Chapter 34: PrepU - Nursing Management: Patients With Male Reproductive Disorders

Which of the following herbal remedies is used to treat symptoms of benign prostatic hypertrophy (BPH)? 1- Saw palmetto 2- Garlic 3- Gingko 4- Green tea

1

Erectile dysfunction would not be characterized as the inability to: 1- achieve an erection after sexual activity. 2- achieve an erection. 3- achieve or maintain an erection that is sufficiently rigid for sexual activity. 4- sustain erection for a satisfactory period of time.

1

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? 1- Finasteride (Proscar) 2- Tamsulosin (Flomax) 3- Terazosin (Hytrin) 4- Oxybutynin chloride (Ditropan)

1

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? 1- Monthly testicular self-examination (TSE) 2- Annual digital rectal examination (DRE) after age 35 years 3- Annual prostate-specific antigen (PSA) testing after age 40 years 4- Transrectal ultrasound every 5 years after age 50 years

1

Which term refers to the surgical removal of one or both testes? 1- Orchiectomy 2- Circumcision 3- Vasectomy 4- Hydrocelectomy

1

Which assessment finding would create the greatest risk to a client ordered a phosphodiesterase inhibitor such as sildenafil? 1- Use of nitrates 2- History of hypertension 3- Type 2 diabetes 4- Use of diuretics

1

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? 1- Have regular prostate-specific antigen (PSA) levels tested and repeat lymph node biopsies. 2- Avoid sexual intercourse for at least 2 years. 3- Undertake pelvic floor retraining exercises. 4- Avoid strenuous exercises, especially lifting.

1

Which of the following is the most common organism implicated in prostatitis? 1- Escherichia coli 2- Staphylococcus aureus 3- Streptococcus 4- Methicillin-resistant Staphylococcus aureus

1

Which of the following may result if prostate cancer invades the urethra or bladder? 1- Hematuria 2- Backache 3- Hip pain 4- Rectal discomfort

1

Which of the following would a nurse include in a teaching plan for a client with benign prostatic hyperplasia who is not yet a candidate for surgery? 1- Maintaining optimal bladder emptying 2- Using appropriate coping to allay anxiety 3- Performing deep breathing exercises periodically 4- Doing leg exercises at least daily

1

Which of the following would be most important to include in a teaching plan for a client who has had a vasectomy? 1- Using a reliable method of contraception for several weeks. 2- Applying warm compresses to the scrotum for the first 24 hours. 3- Taking a prescribed opioid analgesic for pain relief. 4- Resuming sexual activity in 24 to 48 hours.

1

Which should be included as part of the home care instructions for a client with epididymitis and orchitis? 1- Take prescribed antibiotics. 2- Undertake lifting exercises. 3- Apply ice to the area after scrotal swelling subsides. 4- Resume sexual intercourse.

1

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 1- Dysuria 2- Nocturia 3- Perineal pain 4- Decreased force of urinary stream

1,2,3

A nurse is conducting an exam of a male client's reproductive system. Which finding would the nurse interpret as a normal age-related change? Select all that apply. 1- reports of taking longer to achieve an erection 2- urinary frequency 3- dysuria 4- testicular enlargement 5- reports of decreased libido

1,2,5

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? 1- Using a bearing down motion to promote complete bladder emptying when voiding 2- Performing perineal exercises frequently throughout the day 3- Engaging in strenuous exercise to strengthen abdominal muscles 4- Waiting to urinate for 5 to 10 minutes after feeling the initial urge

2

A 30-year-old patient is receiving analgesics and antibiotics for the treatment of epididymitis. The patient normally leads an active lifestyle and is concerned about the effect that his recovery will have on his routines. What should the nurse teach the patient about lifestyle modifications during his recovery? 1- The patient should try to maintain his normal activity level if possible. 2- The patient should avoid lifting and sexual activity until his infection is resolved. 3- The patient should emphasize light weight-bearing activity while recovering to strengthen his core muscles. 4- The patient should stay on bed rest until his epididymitis has resolved.

