Ch. 59 Male Reproductive Issues

The physician orders an alpha-adrenergic blocker for a client with benign prostatic hypertrophy. The nurse understands that this drug acts to achieve which of the following?

Relieve urinary symptoms

Which cancer ranks second as the cause of death in American men? prostate testicular skin penis

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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, p. 1764.

A patient is 62 years old and weighs 176 pounds. Post prostatectomy, the nurse assesses hourly urine output. Select the measurement that would require notification of the healthcare provider.

25 mL per hour

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."

The nurse is educating a patient about performing testicular self-examination (TSE). The nurse informs the patient that the best time to perform the exam is when? In the morning when arising After exercise After a warm bath or shower At bedtime

After a warm bath or shower Explanation: Testicular self-examination is to be performed once a month. The test is neither difficult nor time-consuming. A convenient time is usually after a warm bath or shower when the scrotum is more relaxed. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Chart 59-6, p. 1781.

A group of students are reviewing information about the classifications of testicular cancer. The students demonstrate understanding of the information when they describe which of the following? Nongerminal tumors are the most common type of testicular tumor. Seminomas are typically fast growing tumors. Choriocarcinoma is an example of a nonseminoma. Prostate cancer is the most common cause of secondary testicular tumors.

Choriocarcinoma is an example of a nonseminoma. Explanation: Testicular tumors are classified as germinal or nongerminal. Germinal tumors are further classified as seminomas (slow-growing forms usually found in men in their 30s and 40s) and nonseminomas (more common and grow more rapidly). Nonseminomas include choriocarcinomas, embryonal carcinomas, teratomas, and yolk sac tumors. Nongerminal tumors account for less than 10% of testicular cancers. Lymphoma is the most common cause of secondary testicular cancer. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Germinal Tumors, p. 1780.

A health care provider prescribes ketoconazole (Nizoral), a second-line hormonal agent for the treatment of prostatic cancer. The nurse explained to the patient that this drug acts by:

Decreasing the endocrine production of androgen.

A nurse is reviewing the history of a client who is experiencing difficulty sustaining an erection. Which of the following might the nurse suspect as a possible contributing factor? Lower back pain Hypertension Sinus infections Asthma

Hypertension Explanation: Hypertension may be a contributing factor because some types of antihypertensive agents can reduce a male's ability to achieve or sustain an erection. A history of lower back pain, sinus infections, or asthma is unrelated to erectile dysfunction. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Erectile Dysfunction, p. 1756.

Following prostatectomy, the nurse monitors the patient for indicators of fluid volume excess. Which of the following are positive indicators?

Jugular vein distention. In S3 Gallup heart sound. Pulmonary crackles. Dyspnea and wheezing.

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. Spermatogenesis 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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Gerontologic Considerations, p. 1754.

Ernst Weber, a 73-year-old retired carpenter, has been diagnosed with epididymitis after examination and diagnostics ordered by a physician with the urology group where you practice nursing. What would you expect to find in the lab results from his urinalysis?

Pus and bacteria

A nurse is reviewing a journal article about benign prostatic hyperplasia and possible risk factors associated with this condition. Which factor would the nurse most likely find as playing a role in increasing a man's risk for this condition? Select all that apply. Smoking Social alcohol use Hypertension Diabetes Atrial fibrillation

Smoking Hypertension Diabetes Explanation: Recent studies have identified smoking (both current and former smoking), heavy alcohol consumption, hypertension, heart disease, and diabetes as risk factors associated with BPH. Atrial fibrillation has not been associated with BPH.

Surgical removal of a client's testicle and biopsy revealed a stage I tumor confined to the testis. Initially, the client was treated with an aggressive chemotherapy protocol, but, recently, tumor markers have improved and the chemotherapy has been modified. The nurse provides client education about family planning. Which client statement indicates that the client understood the education provided?

"Spermatogenesis eventually resumes months or years after chemotherapy."

A male client being discharged after having an acute myocardial infarction asks why the health care provider omitted a prescription for sildenafil. Which response will the nurse make? "It must have been accidentally omitted." "The medication cannot be taken for at least 6 months." "I will ask for the prescription before you leave the hospital." "You can ask for the prescription when you have your follow-up appointment."

"The medication cannot be taken for at least 6 months." Explanation: Sildenafil is a medication used to treat erectile dysfunction. It is contraindicated if the client has had a myocardial infarction within the past 6 months. The prescription was not accidentally omitted and the nurse will not be able to get the prescription for the client before leaving the hospital. The client will not be given the prescription if the appointment is within 6 months following the myocardial infarction.

A 55-year-old Asian man has a PSA level of 4.8 ng/mL. Based on the client's PSA level, which assessment question does the nurse need to ask? "How often do you include foods high in purines in your diet?" "When was the last time you experienced ejaculation?" "Will you remember to schedule your next PSA test in 1 year?" "Do you wear boxers or briefs?"

"When was the last time you experienced ejaculation?" Explanation: Values of PSA may increase after ejaculation. PSA levels are measured in nanograms per milliliter. In most laboratories, values less than 4.0 ng/mL are generally considered normal, and values greater than 4.0 ng/mL are considered elevated. Foods high in purines place individuals at risk for gout, but purines do not increase PSA levels. Because the client's PSA level is elevated, further assessment is indicated. Type of underwear affects how close the testes are held to the body and may affect male fertility; type of underwear does not affect PSA levels. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, p. 1756.

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.

The prostate-specific antigen (PSA) test is recommended for men over age 50. Elevated levels may indicate prostate cancer or inflammation and or enlargement of the prostate. If patient is told that his PSA level indicates a possible diagnosis of prostate cancer. The nurse knows that this level is approximately:

4 to 8ng/ml

A 29-year-old patient visits his provider because of a lump on his left testicle that is not painful. During a history and physical exam, he mentions another symptom. Which of the following is a significant diagnostic symptom that is suggestive of metastasis?

A backache

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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Prostate-Specific Antigen Test, p. 1756.

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?depression All options are correct. atherosclerosis hypertension medication

All of the options are correct

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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, p. 1780.

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 Priapism

Cryptorchidism Explanation: Structural abnormalities include cryptorchidism, torsion of the spermatic cord, phimosis, paraphimosis, hydrocele, spermatocele, and varicocele. Erectile dysfunction and priapism are erection disorders. Prostatitis is an infectious disorder. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Risk Factors, p. 1780.

A patient expresses concerns about future reproduction after a surgery to correct the cancer of the testes and for whom treatment has proceeded without collecting and storing sperm. Which of the following alternatives should a nurse suggest to the patient?

