of 6,000 mm3. The nurse most likely suspects that the client is experiencing which condition? Prostatitis Prostatism Prostate cancer Prostatectomy
Prostatism Explanation: Symptoms of prostatism include increased frequency of urination, nocturia, urgency, dribbling, hematuria, and a sensation that the bladder has not completely emptied. PSA and WBC levels are within expected ranges. Prostatitis is an inflammation of the prostate gland. Prostaglandins are physiologically active substances present in tissues with vasodilator properties. Prostatectomy refers to the surgical removal of the prostate gland.
Consuming a diet high in which of the following has been found to increase the risk for prostate cancer? Red meats Green leafy vegetables Carbohydrates Whole grains
Red meats Explanation: Data suggest that men who consume a diet containing excessive amounts of red meat or dairy products that are high in fat are at increased risk for prostate cancer.
Which should be included as part of the home care instructions for a client with epididymitis and orchitis? Take prescribed antibiotics Undertake lifting exercises Apply ice to the area after scrotal swelling subsides Resume sexual intercourse
Take prescribed antibiotics Explanation: Home care for a client with epididymitis and orchitis includes instructions to continue administering prescribed antibiotics and to take Sitz baths, apply local heat after scrotal swelling subsides, avoid lifting, and refrain from sexual intercourse until symptoms are relieved.
Which is the most common type of prostate surgery? Retropubic prostatectomy Transurethral resection of the prostate Suprapubic prostatectomy Perineal prostatectomy
Transurethral resection of the prostate Explanation: Transurethral resection of the prostate, or TURP, is the most common procedure used and can be carried out through endoscopy. Suprapubic, perineal, and retropubic prostatectomies are surgical procedures for the prostate, but they are not the most common.
A client diagnosed with prostate cancer is to receive brachytherapy. Which of the following would the nurse include when discussing this therapy with the client? Need for daily treatments over a 7- to 8-week period Use of radioactive seeds implanted into the prostate Surgical castration to decrease the level of circulating testosterone Use of probes inserted using ultrasound to freeze the tissue
Use of radioactive seeds implanted into the prostate Explanation: Brachytherapy involves the implantation of interstitial radioactive seeds under anesthesia. External beam radiation therapy (teletherapy) involves the use of radiation treatments, usually 5 days/week over 7 to 8 weeks. Surgical castration is a type of androgen-deprivation therapy. Cryosurgery invovles the insertion of transperineal probes into the prostate to freeze the tissue directly.
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. intermittent inflow and continuous outflow of irrigation solution. continuous inflow and intermittent outflow of irrigation solution. intermittent flow of irrigation solution and prevention of hemorrhage.
continuous inflow and outflow of irrigation solution. Explanation: When preparing for continuous bladder irrigation, a triple-lumen indwelling urinary catheter is inserted. The three lumens provide for balloon inflation and continuous inflow and outflow of irrigation solution.
Testicular cancer risk is highest for adolescents and men younger than age 35. To specifically address testicular cancer risk, a nurse should modify client teaching for male clients to include: physician visits. testicular self-examination. risk factors. family history.
testicular self-examination. Explanation: Testicular self-examination is a relatively simple technique that's extremely useful in detecting cancer-related testicular changes. Physician visits, risk factors, and family history are important to all clients, regardless of gender, and don't specifically address risk factors associated with testicular cancer.
Medical management of BPH includes pharmacologic therapy. Which of the following medications would the nurse expect the health care provider to prescribe for this diagnosis? Diuretic Alpha-adrenergic blocker Analgesic Antispasmodic
Alpha-adrenergic blocker Explanation: Alpha-adrenergic blockers relax the smooth muscle of the bladder neck and prostate, improving urine flow and relieving BPH symptoms.
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? Using a bearing down motion to promote complete bladder emptying when voiding Performing perineal exercises frequently throughout the day Engaging in strenuous exercise to strengthen abdominal muscles Waiting to urinate for 5 to 10 minutes after feeling the initial urge
Performing perineal exercises frequently throughout the day Explanation: After a prostatectomy, the client should be instructed in how to perform perineal exercises and to perform them hourly throughout the day, each day. In addition, the client should avoid bearing down (straining) to urinate because of the increased risk for hematuria. He should also avoid strenuous exercise, which increases the tendency to rebleed. The client should be instructed to urinate as soon as he feels the first urge to do so.
Which of the following herbal remedies is used to treat symptoms of benign prostatic hypertrophy (BPH)? Saw palmetto Garlic Gingko Green tea
Saw palmetto Explanation: Saw palmetto is an herbal product used to treat symptoms associated with BPH.
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? "I'll use my right hand to check the left testicle and the left hand to check the right one." "The best time to do it is once a month after I take my warm morning shower." "If the top and back of the testicle feels cordlike, I'll call my physician." "I should roll the testis in a circular pattern around the palm of my hand."
"The best time to do it is once a month after I take my warm morning shower." Explanation: TSE is to be performed monthly, usually after a warm bath or shower when the scrotum is more relaxed. Both hands are used to palpate the testis. The index and middle fingers are placed under the testis and the thumb is placed on top. The testis is rolled gently in a horizontal plane between the thumb and fingers. A cordlike structure on the top and back of the testicle is the epididymis. This is normal and does not need to be reported.
Which of the following should nurses teach all men, especially those who have had cryptorchidism? Need for blood tests to measure serum acid phosphatase levels Importance of regular monitoring of prostate-specific antigen (PSA) levels Need to undergo a baseline and follow up lymph node biopsies How to perform a testicular self-examination
How to perform a testicular self-examination Explanation: The nurses should teach all men, especially those who have had cryptorchidism, to perform testicular self-examination to detect any abnormal mass in the scrotum. The nurse instructs the clients to examine the testicles monthly, preferably when warm, such as in the shower. Having regular PSA levels, lymph node biopsies, and blood tests for measuring serum acid phosphatase are for the clients who are treated for prostate cancer.
Which of the following should nurses teach all men, especially those who have had cryptorchidism? Need for blood tests to measure serum acid phosphatase levels. Importance of regular monitoring of prostate-specific antigen (PSA) levels. Need to undergo a baseline and follow up lymph node biopsies. How to perform a testicular self-examination.
How to perform a testicular self-examination. Explanation: The nurses should teach all men, especially those who have had cryptorchidism, to perform testicular self-examination to detect any abnormal mass in the scrotum. The nurse instructs the clients to examine the testicles monthly, preferably when warm, such as in the shower. Having regular PSA levels, lymph node biopsies, and blood tests for measuring serum acid phosphatase are for the clients who are treated for prostrate cancer.
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? Spironolactone Cimetidine Ibuprofen Methyldopa
Ibuprofen Explanation: Certain medications, such as antihypertensive agents (e.g. methyldopa and spironolactone), antidepressants, narcotics, and cimetidine cause sexual dysfunction in men. Ibuprofen is not associated with causing erectile dysfunction.
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 hold it when the physician inserts a gloved finger into the rectum. Take a deep breath and exhale when the physician inserts a gloved finger into the rectum. When bending over the examining table, point the feet outward to decrease the discomfort. Inform the patient that the examination is not uncomfortable and will be over in a short period of time.
Take a deep breath and exhale when the physician inserts a gloved finger into the rectum. Explanation: To minimize discomfort and relax the anal sphincter during the digital rectal examination, the patient is instructed to take a deep breath and exhale slowly as the practitioner inserts a finger. If possible, he should turn his feet inward so his toes are touching.