2

A 68-year-old man comes to the clinic complaining that he is having difficulty obtaining an erection. When reviewing the patient's history, what might the nurse note that contributes to erectile dysfunction? 1- Recent antibiotic use 2- History of heavy alcohol use 3- Increasing age 4- Lack of exercise

2

The nurse is providing instruction for testicular self-examination to a group of young adolescents. Which is the most correct examination technique? 1- Palpate both testicles simultaneously for comparison. 2- Palpate each testicle separately, following a warm shower. 3- Palpate the front of the testicle first, where most tumors are found. 4- Palpate for a soft, round shape with normal ridges on the testicles.

2

The obstructive and irritative symptom complex caused by benign prostatic hypertrophy is called 1- prostatitis. 2- prostatism. 3- prostaglandin. 4- prostatectomy.

2

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? 1- Spironolactone 2- Cimetidine 3- Ibuprofen 4- Methyldopa

3

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? 1- Increased libido 2- Deepening of voice 3- Breast tenderness 4- Enhanced potency

3

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? 1- Erectile dysfunction 2- Prostatitis 3- Cryptorchidism 4- Priaprism

3

A client diagnosed with epididymitis is being discharged from the emergency department. Which of the following would be most important for the nurse to include as part of the client's discharge teaching? 1- "Apply ice to the top of your scrotum to help reduce the swelling." 2- "Engage in sexual intercourse frequently to help drain the area." 3- "If you have a fever, call the physician so he can order an antibiotic right away." 4- "Keep your scrotum elevated on a folded towel until the swelling goes down."

4

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? 1- Need for daily treatments over a 7- to 8-week period 2- Use of radioactive seeds implanted into the prostate 3- Surgical castration to decrease the level of circulating testosterone 4- Use of probes inserted using ultrasound to freeze the tissue

2

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? 1- Ensure greater fluid intake. 2- Ask the client to keep a diet diary. 3- Include fruits in the client's diet. 4- Administer serotonin blockers.

2

The nurse is obtaining a health history from a 58-year-old client stating that he is having difficulty obtaining an erection during sexual activity. The client asks how an "erectile medication" works and if there are any side effects to the medication. The nurse explains the action of the medication and directions for use and warns of which side effect related to the client's history? 1- Asthma with beta-adrenergic inhaler use 2- Hypotension with nitrate use 3- Chronic pain with narcotic use 4- Arthritis with corticosteroid use

2

A nurse is conducting a health promotion class for a group of younger middle-aged men. When discussing the need for a digital rectal exam, the nurse would recommend this exam for every man over age: 1- 35. 2- 40. 3- 45. 4- 50.

4

Which is inconsistent with digital rectal examination (DRE)? 1- Recommended for men older than 40 years of age 2- Assists in screening for cancer of prostate gland 3- Enables examiner to assess size, shape, and consistency of prostate gland 4- Can reveal a hydrocele

4

A nurse is reviewing the history of a client diagnosed with erectile dysfunction. Which information would the nurse interpret as indicating that use of a PDE-5 inhibitor would be contraindicated. 1- use of nitroglycerin for angina 2- history of heart attack 2 years ago 3- hypertension controlled with medications 4- use of antiseizure medications

1

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? 1- Hyperplasia of the prostate gland 2- Thickening of the seminiferous tubules 3- Fibrotic changes of the corpora cavernosa 4- Hypogonadism

1

Consuming a diet high in which of the following has been found to increase the risk for prostate cancer? 1- Red meats 2- Green leafy vegetables 3- Carbohydrates 4- Whole grains

1

A nurse is discussing the importance of testicular self-examination with a client who had cryptorchidism. What should the nurse exclude from the discussion? 1- Regular testicular self-examinations should be performed by all men. 2- It is normal to find that one testis is larger than the other. 3- Locate and palpate the epididymis, a cordlike structure on the top and back of the testicle. 4- Examine the testicles, preferably when warm, such as in the shower.

