Lung & Prostate Cancer & BPH

1. To determine the severity of the symptoms for a patient with benign prostatic hyperplasia (BPH), the nurse will ask the patient about blood in the urine. lower back or hip pain. force of urinary stream. erectile dysfunction (ED).

force of urinary stream.

The nurse reviews the laboratory results of a patient who is receiving chemotherapy. Which laboratory result is most important to report to the health care provider? 1. Hematocrit 30% 2. Platelets 95,000/μL 3. Hemoglobin 10 g/L 4. White blood cells (WBC) 2700/μL

White blood cells (WBC) 2700/μL

6. The nurse will plan to teach the patient scheduled for photovaporization of the prostate (PVP) that urine will appear bloody for several days. how to care for an indwelling urinary catheter. that symptom improvement takes 2 to 3 weeks. about complications associated with urethral stenting.

how to care for an indwelling urinary catheter.

After change-of-shift report on the oncology unit, which patient should the nurse assess first? 1. Patient who has a platelet count of 82,000/μL after chemotherapy 2. Patient who has xerostomia after receiving head and neck radiation 3. Patient who is neutropenic and has a temperature of 100.5° F (38.1° C) 4. Patient who is worried about getting the prescribed long-acting opioid on time

Patient who is neutropenic and has a temperature of 100.5° F (38.1° C)

A patient develops neutropenia after receiving chemotherapy. Which information about ways to prevent infection will the nurse include in the teaching plan (select all that apply)? 1. Cook food thoroughly before eating. 2. Choose low fiber, low residue foods. 3. Avoid public transportation such as buses. 4. Use rectal suppositories if needed for constipation. 5. Talk to the oncologist before having any dental work.

1. Cook food thoroughly before eating. 3. Avoid public transportation such as buses. 5. Talk to the oncologist before having any dental work.

The nurse receives change-of-shift report on the oncology unit. Which patient should the nurse assess first? 1. A 35-yr-old patient who has wet desquamation associated with abdominal radiation 2. A 42-yr-old patient who is sobbing after receiving a new diagnosis of ovarian cancer 3. A 24-yr-old patient who received neck radiation and has blood oozing from the neck 4. A 56-yr-old patient who developed a new pericardial friction rub after chest radiation

A 24-yr-old patient who received neck radiation and has blood oozing from the neck

29. The health care provider prescribes the following interventions for a patient with acute prostatitis caused by Escherichia coli. Which intervention should the nurse question? Give trimethoprim/sulfamethoxazole 1 tablet daily for 28 days. Administer ibuprofen 400 mg every 8 hours as needed for pain. Instruct patient to avoid sexual intercourse until treatment is complete. Catheterize the patient as needed if symptoms of urinary retention develop.

Catheterize the patient as needed if symptoms of urinary retention develop.

23. After a transurethral resection of the prostate (TURP), a 64-yr-old patient with continuous bladder irrigation complains of painful bladder spasms. The nurse observes clots in the urine. Which action should the nurse take first? Increase the flow rate of the bladder irrigation. Administer the prescribed IV morphine sulfate. Give the patient the prescribed belladonna and opium suppository. Manually instill and then withdraw 50 mL of saline into the catheter.

Manually instill and then withdraw 50 mL of saline into the catheter.

The nurse is caring for a patient who has just had a thoracentesis. Which assessment information obtained by the nurse is a priority to communicate to the health care provider? O2 saturation is 88%. Blood pressure is 155/90 mm Hg. Pain level is 5 (on 0 to 10 scale) with a deep breath. Respiratory rate is 24 breaths/minute when lying flat.

O2 saturation is 88%. O2 saturation would be expected to improve after a thoracentesis. A saturation of 88% indicates that a complication such as pneumothorax may be occurring. The other assessment data also indicate a need for ongoing assessment or intervention, but the low O2 saturation is the priority.

The nurse supervises the care of a patient with a temporary radioactive cervical implant. Which action by unlicensed assistive personnel (UAP), if observed by the nurse, would require an intervention? 1. The UAP flushes the toilet once after emptying the patient's bedpan. 2. The UAP stands by the patient's bed for 30 minutes talking with the patient. 3. The UAP places the patient's bedding in the laundry container in the hallway. 4. The UAP gives the patient an alcohol-containing mouthwash to use for oral care.