Donor insemination or adoption

In a client with benign prostatic hyperplasia (BPH), which assessment finding provides the best indication of urinary retention? Frequency Urgency Hesitancy Dribbling

Frequency Explanation: As residual urine accumulates, the client has an urge to void more often. Urgency, hesitancy, and dribbling are all urinary symptoms associated with BPH but not specific to urinary retention. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Clinical Manifestations, p. 1763.

All prostatectomies include the risk of damage to the prudendal nerve. Therefore, postoperatively, the nurse assesses for;

Impotence

Which of the following is the best surgical approach for treatment of prostate disorders because it is very effective for radical cancer therapy?

Perineal approach

Which of the following is the most common type of prostate surgery?

TURP

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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, p. 1764.

what are the most common side effects of phosphodiesterase type 5 (PDE-5) inhibitor (drugs that tx erectile dysfunction)

headache flushing dyspepsia diarrhea nasal congestion lightheadedness

Erectile dysfunction would not be characterized as the inability to:

achieve an erection after sexual activity.

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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Chart 59-7, p. 1782.

A patient has been prescribed an oral medication for the treatment of ED. The three most common drugs are slightly different in dosage, use, and side effects. As part of health teaching, the nurse knows to tell the patient that Cialis has a unique side effect which is: Headaches Nasal congestion. Skin flushing. Back pain.

Back pain. Explanation: Back pain is an anticipated side effect of Cialis but not of Viagra or Levitra. Refer to Table 34-2 in the text.

Which of the following is a major cause of relapsing urinary tract infections in men? Chronic bacterial prostatitis Urinary retention Improper hygiene Pyelonephritis

Chronic bacterial prostatitis Explanation: Chronic bacterial prostatitis is a major cause of relapsing urinary tract infection in men. Complications of prostatitis include swelling of the prostate gland, urinary retention, epididymitis, bacteremia, and pyelonephritis. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Prostatitis, p. 1762.

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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, p. 1754.

The diagnosis of prostate cancer is confirmed by which of the following? Histologic exam of tissue Computed tomography Bone scan Magnetic resonance imaging

Histologic exam of tissue Explanation: The diagnosis of prostate cancer is confirmed by a histologic examination of tissue. Other tests that may be used to establish the extent of the disease include bone scans to detect metastases to the bones, and computed tomography scan to identify metastases in the pelvic lymph nodes. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Assessment and Diagnostic Findings, p. 1765.

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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Chart 59-1, p. 1757.

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.

Which structure is involved in keeping the testes at the necessary temperature to ensure sperm production? scrotum testicles epididymis shaft

scrotum Explanation: To maintain the temperature of the testes 3 degrees cooler than body temperature, smooth and skeletal muscles in the scrotum pull the tissue toward the body when external temperatures are cold. On the other hand, the smooth muscles relax, causing the scrotum to become loose and hang away from the body when environmental temperatures are hot. The scrotum is the divided sac of skin that contains the right and left testes, also called testicles. The location of the testes within the scrotal sac ensures optimum conditions for sperm production. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, p. 1753.

Which client would the nurse identify as having the greatest risk for testicular cancer? A 20-year-old African American who was exposed to diethylstilbestrol prenatally A 36-year-old European American who is HIV positive A 50-year-old Hispanic American who works in a textile factory A 45-year-old Asian American with an enlarged prostate

A 36-year-old European American who is HIV positive Explanation: The client who is 36 years old, European American, and HIV-positive would have the greatest risk. Testicular cancer is the most common cancer diagnosed in men 15 to 35 years old and the second most common malignancy in those 35 to 39 years old. European Americans have a five times greater risk than African Americans and more than two to three times greater risk than Asian, Native American, and Hispanic men. The risk of developing testicular cancer is higher in HIV-positive men. Occupational hazards such as exposure to chemicals in mining, oil, and gas production, and leather processing have been suggested as possible risk factors. No evidence has linked testicular cancer to prenatal exposure to diethylstilbestrol. The client who is 20 years old is in the appropriate age group, but his ethnicity poses a lower risk than that of the 36-year-old European American. Both the 50-year-old Hispanic American and 45-year-old Asian American are at lower risk based on their ethnic group. Additionally, both these clients are not in the typical age group affected. Working in a textile factory and having an enlarged prostate are not risk factors associated with testicular cancer. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Risk Factors, p. 1780.

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.

Which of the following patient populations have the highest risk for developing testicular cancer? European American African American Asian American Hispanic American

European American Explanation: European American men have a five times greater risk than that of African American men and more than double the risk of Asian American men. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Risk Factors, p. 1780.

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 European American 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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, p. 1764.

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? Regularly drain the gland. Avoid caffeine. All options are correct. Complete the prescribed antibiotic treatment.

All options are correct

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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Pharmacologic Therapy, p. 1763.

Which of the following medication classifications are associated with erectile dysfunction? Select all that apply. Antifungals Antipsychotics Beta blockers Antiseizure agents Antispasmodics

Antifungals Antipsychotics Beta blockers Antiseizure agents Antispasmodics Explanation: Classes of medications associated with erectile dysfunction include antifungals, antipsychotics, beta blockers, antiseizure agents, and antispasmodics. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Chart 59-1, p. 1757.

A patient is being treated for prostatitis and the nurse is providing education about the treatment. What should the nurse include in the education of this patient? Force fluids to prevent urine from backing up and distending the bladder. Take several cool baths during the day to alleviate discomfort. Be sure to take the 3-day course of antifungal medication. Avoid foods and liquids with diuretic action or that increase prostatic secretions.

Avoid foods and liquids with diuretic action or that increase prostatic secretions. Explanation: The nurse educates the patient about the importance of completing the prescribed course of antibiotic therapy. If IV antibiotic agents are to be administered at home, the nurse educates the patient and family about correct and safe administration. Arrangements for a home care nurse to oversee administration may be needed. Warm sitz baths (10 to 20 minutes) may be taken several times daily. Fluids are encouraged to satisfy thirst but are not "forced," because an effective medication level must be maintained in the urine. Foods and liquids with diuretic action or that increase prostatic secretions, such as alcohol, coffee, tea, chocolate, cola, and spices, should be avoided. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Nursing Management, p. 1762.

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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Chart 59-4, p. 1774.

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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Clinical Manifestations, p. 1764.

A patient with an indwelling catheter after a radical prostatectomy is having bladder spasms. What medication prescribed by the physician can the nurse administer to help alleviate the discomfort? Cephalexin (Keflex) Phenazopyridine (Pyridium) Oxybutynin (Ditropan) Tadalafil (Cialis)

Oxybutynin (Ditropan) Explanation: Patients experiencing bladder spasms may report urgency to void, a feeling of pressure or fullness in the bladder, and bleeding from the urethra around the catheter. Medications that relax the smooth muscles can help ease the spasms, which can be intermittent and severe; these medications include flavoxate (Urispas) and oxybutynin (Ditropan). Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Relieving Pain, p. 1775.

x 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, take Sitz baths, apply local heat after scrotal swelling subsides, avoid lifting, and refrain from sexual intercourse until symptoms are relieved. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, p. 1762.