1

A patient has returned to the floor from the PACU after undergoing a suprapubic prostatectomy. The nurse notes urine leakage around the suprapubic tube. How should the nurse follow up this finding? 1- Give meticulous aseptic care to and around the suprapubic tube 2- Call the urologist immediately 3- Remove the suprapubic tube 4- Administer antispasmodic drugs as ordered

1

A 29-year-old patient has just been told that he has testicular cancer and needs to have surgery. The surgery is scheduled for the following week. That afternoon, the patient calls the nurse and tells her he wants to cancel the surgery because he thinks he might be better off dead. The nurse asks him why he feels that way. The patient states "My wife won't want to have sex with me anymore. He says he feels like he's spoiled a happy, satisfying sex life with his wife and he starts to cry. Based on these statements, which nursing diagnosis would be most appropriate for creating a plan of care for this patient? 1- Situational low self-esteem 2- Inability to function 3- Social isolation 4- Risk for loneliness

1

A 61-year-old man's elevated prostate screening antigen (PSA) levels and abnormal digital rectal examination (DRE) results prompted his care provider to refer him for treatment. The patient has subsequently been diagnosed with prostate cancer and is scheduled for surgery. The nurse should recognize that this patient's plan of nursing care should include interventions to address what potential long-term complication of prostate surgery? 1- Erectile dysfunction 2- Stress incontinence 3- Urge incontinence 4- Abdominal distention

1

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: 1- continuous inflow and outflow of irrigation solution. 2- intermittent inflow and continuous outflow of irrigation solution. 3- continuous inflow and intermittent outflow of irrigation solution. 4- intermittent flow of irrigation solution and prevention of hemorrhage.

1

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? 1- "It should begin in adolescence." 2- "It should begin in men over age 50." 3- "It should be performed in high-risk males over age 30." 4- "It should begin at age 40."

1

A 44-year-old man admits to his nurse that he has been having difficulty attaining and maintaining an erection for the past few years. The patient states that he is deeply embarrassed about this problem and has not previously discussed it with anyone. How can the nurse most accurately respond to this patient's statement? 1- "You're not alone in this. About half of all men over 40 experience this problem at some point." 2- "The important thing is to relax and not think about the problem, because it will then usually resolve itself." 3- "This likely means that there is some relational tension between you and your partner." 4- "Rest assured that this is a physical problem that can be resolved with medication."

1

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? 1- All options are correct. 2- Avoid caffeine. 3- Regularly drain the gland. 4- Complete the prescribed antibiotic treatment.

1

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? 1- All options are correct. 2- hypertension medication 3- atherosclerosis 4- depression

1

A nurse is teaching a male client to perform monthly testicular self-examinations. Which point is appropriate to make? 1- Testicular cancer is a highly curable type of cancer. 2- Testicular cancer is very difficult to diagnose. 3- Testicular cancer is the number one cause of cancer deaths in males. 4- Testicular cancer is more common in older men.

1

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? 1- Take the patient's blood pressure. 2- Ask the patient to obtain a urine specimen. 3- Start an IV. 4- Administer atropine 0.5 mg.

1

A patient on a surgery unit is received continuous bladder irrigation (CBI) to prevent clots in the hours following prostate surgery. Consequently, the nurse is carefully monitoring the patient's intake and output and documenting this hourly. Over the past hour, 3,000 mL of irrigant has infused and 3,150 mL of output has been drained from the patient's collection bag. How should the nurse document this patient's hourly urine output? 1- 150 mL 2- 3150 mL 3- 2850 mL 4- 75 mL

1

Students preparing for a test are reviewing the structure and function of the male reproductive system. They demonstrate understading of the material when they identify which of the following as the site of spermatogenesis? 1- Vas deferens 2- Testes 3- Prostate gland 4- Seminal vesicles

2

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? 1- "I'll have to stay in the hospital for about 3 to 4 days after the surgery." 2- "I'll have a small incision on my lower abdomen after the procedure." 3- "The surgeon is going to remove the entire prostate gland." 4- "The surgeon is going to insert a scope through my urethra to remove a portion of the gland."

4

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: 1- testosterone therapy during childhood. 2- sexually transmitted disease. 3- early onset of puberty. 4- cryptorchidism.