The UAP stands by the patient's bed for 30 minutes talking with the patient.

3. The health care provider prescribes finasteride (Proscar) for a patient who has benign prostatic hyperplasia (BPH). When teaching the patient about the drug, the nurse informs him that he should change position from lying to standing slowly to avoid dizziness. his interest in sexual activity may decrease while he is taking the medication. improvement in the obstructive symptoms should occur within about 2 weeks. he will need to monitor his blood pressure frequently to assess for hypertension.

his interest in sexual activity may decrease while he is taking the medication.

10. A 70-yr-old patient who has had a transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH) is being discharged from the hospital today. Which patient statement indicates a need for the nurse to provide additional instruction? "I should call the doctor if I have incontinence at home." "I will avoid driving until I get approval from my doctor." "I should schedule yearly appointments for prostate examinations." "I will increase fiber and fluids in my diet to prevent constipation."

"I should call the doctor if I have incontinence at home."

16. The following patients call the outpatient clinic. Which phone call should the nurse return first? A 44-yr-old patient who has bloody discharge after a hysteroscopy earlier today A 64-yr-old patient who is experiencing shoulder pain after a laparoscopy yesterday A 34-yr-old patient who is short of breath after having a pelvic CT with contrast dye A 54-yr-old patient who has severe breast tenderness following a needle aspiration breast biopsy

A 34-yr-old patient who is short of breath after having a pelvic CT with contrast dye

2. A patient who has been recently diagnosed with benign prostatic hyperplasia (BPH) tells the nurse that he does not want to have a transurethral resection of the prostate (TURP) because it might affect his ability to have sexual intercourse. Which action should the nurse take? Discuss alternative methods of sexual expression. Teach about medication for erectile dysfunction (ED). Clarify that TURP does not commonly affect erection. Offer reassurance that fertility is not affected by TURP.

Clarify that TURP does not commonly affect erection.

34. When caring for a patient with continuous bladder irrigation after having transurethral resection of the prostate, which action could the nurse delegate to unlicensed assistive personnel (UAP)? Teach the patient how to perform Kegel exercises. Report any complaints of pain or spasms to the nurse. Monitor for increases in bleeding or presence of clots. Increase the flow rate of the irrigation if clots are noted.

Report any complaints of pain or spasms to the nurse.

The nurse prepares a patient with a left-sided pleural effusion for a thoracentesis. How should the nurse position the patient? High-Fowler's position with the left arm extended Supine with the head of the bed elevated 30 degrees On the right side with the left arm extended above the head Sitting upright with the arms supported on an over bed table

Sitting upright with the arms supported on an over bed table The upright position with the arms supported increases lung expansion, allows fluid to collect at the lung bases, and expands the intercostal space so that access to the pleural space is easier. The other positions would increase the work of breathing for the patient and make it more difficult for the health care provider performing the thoracentesis.

When caring for a patient who is pancytopenic, which action by unlicensed assistive personnel (UAP) indicates a need for the nurse to intervene? 1. The UAP assists the patient to use dental floss after eating. 2. The UAP adds baking soda to the patient's saline oral rinses. 3. The UAP puts fluoride toothpaste on the patient's toothbrush. 4. The UAP has the patient rinse after meals with a saline solution.

The UAP assists the patient to use dental floss after eating.

4. The nurse will anticipate that a 61-yr-old patient who has an enlarged prostate detected by digital rectal examination (DRE) and an elevated prostate specific antigen (PSA) level will need teaching about cystourethroscopy. uroflowmetry studies. magnetic resonance imaging (MRI). transrectal ultrasonography (TRUS).

transrectal ultrasonography (TRUS).

19. The nurse taking a focused health history for a patient with possible testicular cancer will ask the patient about a history of testicular torsion. testicular trauma. undescended testicles. sexually transmitted infection (STI).

undescended testicles.

31. The nurse is obtaining the pertinent health history for a man who is being evaluated for infertility. Which question focuses on a possible cause of infertility? "Are you circumcised?" "Have you had surgery for phimosis?" "Do you use medications to improve muscle mass?" "Is there a history of prostate cancer in your family?"

"Do you use medications to improve muscle mass?"