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? Ensure greater fluid intake. Ask the client to keep a diet diary. Include fruits in the client's diet. Administer serotonin blockers.

Ask the client to keep a diet diary. Explanation: The appropriate nursing task in this situation is to assess the amount of food eaten. This assessment will help determine nutrient intake. The nurse should ensure adequate fluid hydration before, during, and after drug administration when the client has side effects of nausea and vomiting. Administration of fruits is not recommended when the client is at risk of infection, such as during chemotherapy. Serotonin blockers are administered to control nausea and vomiting. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Chart 59-3, p. 1767.

A nurse is preparing a presentation for a local senior citizen group about age-related changes in the body systems. Which of the following would the nurse include as associated with the male reproductive system? Select all that apply. Shrinkage of the prostate gland Decrease in sexual energy level Loss of testicular firmness Enlargement of the testes Thickening of the seminiferous tubules

Decrease in sexual energy level Loss of testicular firmness Thickening of the seminiferous tubules Explanation: Age-related changes in the male reproductive system are associated with decreased sex hormone secretion, especially testosterone. Subsequently, the older man experiences decreased sexual energy, loss of testicular firmness, shrinkage of the testes, enlargement of the prostate gland, and thickening of the seminiferous tubules. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Gerontologic Considerations, p. 1754.

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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Negative-Pressure Devices, p. 1760.

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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Monitoring and Managing Potential Complications, p. 1776.

A health care provider prescribed a luteinizing hormone-releasing hormone (LHRH) agonist to suppress testicular androgen and treat prostate cancer. Which medication is the primary drug of choice? Lupron Eulexin Casodex Nilandron

Lupron Explanation: Lupon is an LHRH agonist. The other three choices are antiandrogen receptor antagonists. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Hormonal Strategies, p. 1770.

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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Orchitis, p. 1778.

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 atrophy 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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Testicular Torsion, p. 1779.

The student nurse studying the male reproductive tract demonstrates understanding movement of testicular secretions when they exit the penis by selecting which pathway? Epididymis, ejaculatory duct, vas deferens, penis Seminiferous tubules, epididymis, vas deferens, ejaculatory duct Vas deferens, epididymis, ejaculatory duct, urethra Seminiferous tubules, urethra, ejaculatory duct, penis

Seminiferous tubules, epididymis, vas deferens, ejaculatory duct Explanation: The correct pathway of testicular secretions is seminiferous tubules, epididymis, vas deferens, ejaculatory duct, urethra, and penis. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, p. 1753.

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 involves the insertion of transperineal probes into the prostate to freeze the tissue directly. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Radiation Therapy, p. 1769.

A client underwent a transurethral resection of the prostate gland 24 hours ago and is on continuous bladder irrigation. Which nursing intervention is appropriate? Tell the client to try to urinate around the catheter to remove blood clots. Restrict fluids to prevent the client's bladder from becoming distended. Prepare to remove the catheter. Use sterile technique when irrigating the catheter.

Use sterile technique when irrigating the catheter. Explanation: If the catheter is blocked by blood clots, it may be irrigated according to physician's orders or facility protocol. The nurse should use sterile technique to reduce the risk of infection. Urinating around the catheter can cause painful bladder spasms. The nurse should encourage the client to drink fluids to dilute the urine and maintain urine output. The catheter remains in place for 2 to 4 days after surgery and is removed only with a physician's order. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Postoperative Nursing interventions, p. 1775.

Which of the following would be most important to include in a teaching plan for a client who has had a vasectomy? Using a reliable method of contraception for several weeks. Applying warm compresses to the scrotum for the first 24 hours Taking a prescribed opioid analgesic for pain relief Resuming sexual activity in 24 to 48 hours

Using a reliable method of contraception for several weeks. Explanation: It may take several weeks or more after surgery before the ejaculatory fluid is free of sperm, and the client is informed to use a reliable method of contraception until sperm no longer are present. The client should apply ice packs to the scrotum to reduce swelling and use a mild analgesic such as aspirin or acetaminophen for pain relief. The client typically can resume sexual activity when comfortable, usually in 1 week. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Nursing Management, p. 1783.

Which treatment involves implantation of interstitial radioactive seeds under anesthesia to treat prostate cancer? Hormone therapy Brachytherapy Teletherapy Chemotherapy

Brachytherapy Explanation: Brachytherapy involves the implantation of interstitial radioactive seeds under anesthesia. Hormone therapy for advanced prostate cancer suppresses androgenic stimuli to the prostate by decreasing the level of circulating plasma testosterone or interrupting the conversion to or binding of DHT. Teletherapy involves 6 to 7 weeks of daily radiation treatments. High-dose ketoconazole (HDK) lowers testosterone through its abilities to decrease both testicular and endocrine production of androgen. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, p. 1769.

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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Chart 59-1: Pharmacology; Medications Associated With Erectile Dysfunction, p. 1757.

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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Phimosis, p. 1784.

Which of the following herbal remedies is used to treat symptoms of benign prostatic hypertrophy (BPH)? Saw palmetto Garlic Ginkgo Green tea

Saw palmetto Explanation: Saw palmetto is an herbal product used to treat symptoms associated with BPH. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Pharmacologic Therapy, p. 1763.

Lately, a 75-year-old man is having difficulty emptying his bladder. He is unable to empty it completely and yet it feels full, causing discomfort. The physician suspects prostate cancer. Which question(s) would you expect the physician to ask the client? Select all that apply. "Do you pass blood in your urine?" "Do you feel thirsty often?" "Do you have a burning sensation during urination?" "Do you leak urine involuntarily?" "Do you have a family history of prostate cancer?"

"Do you pass blood in your urine?" "Do you have a burning sensation during urination?" "Do you have a family history of prostate cancer?" Explanation: The symptoms of prostate cancer include a slow urinary stream; hematuria, which is passing blood with urine; urinary hesitancy; incomplete bladder emptying; and dysuria (painful urination). A family history of prostate cancer would increase the client's risk of developing it himself. Urine leakage is a symptom of cervical cancer. Thirst is not related to prostate cancer. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, p. 1764.

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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Cancer of the Prostate, p. 1764.

A nurse is working in an oncology treatment center. Which clinical manifestation when reported by a client would the nurse know may be related to metastasis from prostate cancer? Frequent nighttime urination Constant hip aching and discomfort Weight gain of 3 pounds in 1 month Large amounts of dilute urine when voiding

Constant hip aching and discomfort Explanation: Symptoms related to metastases include backache, hip pain, perineal and rectal discomfort, anemia, oliguria, weight loss, weakness, nausea, and spontaneous pathologic fractures. These symptoms may be the first indications of prostate cancer. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, p. 1764.