4

Which of the following should nurses teach all men, especially those who have had cryptorchidism? 1- Need for blood tests to measure serum acid phosphatase levels. 2- Importance of regular monitoring of prostate-specific antigen (PSA) levels. 3- Need to undergo a baseline and follow up lymph node biopsies. 4- How to perform a testicular self-examination.

4

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? 1- Discontinue the irrigations. 2- Increase the rate of the IV fluids. 3- Administer a unit of packed red blood cells. 4- Prepare the patient for an ECG.

1

A 58-year-old patient has been diagnosed with acute prostatitis after seeking care for severe perineal pain. The patient's severe leukocytosis has prompted the care team to admit him to the medical unit of the hospital for treatment. The nurse should anticipate that this patient's treatment regimen will include which of the following? 1- Insertion of a suprapubic catheter 2- Administration of IV antibiotics 3- Intermittent urinary catheterization every 2 to 4 hours 4- Administration of beta-adrenergic blockers to relax the prostate

2

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? 1- Apply a scrotal support 2- Prepare the client for surgery 3- Apply a dressing over the scrotum 4- Prepare the client for circumcision

2

A patient has been prescribed sildenafil citrate. What should the nurse teach the patient about this medication? 1- Sexual stimulation is not needed to obtain an erection. 2- The drug should be taken 1 hour prior to intercourse. 3- Facial flushing or headache should be reported to the health care provider immediately. 4- A high dose may result in a permanent change of vision.

2

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? 1- Do not use the device while taking nitrates. 2- Do not leave the constricting band in place for longer than 1 hour to avoid penile injury. 3- Watch for erosion of the prosthesis through the skin. 4- Watch for the development of infection.

2

When assessing a client with benign prostatic hyperplasia, which of the following would the nurse expect the client to report as the initial complaint? 1- Dark brown urine 2- Increased effort to void 3- Narrowing of urinary stream 4- Nocturia

2

Which client would the nurse identify as being at highest risk for the development of testicular cancer? 1- A 45-year-old white male with a history of hypertension 2- A 25-year-old male with a history of cryptorchidism 3- A 39-year-old African American male who is HIV-negative 4- A 75-year-old white male with erectile dysfunction

2

Which is the most common type of prostate surgery? 1- Retropubic prostatectomy 2- Transurethral resection of the prostate 3- Suprapubic prostatectomy 4- Perineal prostatectomy

2

Which nursing assessment finding is most significant in determining the plan of care in a client with erectile dysfunction? 1- Age 2- Medication use 3- Sexual history 4- Undescended testicle

2

Which of the following is the only definitive test that can determine if cancer of the testis is present? 1- Elevated lactate dehydrogenase 2- Tissue biopsy 3- Positive alpha-fetoprotein level 4- Computed tomography (CT) scan of the abdomen

2

Which treatment involves implantation of interstitial radioactive seeds under anesthesia to treat prostate cancer? 1- Hormone therapy 2- Brachytherapy 3- Teletherapy 4- Chemotherapy

2

A patient is recovering in the PACU following a transurethral resection of the prostate (TURP). The patient is receiving continuous bladder irrigation (CBI), and the nurse has observed several clots in the collection bag and tubing. In the last few minutes, output has ceased despite the continued infusion of normal saline through the patient's triple-lumen urinary catheter. How should the nurse respond to this assessment finding? 1- Slow the rate of CBI to half of the previous rate. 2- Reposition the patient to a semi-Fowler's position. 3- Manually irrigate the patient's catheter with normal saline. 4- Remove the triple-lumen catheter and replace it with a double-lumen catheter.

3

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? 1- Erection of the penis 2- Unclean glans 3- Painful swelling 4- Nausea and vomiting

3

Which statement is accurate regarding sildenafil? 1- It can be taken twice daily for increased effect. 2- The medication should be taken right before intercourse. 3- Its side effects include headache, flushing, and dizziness. 4- Sexual stimulation is not needed to produce an erection.

3

A client is having prostate-specific antigen (PSA) testing done. Which result would the nurse identify as abnormal? 1- 2.7 nanograms/milliliter 2- 3.2 nanograms/milliliter 3- 3.8 nanograms/milliliter 4- 4.6 nanograms/milliliter

4