24. A 22-yr-old patient tells the nurse at the health clinic that he has recently had some problems with erectile dysfunction. Which question should the nurse ask to assess for possible etiologic factors in this age group? "Do you use recreational drugs or drink alcohol?" "Do you experience an unusual amount of stress?" "Do you have cardiovascular or peripheral vascular disease?" "Do you have a history of an erection that lasted for 6 hours or more?"

"Do you use recreational drugs or drink alcohol?"

1. Which question should the nurse ask when assessing a 60-yr-old patient who has a history of benign prostatic hyperplasia (BPH)? "Have you noticed any unusual discharge from your penis?" "Has there been any change in your sex life in the past year?" "Has there been a decrease in the force of your urinary stream?" "Have you been experiencing any difficulty in achieving an erection?"

"Has there been a decrease in the force of your urinary stream?"

The nurse at the clinic is interviewing a 64-yr-old woman who is 5 feet, 3 inches tall and weighs 125 lb (57 kg). The patient has not seen a health care provider for 20 years. She walks 5 miles most days and has a glass of wine two or three times a week. Which topics will the nurse plan to include in patient teaching about cancer screening and decreasing cancer risk (select all that apply)? 1. Pap testing 2. Tobacco use 3. Sunscreen use 4. Mammography 5. Colorectal screening

1. Pap testing 3. Sunscreen use 4. Mammography 5. Colorectal screening

25. A 58-yr-old patient with erectile dysfunction (ED) tells the nurse he is interested in using sildenafil (Viagra). Which action should the nurse take first? Assure the patient that ED is common with aging. Ask the patient about any prescription drugs he is taking. Tell the patient that Viagra does not always work for ED. Discuss the common adverse effects of erectogenic drugs.

Ask the patient about any prescription drugs he is taking.

15. A 27-yr-old patient who has testicular cancer is being admitted for a unilateral orchiectomy. The patient does not talk to his wife and speaks to the nurse only to answer the admission questions. Which action is appropriate for the nurse to take? Teach the patient and the wife that impotence is unlikely after unilateral orchiectomy. Ask the patient if he has any questions or concerns about the diagnosis and treatment. Inform the patient's wife that concerns about sexual function are common with this diagnosis. Document the patient's lack of communication on the health record and continue preoperative care.

Ask the patient if he has any questions or concerns about the diagnosis and treatment.

A patient who is being treated for stage IV lung cancer tells the nurse about new-onset back pain. Which action should the nurse take first? 1. Give the patient the prescribed PRN opioid. 2. Assess for sensation and strength in the legs. 3. Notify the health care provider about the symptoms. 4. Teach the patient how to use relaxation to reduce pain.

Assess for sensation and strength in the legs.

The nurse is caring for a patient who smokes two packs/day. Which action by the nurse could help reduce the patient's risk of lung cancer? 1. Teach the patient about the seven warning signs of cancer. 2. Plan to monitor the patient's carcinoembryonic antigen (CEA) level. 3. Teach the patient about annual chest x-rays for lung cancer screening. 4. Discuss risks associated with cigarette smoking during each patient encounter.

Discuss risks associated with cigarette smoking during each patient encounter.

21. A patient who has benign prostatic hyperplasia (BPH) with urinary retention is admitted to the hospital with elevated blood urea nitrogen (BUN) and creatinine. Which prescribed therapy should the nurse implement first? Infuse normal saline at 50 mL/hr. Insert a urinary retention catheter. Draw blood for a complete blood count. Schedule pelvic magnetic resonance imaging

Insert a urinary retention catheter.

14. Which information will the nurse plan to include when teaching a young adult who has a family history of testicular cancer about testicular self-examination? Testicular self-examination should be done at least weekly. Testicular self-examination should be done in a warm room. The only structure normally felt in the scrotal sac is the testis. Call the health care provider if one testis is larger than the other.

Testicular self-examination should be done in a warm room.

33. Which action by the unlicensed assistive personnel (UAP) who are assisting with the care of male patients with reproductive problems indicates that the nurse should provide more teaching? The UAP apply a cold pack to the scrotum for a patient with mumps orchitis. The UAP help a patient who has had a prostatectomy to put on antiembolism hose. The UAP leave the foreskin pulled back after cleaning the glans of a patient who has a retention catheter. The UAP encourage a high oral fluid intake for patient who had transurethral resection of the prostate yesterday.