Which of the following would be most important to include in a teaching plan for a client who has had a vasectomy? Using a reliable method of contraception for several weeks. Applying warm compresses to the scrotum for the first 24 hours. Taking a prescribed opioid analgesic for pain relief. Resuming sexual activity in 24 to 48 hours.

Using a reliable method of contraception for several weeks. Explanation: It may take several weeks or more after surgery before the ejaculatory fluid is free of sperm, and the client is informed to use a reliable method of contraception until sperm no longer are present. The client should apply ice packs to the scrotum to reduce swelling and use a mild analgesic such as aspirin or acetaminophen for pain relief. The client typically can resume sexual activity when comfortable, usually in 1 week. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Nursing Management, p. 1084.

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 Undertake herbal alternatives Suggest the use of sildenafil Reverse the surgery

Suggest donor insemination or adoption Explanation: For a client after a surgery to correct cancer of the testes and for whom treatment had proceeded without first collecting and storing sperm, the nurse explains other pregnancy options, such as donor insemination or adoption. Reversal of surgery is not possible for testicular cancer. In addition, undertaking herbal alternatives should not be advised by the nurse. Sildenafil would not enhance that chance of that this client could cause a woman to become pregnant.

During a physical examination, the nurse inspects the external genitalia of a male client. Which of the following would the nurse identify as an abnormality? Absence of urethral discharge Skin lesions Prepuce covering the glans penis Slightly pendulous scrotum

Skin lesions Explanation: During a physical examination, the nurse inspects the external genitalia, looking for abnormalities such as skin lesions and urethral discharge. Prepuce covering the glans penis is a normal finding in an uncircumcised male. The scrotum is normally pendulous, and with increasing age, it becomes more pendulous. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Assessment and Diagnostic Findings, p. 1785.

A client with erectile dysfunction is prescribed sildenafil (Viagra). Which of the following would the nurse include in the teaching plan for this client? "You need to take this medication throughout the day to be effective." "The effects of this medication usually last for up to 48 hours." "You may experience headache and some flushing with this drug." "Your blood glucose level might increase when you take this drug."

"You may experience headache and some flushing with this drug." Explanation: Sildenafil (Viagra) may cause headache, flushing, dyspepsia, diarrhea, nasal congestion, and lightheadedness. It is taken 30 minutes to 4 hours before sexual activity. It can be taken more than once a day, but doing so will not increase its effect. It should be taken only when the client wants to have intercourse, to a maximal dose of 100 mg/24 hours. The drug may cause low blood glucose levels and abnormal liver function tests. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Table 59-2, p. 1758.

Which of the following would lead a nurse to suspect that a client is experiencing acute prostatitis? Select all that apply. Below normal body temperature Dysuria Nocturia Perineal pain Decreased force of urinary stream

Dysuria Nocturia Perineal pain Explanation: Acute prostatitis is often manifested by a sudden onset of fever, dysuria, perineal prostatic pain, and severe lower urinary tract symptoms such as dysuria, urinary frequency, urinary urgency, urinary hesitancy, and nocturia. A decreased force of the urinary stream is associated with benign prostatic hyperplasia. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Clinical Manifestations, p. 1762.

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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, p. 1754.

Which assessment finding would create the greatest risk to a client ordered a phosphodiesterase inhibitor such as sildenafil? Use of nitrates History of hypertension Type 2 diabetes Use of diuretics

Use of nitrates Explanation: PDE5 inhibitors facilitate penile erection by producing smooth muscle relaxation in the corpora cavernosa via vasodilation of the blood vessels. If a client is using nitrates (which also exhibit vasodilation) hypotension is likely to occur. History of hypertension and diabetes does not interfere with the administration of PDE5 inhibitors. Use of diuretics is not significant. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Pharmacologic Therapy, p. 1759.

Which of the following is considered first-line treatment for prostate cancer? Radical prostatectomy Radiation Hormonal therapy Cryosurgery

Radical prostatectomy Explanation: Radical prostatectomy is the complete surgical removal of the prostate, seminal vesicles, and often the surrounding fat, nerves, lymph nodes and blood vessels. It is considered the standard first-line treatment for prostate cancer. If prostate cancer is detected in its early stage, the treatment may be curative radiation therapy. Hormonal therapy for advanced prostate cancer suppresses androgenic stimuli to the prostate by decreasing the level of circulating plasma testosterone or interrupting the conversion to or binding of dihydrotestosterone. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Surgical Management, p. 1765.

Based on the nurse's knowledge of the probable first indicator of prostate cancer, which of the following questions should be included in the history and physical examination? "Are you waking up during the night to urinate?" "Do you have any perineal discomfort?" "Have you noticed a decrease in the volume of your urinary stream?" "Do you have abdominal straining with urination?"

"Do you have any perineal discomfort?" Explanation: Perineal and rectal discomfort may be the first indicators of prostate cancer. The other choices address symptoms of BPH, not cancer metastases. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Health History, p. 1754.

The nurse knows that a client being screened for prostate cancer needs further instruction when he makes which statement? "I understand blood in the urine is the first symptom of prostate cancer." "I'm concerned that I may have prostate cancer because I have difficulty urinating." "This back pain I have had for approximately 6 months could be a symptom of prostate cancer." "It worries me that I continue to experience urinary dribbling."

"I understand blood in the urine is the first symptom of prostate cancer." Explanation: While blood in the urine can be a sign of prostate cancer, it does not occur frequently with this disease. More common symptoms include difficulty urinating, urinary retention, urinary dribbling, back pain, and urinary/bladder inflammation. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, p. 1764.

Which assessment finding is most important in determining which client has a higher risk for developing testicular cancer? Previous sexually transmitted infection (STI) Low sperm count Cryptorchidism as an infant Family history of cancer

Cryptorchidism as an infant Explanation: Men who have had cryptorchidism as an infant, regardless of whether an orchiopexy was performed, are at higher risk for incidence of testicular cancer. STIs, low sperm count, and family history of general cancers are not indicative of testicular cancer risk. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Risk Factors, p. 1780.

A client recovering from urethral dilation to correct a urethral stricture is instructed by the nurse about post-procedure care. Which statement indicates to the nurse that teaching was successful? "My urine stream will be weak for a few weeks." "I can expect to have difficulty voiding for several months." "It will take a year to determine if the treatment was successful." "I can expect to develop a prostate problem because of the surgery."

"It will take a year to determine if the treatment was successful." Explanation: Urethral stricture is a condition in which a section of the urethra is narrowed. Treatment involves dilation of the urethra. Treatment should not be considered successful until at least 1 year has passed because strictures may recur at any time during that period. A weak urine stream is a symptom of a urethral stricture. The client should not have difficulty voiding for months after the surgery. Prostatitis is a common complication of urethral strictures.

A client comes to the emergency department complaining of moderate to severe testicular pain and tenderness. Both testicles are swollen and a penile discharge is present. The client is diagnosed with viral orchitis. Which of the following would the nurse include in this client's plan of care? Administering prescribed antibiotics Keeping the scrotum in a dependent position Applying ice to the scrotum Preparing the client for incision and drainage

Applying ice to the scrotum Explanation: Care for the client with viral orchitis includes elevating the scrotum and applying ice to it, promoting rest, and using analgesics and anti-inflammatory agents for pain relief. Antibiotics would be used if the orchitis was bacterial. Incision and drainage are not performed. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Orchitis, p. 1779.

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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Chart 59-6, p. 1781.

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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Clinical Manifestations, p. 1763.

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? 3 5 7 9

9 Explanation: The Gleason score is the most commonly used tumor grading system which assigns two scores with a combined value ranging from 2 to 10. With each increase in Gleason score, there is an increase in tumor aggressiveness. High Gleason scores indicate more aggressive cancer. A total score of 8 to 10 indicate a high-grade cancer. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Assessment and Diagnostic Findings, p. 1765.

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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, p. 1754.

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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Monitoring and Managing Potential Complications, p. 1776.

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 Black 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 White men 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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Risk Factors, p. 1780.

Students preparing for a test are reviewing the structure and function of the male reproductive system. They demonstrate understanding of the material when they identify which of the following as the site of spermatogenesis? Vas deferens Testes Prostate gland Seminal vesicles

Testes Explanation: The testes are responsible for producing sperm (spermatogenesis). The vas deferens are the tubes that carry the sperm from the testicles and epididymis to the seminal vesicles, which acts as the reservoir for testicular secretions. The prostate gland produces a secretion that is chemically and physiologically suitable to the needs of the sperm in their passage from the testes. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Anatomic and Physiologic Overview, p. 1753.

A client comes to the outpatient clinic for information on a vasectomy. Which instruction should be included by the nurse? Vasectomies should be considered a permanent means of birth control. Following surgery, sexual intercourse should be avoided for 3 months. Postoperative discomfort can be relieved with use of warm sitz baths. Vasectomy can result in permanent impotence.

Vasectomies should be considered a permanent means of birth control. Explanation: Although attempts to reverse a vasectomy have proven successful, a vasectomy should be considered a permanent means of birth control. Scar formation and/or sperm leakage can interfere with restoration of reproductive effectiveness. Sexual intercourse can be resumed when it is comfortable to do so, usually in about 1 week. Postoperative discomfort should be controlled with application of cold to reduce swelling or use of mild analgesics. On occasion, clients have complained of impotence, but vasectomies have no effect on erection or ejaculation. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Vasectomy, p. 1783.

A client is suspected of having prostate cancer. The nurse would expect to prepare the client for which of the following to confirm the diagnosis? Digital rectal examination (DRE) Prostate-specific antigen (PSA) testing Transurethral needle ablation (TUNA) Biopsy via transrectal ultrasound

Biopsy via transrectal ultrasound Explanation: Although abnormal findings on DRE and elevated levels of PSA may raise suspicion of prostate cancer, detection requires confirmation with a needle biopsy of the prostate using transrectal ultrasound. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Assessment and Diagnostic Findings, p. 1765.

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 type of contraception used The number of times the person has contact with a partner The number of sexual partners Where the patient lives

The number of sexual partners Explanation: The single greatest risk factor for contracting an STI is the number of sexual partners. As the number of partners increases, so does the risk of exposure to a person infected with an STI. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Infections of the Male Genitourinary Tract, p. 1761.

A client with a penile implant is to be informed about the possible complications after discharge. Which complication occurs due to a midsized implant, pressure, or friction of the implanted cylinders? erosion of penile or urethral tissue migration of the cylinders, pump, and reservoir erosion of scrotal, bowel, or bladder tissue malfunction of the device

erosion of penile or urethral tissue Explanation: Erosion of penile or urethral tissue may occur from a midsized implant, pressure, and friction of the implanted cylinders, which is evidenced by seeing the implant through the skin. Migration of the cylinders, pump, and reservoir is a possible complication but not due to a midsized implant, pressure, or friction of the implanted cylinders. Erosion of scrotal, bowel, or bladder tissue can occur when an implant with a fluid reservoir is used. Malfunction of the device can occur with migration, accidental trauma such as a fall, or aggressive or improper use of the device. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, p. 1759.

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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Risk Factors, p. 1780.

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 a fever and noticed I've been running to the bathroom more often." "I'm waking up at night to urinate and I've noticed some burning, too." "I've had trouble getting started when I urinate, often straining to do so." "I've had some pain in my lower abdomen lately and felt a bit sick to my stomach."

"I've had trouble getting started when I urinate, often straining to do so." Explanation: Symptoms that might alert the nurse to BPH include difficulty initiating urination and abdominal straining with urination. Although fever, urinary frequency, nocturia, pelvic pain, nausea, vomiting, and fatigue may be noted, they also may suggest other conditions such as urinary tract infection. Fever, nausea, vomiting, and fatigue are general symptoms that can accompany many conditions. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Clinical Manifestations, p. 1763.

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 most likely will not be able to have sexual intercourse after radiation therapy." "You must be sure to use a condom for 2 weeks after implantation and then it will no longer be necessary." "There are no restrictions to sexual activity during radiation." "You must use a condom for at least 6 months after beginning radiation therapy."

"You must be sure to use a condom for 2 weeks after implantation and then it will no longer be necessary." Explanation: Two major forms of radiation therapy are used to treat cancer of the prostate: teletherapy (external) and brachytherapy (internal). Brachytherapy (internal implants) involves the implantation of interstitial radioactive seeds under anesthesia. Radiation safety guidelines include straining urine for seeds and using a condom during sexual intercourse for 2 weeks after implantation to catch any seeds that pass through the urethra. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Radiation Therapy, p. 1769.

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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Digital Rectal Examination, p. 1755.

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 35-year-old man 1 hour after vasectomy, with scrotal swelling, a pain rating of 5, and scrotal ecchymoses. Vital signs are temperature 98.9°F, pulse 72, respirations 16, and blood pressure 140/82. A 45-year-old man diagnosed with acute bacterial prostatitis and painful urination. Vital signs are temperature 101.2°F, pulse 92, respirations 16, blood pressure 148/88. 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. A 55-year-old male patient admitted with orchitis, with tenderness in both testicles, unilateral testicular swelling, and a WBC of 114,000 mm3. Vital signs are temperature 100.2°F, pulse 82, respirations 18, and blood pressure 140/80.