The UAP leave the foreskin pulled back after cleaning the glans of a patient who has a retention catheter.

27. Which assessment information collected by the nurse may present a contraindication to a testosterone replacement therapy (TRT)? The patient has noticed a decrease in energy level for a few years. The patient's symptoms have increased steadily over the past few years. The patient has been using sildenafil (Viagra) several times every week. The patient has had a gradual decrease in the force of his urinary stream.

The patient has had a gradual decrease in the force of his urinary stream.

9. The nurse will plan to teach the patient who is incontinent of urine following a radical retropubic prostatectomy to restrict oral fluid intake. do pelvic muscle exercises. perform intermittent self-catheterization. use belladonna and opium suppositories.

do pelvic muscle exercises.

8. The plan of care for a patient immediately after a perineal radical prostatectomy will include decreasing the risk for infection related to urinary incontinence. prolonged urinary stasis. fecal wound contamination. suprapubic catheter placement.

fecal wound contamination.

The nurse teaches a patient who is scheduled for a prostate needle biopsy about the procedure. Which statement, if made by the patient, indicates that teaching was effective? 1. "The biopsy will remove the cancer in my prostate gland." 2. "The biopsy will determine how much longer I have to live." 3. "The biopsy will help decide the treatment for my enlarged prostate." 4. "The biopsy will indicate whether the cancer has spread to other organs."

"The biopsy will help decide the treatment for my enlarged prostate."

A patient with cancer has a nursing diagnosis of imbalanced nutrition: less than body requirements related to altered taste sensation. Which nursing action would address the cause of the patient problem? 1. Add protein powder to foods such as casseroles. 2. Tell the patient to eat foods that are high in nutrition. 3. Avoid giving the patient foods that are strongly disliked. 4. Add spices to enhance the flavor of foods that are served.

3 Avoid giving the patient foods that are strongly disliked.

18. A patient with urinary obstruction from benign prostatic hyperplasia (BPH) tells the nurse, "My symptoms are much worse this week." Which response by the nurse is appropriate? "Have you taken any over-the-counter (OTC) medications recently?" "I will talk to the doctor about a prostate specific antigen (PSA) test." "Have you talked to the doctor about surgery such as transurethral resection of the prostate (TURP)?" "The prostate gland changes in size from day to day, and this may be making your symptoms worse."

"Have you taken any over-the-counter (OTC) medications recently?"

The home health nurse is caring for a patient who has been receiving interferon therapy for treatment of cancer. Which statement by the patient indicates a need for further assessment? 1. "I have frequent muscle aches and pains." 2. "I rarely have the energy to get out of bed." 3. "I experience chills after I inject the interferon." 4. "I take acetaminophen (Tylenol) every 4 hours."

"I rarely have the energy to get out of bed."

32. The following male patients recently arrived in the emergency department. Which one should the nurse assess first? A 19-yr-old patient who is complaining of severe scrotal pain A 60-yr-old patient with a nontender ulceration of the glans penis c. A 64-yr-old patient who has dysuria after brachytherapy for prostate cancer d. A 22-yr-old patient who has purulent urethral drainage and severe back pain

A 19-yr-old patient who is complaining of severe scrotal pain

A nurse assesses a client after a thoracentesis. Which assessment finding warrants immediate action? a. The client rates pain as a 5/10 at the site of the procedure. b. A small amount of drainage from the site is noted. c. Pulse oximetry is 93% on 2 liters of oxygen. d. The trachea is deviated toward the opposite side of the neck.

ANS: D A deviated trachea is a manifestation of a tension pneumothorax, which is a medical emergency. The other findings are normal or near normal.