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. Explanation: This client's condition is consistent with hyponatremia and needs to be reported to the physician. Scrotal swelling, discomfort, and ecchymoses are expected findings following a vasectomy. Acute prostatitis is characterized by the sudden onset of fever, dysuria, perineal prostatic pain, and severe lower urinary tract symptoms (dysuria, frequency, urgency, hesitancy, and nocturia). The signs and symptoms listed are expected in a client with orchitis. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, p. 1775.

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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Hormonal Strategies, p. 1770.

Which is inconsistent with a digital rectal examination (DRE)? Recommended for men older than 50 years of age Assists in screening for cancer of prostate gland Enables examiner to assess size, shape, and consistency of prostate gland Can reveal a hydrocele

Can reveal a hydrocele Explanation: DRE is recommended as part of the regular health checkup for every man older than 50 years of age. It is a screening for cancer of the prostate gland. It enables the examiner to assess the size, shape, and consistency of the prostate gland. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, p. 1755.

Which of the following is an immediate danger after a prostate surgery? Hemorrhagic shock Deep vein thrombosis Catheter obstruction Sexual dysfunction

Hemorrhagic shock Explanation: The immediate dangers after prostate surgery are bleeding and hemorrhagic shock. The patient is monitored for major complications such as hemorrhage, infection, deep vein thrombosis, catheter obstruction, and sexual dysfunction. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Collaborative Problems/Potential Complications, p. 1774.

Which of the following should be included when teaching a client about the management of benign prostatic hyperplasia (BPH)? Select all that apply. Moderate use of alcohol is useful for bladder relaxation. Do not delay the urge to void. Low-dose Benadryl will promote restful sleep. Prolonged exposure to heat increases bladder spasms. Painless hematuria is a common symptom of BPH. Schedule digital rectal exams.

Do not delay the urge to void. Schedule digital rectal exams. Explanation: The client should be instructed to void promptly when the urge to empty the bladder is signaled by the stretch receptors in the bladder. Voiding promptly will decrease the risk for urinary retention. Digital rectal exams should be monitored to detect further enlargement of the gland and/or presence of prostatic nodules. Alcohol and antihistamines (e.g., Benadryl) should be avoided in the management of BPH. Exposure to heat and painless hematuria are not significant in the management of BPH. Alcohol and antihistamines interact with many BPH drugs. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Medical Management, p. 1763.

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. Engage in activities and exercises that minimize heavy lifting. Encourage the consumption of foods that are rich in fat and starch. Urge the limited intake of foods and fluids containing caffeine.

Ensure immunizations against infectious diseases such as mumps. Explanation: Nurses should advocate for infant and childhood immunizations against infectious diseases such as mumps to reduce potential adult complications such as orchitis. Minimizing activities involving heavy lifting or urging limited intake of caffeine have no effect on the potential for adult complications such as orchitis. The nurse should encourage foods that are low in fat and starch; however, this also would have no effect on the potential for orchitis. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Orchitis, pp. 1778-1779.

The nurse is providing preoperative care to a client who is to undergo a radical prostatectomy for prostate cancer. The client's plan of care includes the nursing diagnosis of "anxiety related to surgery and its outcome." Which of the following would be most appropriate for the nurse to do? Tell the client that prostate cancer is very curable if caught early. Inform the client that risk of recurrence is decreased with this type of surgery. Ensure privacy when discussing sensitive or embarrassing sexual issues. Allow the client to assume a passive role in the preparation.

Ensure privacy when discussing sensitive or embarrassing sexual issues. Explanation: To help reduce anxiety, the nurse should provide clear explanations about the events before, during, and after surgery, reinforcing information already provided by the surgeon. In addition, the nurse should establish a trusting relationship and allow the client to ask questions and verbalize his feelings related to the diagnosis, surgery, and outcomes. Because the surgery involves reproductive issues that the client may find sensitive or embarrassing, the nurse needs to ensure the client's privacy when discussing any of these issues. Telling the client that the cancer is very curable and informing him of a lower risk of recurrence would give the client false reassurance. In addition, anxiety could be increased, especially if the client's cancer is not at an early stage. Regardless of the diagnosis, clients need to participate in their care to foster autonomy and feelings of control over the situation. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Reducing Anxiety, p. 1774.

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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Erectile Dysfunction, p. 1756.

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? Staphylococcus Streptococcus Escherichia coli Paramyxovirus

Escherichia coli Explanation: Prostatitis is an inflammation of the prostate gland and is most often caused by microorganisms that reach the prostate by way of the urethra. Escherichia coli and microbes that cause sexually transmitted infections often are responsible. Staphylococcus and Streptococcus are not typically a cause of prostatitis. Paramyxovirus is the cause of mumps. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Prostatitis, p. 1761.

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 TAKE ANOTHER QUIZ

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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, p. 1763.

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? Finasteride (Proscar) Tamsulosin (Flomax) Terazosin (Hytrin) Oxybutynin chloride (Ditropan)

Finasteride (Proscar) Explanation: Finasteride (Proscar) inhibits the conversion of testosterone, depriving the gland of dihydrotestosterone (more potent type of testosterone), which stimulates prostatic growth. Tamsulosin (Flomax) and terazosin (Hytrin) work by reducing the tone of smooth muscle in the bladder neck and prostate gland but have little effect on reducing prostate size. Oxybutynin chloride (Ditropan) is an antimuscarinic, antispasmodic drug used for treatment of overactive bladder. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Medical Management, p. 1763.

A client is receiving leuprolide as part of his treatment for prostate cancer. The nurse would be alert for which of the following as a possible adverse effect? Reports of increased libido Muscle overgrowth Gynecomastia Nipple retraction

Gynecomastia Explanation: Adverse effects associated with leuprolide, a luteinizing hormone-releasing hormone agonist, are related to hypogonadism and include vasomotor flushing, loss of libido, decreased bone density, anemia, fatigue, increased fat mass, decreased muscle mass, gynecomastia, and mastodynia (breast/nipple tenderness). Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Hormonal Strategies, p. 1770.

A nurse is teaching a male client who is older than 50 years about prostate cancer. What teaching should be included by the nurse? Have a digital rectal examination. Have a transrectal ultrasound every 5 years. Perform monthly testicular self-examinations, especially after age 50. Have a complete blood count, blood urea nitrogen, and creatinine levels checked yearly.

Have a digital rectal examination. Explanation: A serum prostate-specific antigen level test and a digital rectal exam, which are recommended by the American Cancer Society, 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 strong family history of prostate cancer and those of African American ethnicity. Testicular self-examinations won't identify changes in the prostate gland because of its location in the body. A transrectal ultrasound, complete blood count, blood urea nitrogen, and creatinine level test are usually done after diagnosis to identify the extent of the disease and potential metastasis. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Gerontologic Considerations, p. 1754.

Which component of client teaching helps the nurse assist a client following treatment for cancer of the prostate gland to manage and minimize the possibility of a recurrence of the primary cancer or metastasis? Have regular prostate-specific antigen (PSA) levels tested and repeat lymph node biopsies. Avoid sexual intercourse for at least 2 years. Undertake pelvic floor retraining exercises. Avoid strenuous exercises, especially lifting.

Have regular prostate-specific antigen (PSA) levels tested and repeat lymph node biopsies. Explanation: Regular monitoring of PSA levels after treatment aids in the early detection of cancer recurrence or metastasis. Repeat lymph node biopsies may be part of the surgical follow-up. Cancer cells are spread via the lymphatic system. Exercise routines and avoiding sexual intercourse are not known to have any role in recurrence of the primary cancer or metastasis. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, p. 1756.

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-iron High-calorie High fiber High-fat diet

High-fat diet Explanation: Although the cause of prostatic cancer is unknown, there seems to be a relationship with increased testosterone levels and a diet high in fat. No other dietary links have been suggested. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Cancer of the Prostate, p. 1764.

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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Chart 59-6: Patient Education; Testicular Self-Examination, p. 1781.

A 65-year-old man complains to his health care provider that, when he urinates, he has to start and stop several times over a period of minutes in order to fully empty his bladder. The nurse is aware that this is not uncommon in men over the age of 60. This "double voiding" is directly related to which of the following? Hyperplasia of the prostate gland Thickening of the seminiferous tubules Fibrotic changes of the corpora cavernosa Hypogonadism

Hyperplasia of the prostate gland Explanation: Urination, without bladder emptying, is an indication that the prostate gland is enlarged. It causes an increased sense of urgency to void, as well as a decreased force of the urine stream. Enlargement of the prostate gland is associated with weakening of prostatic contractions and lower urinary tract obstruction. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Clinical Manifestations, p. 1763.

x A nurse is reviewing the history of a client who is experiencing difficulty sustaining an erection. Which of the following might the nurse suspect as a possible contributing factor? Lower back pain Hypertension Sinus infections Asthma

Hypertension Explanation: Hypertension may be a contributing factor because some types of antihypertensive agents can reduce a male's ability to achieve or sustain an erection. A history of lower back pain, sinus infections, or asthma is unrelated to erectile dysfunction. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Erectile Dysfunction, p. 1756.

A patient comes to the clinic with complaints of inability to sustain an erection and is prescribed a PDE-5 inhibitor, sildenafil (Viagra). What medication should the nurse caution the patient about taking with this medication? Isosorbide (Isordil) Lisinopril (Prinivil) Diphenhydramine (Benadryl) Levothyroxine (Synthroid)

Isosorbide (Isordil) Explanation: These agents are contraindicated in men who take organic nitrates (e.g., isosorbide [Isordil], nitroglycerin), because taken together, these medications can cause side effects such as severe hypotension (Lee, 2011; Porth & Matfin, 2009; Wein et al., 2012). Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Pharmacologic Therapy, p. 1759.

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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Table 59-2, p. 1758.

After a radical prostatectomy for prostate cancer, a client has an indwelling catheter removed. The client then begins to have periods of incontinence. During the postoperative period, which intervention should be implemented first? Kegel exercises Fluid restriction Artificial sphincter use Self-catheterization

Kegel exercises Explanation: Kegel exercises are noninvasive and are recommended as the initial intervention for incontinence. Fluid restriction is useful for the client with increased detrusor contraction related to acidic urine. Artificial sphincter use isn't a primary intervention for post-prostatectomy incontinence. Self-catheterization may be used as a temporary measure but isn't a primary intervention. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Chart 59-3, p. 1767.

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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Potential Catheter Problems, p. 1776.

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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Gerontologic Considerations, p. 1754.

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 strong 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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Chart 59-7, p. 1782.

The nurse is reviewing the history of a client with erectile dysfunction. Which of the following would the nurse least likely identify as contributing to the client's condition? History of type 2 diabetes mellitus for 10 years Use of metoprolol for treating hypertension History of depression treated with fluoxetine New onset of anemia being treated with iron supplements

New onset of anemia being treated with iron supplements Explanation: Anemia and iron supplements are not associated with erectile dysfunction. Diabetes, depression, and certain medications such as metoprolol and fluoxetine are associated with erectile dysfunction. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Erectile Dysfunction, p. 1756.

A 59-year-old African American man has opted for hormonal androgen deprivation therapy (ADT) to treat his prostate cancer. Which surgical procedures is the client most likely to undergo? Orchiectomy Circumcision Vasectomy Hydrocelectomy

Orchiectomy Explanation: ADT is commonly used to suppress androgenic stimuli to the prostate by decreasing the level of circulating plasma testosterone or interrupting the conversion to or binding of dihydrotestosterone (DHT). As a result, the prostatic epithelium atrophies (decreases in size). This effect is accomplished by an orchiectomy (removal of the testes). Circumcision is excision of the foreskin, or prepuce, of the glans penis. Vasectomy is the ligation and transection of part of the vas deferens to prevent the passage of the sperm from the testes. Hydrocelectomy describes the surgical repair of a hydrocele, a collection of fluid in the tunica vaginalis. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, p. 1770.

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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, p. 1770.

A client recovering from a prostatectomy reports ongoing bladder spasms. Which action(s) will the nurse take to reduce the client's discomfort? Select all that apply. Prepare a sitz bath. Provide flavoxate as prescribed. Manipulate the indwelling catheter. Apply warm compresses to the pubis. Reduce the amount of bladder irrigant.

Prepare a sitz bath. Provide flavoxate as prescribed. Apply warm compresses to the pubis. Explanation: After a prostatectomy, the client may experience bladder spasms, an urgency to void, or a feeling of fullness or pressure in the bladder. A sitz bath will help relieve the spasms. Flavoxate is a medication that relaxes the smooth muscles to ease the spasms. Warm compresses to the pubis is another practice that helps to relieve bladder spasms. The indwelling catheter should not be manipulated for any reason. The flow of bladder irrigant is prescribed and should not be altered.

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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Chart 59-6: Patient Education; Testicular Self-Examination, p. 1781.

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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Chart 59-3, p. 1767.

Which condition is associated with the buildup of fibrous plaques in the sheath of the corpus cavernosum, causing curvature of the penis when it is erect? Bowen's disease Phimosis Peyronie's disease Priapism

Peyronie's disease Explanation: Peyronie's disease may require surgical removal of the plaques when the disease makes sexual intercourse painful, difficult, or impossible. Bowen's disease refers to a form of squamous cell carcinoma of the penile shaft in situ. Phimosis refers to the condition in which the foreskin is constricted so that it cannot be retracted over the glans. Priapism refers to an uncontrolled, persistent erection of the penis occurring from either neural or vascular causes. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, p. 1785.