The nurse is caring for a patient with left-sided lung cancer. Which finding would be most important for the nurse to report to the health care provider? 1. Hematocrit of 32% 2. Pain with deep inspiration 3. Serum sodium of 126 mEq/L 4. Decreased breath sounds on left side

Serum sodium of 126 mEq/L

30. Several patients call the urology clinic requesting appointments with the health care provider as soon as possible. Which patient will the nurse schedule to be seen first? A 22-yr-old patient who has noticed a firm, nontender lump on his scrotum A 35-yr-old patient who is concerned that his scrotum "feels like a bag of worms" A 40-yr-old patient who has pelvic pain while being treated for chronic prostatitis A 70-yr-old patient who is reporting frequent urinary dribbling after a prostatectomy

A 22-yr-old patient who has noticed a firm, nontender lump on his scrotum

22. The nurse in the clinic notes elevated prostate specific antigen (PSA) levels in the laboratory results of these patients. Which patient's PSA result is not expected to be elevated? A 38-yr-old patient who is being treated for acute prostatitis A 48-yr-old patient whose father died of metastatic prostate cancer A 52-yr-old patient who goes on long bicycle rides every weekend A 75-yr-old patient who uses saw palmetto to treat benign prostatic hyperplasia (BPH)

A 48-yr-old patient whose father died of metastatic prostate cancer

26. The nurse in a health clinic receives requests for appointments from several patients. Which patient should be seen by the health care provider first? A 48-yr-old patient who has perineal pain and a temperature of 100.4° F A 58-yr-old patient who has a painful erection that has lasted more than 6 hours A 38-yr-old patient who reports that he had difficulty maintaining an erection twice last week A 68-yr-old patient who has pink urine after a transurethral resection of the prostate (TURP) 3 days ago

A 58-yr-old patient who has a painful erection that has lasted more than 6 hours

A nurse is caring for a client who is scheduled to undergo a thoracentesis. Which intervention should the nurse complete prior to the procedure? a. Measure oxygen saturation before and after a 12-minute walk. b. Verify that the client understands all possible complications. c. Explain the procedure in detail to the client and the family. d. Validate that informed consent has been given by the client.

ANS: D A thoracentesis is an invasive procedure with many potentially serious complications. Verifying that the client understands complications and explaining the procedure to be performed will be done by the physician or nurse practitioner, not the nurse. Measurement of oxygen saturation before and after a 12-minute walk is not a procedure unique to a thoracentesis.

5. Which information about continuous bladder irrigation will the nurse teach to a patient who is being admitted for a transurethral resection of the prostate (TURP)? Bladder irrigation decreases the risk of postoperative bleeding. Hydration and urine output are maintained by bladder irrigation. Antibiotics are infused continuously through the bladder irrigation. Bladder irrigation prevents obstruction of the catheter after surgery.

Bladder irrigation prevents obstruction of the catheter after surgery.

A patient with a pleural effusion is scheduled for a thoracentesis. Which action should the nurse take to prepare the patient for the procedure? Start a peripheral IV line to administer sedatives. Position the patient sitting up on the side of the bed. Obtain a collection device to hold 3 liters of pleural fluid. Remind the patient not to eat or drink anything for 6 hours.

Position the patient sitting up on the side of the bed. When the patient is sitting up, fluid accumulates in the pleural space at the lung bases and can more easily be located and removed. The patient does not usually require sedation for the procedure, and there are no restrictions on oral intake because the patient is not sedated or unconscious. Usually only 1000 to 1200 mL of pleural fluid is removed at one time. Rapid removal of a large volume can result in hypotension, hypoxemia, or pulmonary edema.

Which action should the nurse take when caring for a patient who is receiving chemotherapy and complains of problems with concentration? 1. Teach the patient to rest the brain by avoiding new activities. 2. Teach that "chemo-brain" is a short-term effect of chemotherapy. 3. Report patient symptoms immediately to the health care provider. 4. Suggest use of a daily planner and encourage adequate rest and sleep.

Suggest use of a daily planner and encourage adequate rest and sleep.

11. The nurse will inform a patient with cancer of the prostate that side effects of leuprolide (Lupron) may include a. flushing. b. dizziness. c. infection. d. incontinence.

a. flushing.

7. A 53-yr-old patient is scheduled for an annual physical examination. The nurse will plan to teach the patient about the purpose of urinalysis collection. uroflowmetry studies. prostate specific antigen (PSA) testing. transrectal ultrasound scanning (TRUS).

prostate specific antigen (PSA) testing.

The nurse will plan to teach a 51-yr-old man who is scheduled for an annual physical examination about a(n) increased risk for testicular cancer. possible changes in erectile function. normal decreases in testosterone level. prostate specific antigen (PSA) testing.

prostate specific antigen (PSA) testing.