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? DRE PSA Prostate biopsy Cystoscopy

Prostate biopsy Explanation: If prostate cancer is detected early, the likelihood of cure is high (Eggert, 2010). It can be diagnosed through an abnormal finding with the digital rectal examination (DRE), serum prostate-specific antigen (PSA), and ultrasound-guided transrectal ultrasound (TRUS) with biopsy. Detection is more likely with the use of combined diagnostic procedures. The diagnosis of prostate cancer is confirmed by a histologic examination of tissue removed surgically by transurethral resection of the prostate (TURP), open prostatectomy, or ultrasound-guided transrectal needle biopsy. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Assessment and Diagnostic Findings, p. 1765.

A patient is scheduled for a transurethral resection (TUR). The nurse is aware that a disadvantage of this surgical approach is: Recurrent urethral obstruction. Possible damage to the external sphincter. Increased hemorrhage from the prostatic venous plexus. A high incidence of impotence.

Recurrent urethral obstruction. Explanation: There are six operative procedures for prostatic disorders. Recurrent urethral obstruction is a disadvantage of a TUR or TURP. The other disadvantages refer to other surgeries. Refer to Table 34-4 in the text. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Transurethral Resection of the Prostate, p. 1771.

A client has been diagnosed with epididymitis after examination and diagnostic tests. What treatments would the nurse expect the healthcare provider to order? Select all that apply. Scrotal elevation Comfort measures Cold compresses Frequent ejaculations Exercise plan

Scrotal elevation Comfort measures Cold compresses Explanation: Supportive interventions for epididymitis include reduction in physical activity, scrotal support and elevation, ice packs, anti-inflammatory agents, analgesics (including nerve blocks), and sitz baths. Urethral instrumentation (e.g., catheter insertion) and frequent ejaculations are avoided. The client is observed for scrotal abscess formation. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, p. 1779.

A nurse is providing preoperative teaching to a client with prostate cancer who is scheduled to undergo a radical prostatectomy. When describing the surgery, the nurse would identify which structures as being removed? Select all that apply. Seminal vesicles Tips of vas deferens Testes Bladder Ureters

Seminal vesicles Tips of vas deferens Explanation: A radical prostatectomy involves removal of the prostate gland, seminal vesicles, tips of the vas deferens, and often the surrounding fat, nerves, and blood vessels. The testes, bladder, and ureters are not removed during this procedure. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Surgical Management, p. 1765.

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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Digital Rectal Examination, p. 1755.

A patient comes to the emergency department and tells the nurse, "I took a pill to help me perform and then passed out." The nurse is assessing the patient and finds a nitroglycerin patch on his back. What is the first intervention the nurse must perform? Take the patient's blood pressure. Ask the patient to obtain a urine specimen. Start an IV. Administer atropine 0.5 mg.

Take the patient's blood pressure. Explanation: Based on the patient's comments, he is most likely taking a phosphodiesterase type 5 (PDE-5) inhibitor, which is an oral medication used to treat erectile dysfunction. The most common side effects of this medication include headache, flushing, dyspepsia, diarrhea, nasal congestion, and lightheadedness. These agents are contraindicated in men who take organic nitrates (e.g., isosorbide [Isordil], nitroglycerin), because taken together, these medications can cause side effects such as severe hypotension. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Pharmacologic Therapy, p. 1759.

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. Testicular cancer is very difficult to diagnose. Testicular cancer is the number one cause of cancer deaths in males. Testicular cancer is more common in older men.

Testicular cancer is a highly curable type of cancer. Explanation: Testicular cancer is highly curable, particularly when it's treated in its early stage. Self-examination allows early detection and facilitates the early initiation of treatment. The highest mortality rates from cancer among men are in men with lung cancer. Testicular cancer is found more commonly in younger, not older, men. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Testicular Cancer, p. 1780.

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 student 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, tenderness 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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Testicular Torsion, p. 1779.

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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Table 59-4, p. 1772.

The client states to the nurse that he is very anxious about having prostate cancer ever since his prostate-specific antigen (PSA) test came back elevated. The client asks, "Which diagnostic test produces definitive results if cancer is present?" The nurse is most correct to state which of the following? Transrectal ultrasonography Tissue biopsy Tumor marker studies Digital rectal exam

Tissue biopsy Explanation: Obtaining an actual piece of the tissue and analyzing it for cancer is a definitive test when cancer is found. A transrectal ultrasonography is a test to view the prostate gland from different angles. This test provides additional data on the status of the prostate gland. The tumor marker studies include the prostate-specific antigen (PSA) level. This antigen indicates a potential problem but is not definitive. PSA elevations have been noted for reasons other than cancer. A digital rectal exam provided data on the shape, size, and texture of the prostate gland. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Prostate Fluid or Tissue Analysis, p. 1756.

Which therapy uses low-level radiofrequencies to produce localized heat that destroys prostate tissue? Transurethral needle ablation Microwave thermotherapy Saw palmetto Resection

Transurethral needle ablation Explanation: Transurethral needle ablation uses low-level radiofrequencies to produce localized heat that destroys prostate tissue while sparing the urethra, nerves, muscles, and membranes. Sal palmetto is a herbal product used to treat the symptoms associated with benign prostatic hyperplasia. Microwave thermotherapy involves the application of heat to the prostatic tissue. Resection of the prostate can be performed with ultrasound guidance. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Minimally Invasive Therapy, p. 1764.

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) Suprapubic prostatectomy Retropubic prostatectomy Transurethral laser incision of the prostate

Transurethral resection of the prostate (TURP) Explanation: TURP is the most widely used procedure for prostate gland removal. Because it requires no incision, TURP is especially suitable for men with relatively minor prostatic enlargements and for those who are poor surgical risks. Suprapubic prostatectomy, retropubic prostatectomy, and transurethral laser incision of the prostate are less common procedures; each requires an incision. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Surgical Resection, p. 1764.

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? Erosion of penile or urethral tissue Underinflation or bulging of the cylinders during inflation Erosion of scrotal, bowel, or bladder tissue Migration of the cylinders, pump, or reservoir from their intended location

Underinflation or bulging of the cylinders during inflation Explanation: Malfunction of the device is characterized by the underinflation, bulging of the cylinders during inflation, and a loss of fluid from the implant. Erosion of penile or urethral tissue occurs due to a mis-sized implant, pressure, or friction of the implanted cylinders. Erosion of scrotal, bowel, or bladder tissue occurs if an implant with a fluid reservoir is used. Migration of the cylinders, pump, or reservoir from their intended location is accompanied by pain, tenderness, and dysfunction of components that are part of the device. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, Penile Implants, p. 1759.

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. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders, p. 1771.