MedSurg Ch. 59

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?

Performing perineal exercises frequently throughout the day

Which of the following patients is most likely to develop prostate cancer according to a nurse working at a health screening at the local mall?

A 56-year-old African American man

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?

After a warm bath or shower

After teaching about self-care measures to a client who has been diagnosed with prostatitis, the nurse determines that the teaching was successful when the client states which of the following?

"I should avoid fluids like coffee and tea."

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 trouble getting started when I urinate, often straining to do so."

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?

"The best time to do it is once a month after I take my warm morning shower."

A 50-year-old is diagnosed with stage II prostate cancer. The client is upset and verbalizes that he would rather die than have any surgery. Which is the best response by the nurse?

"What concerns you most about having surgery?"

A client is having prostate-specific antigen (PSA) testing done. Which result would the nurse identify as abnormal?

4.6 nanograms/milliliter Normal prostate-specific antigen (PSA) levels are less than 4.0 nanograms/milliliter (ng/mL). A level of 4.6 ng/mL would be considered abnormal.

Which client would the nurse identify as being at highest risk for the development of testicular cancer?

A 25-year-old male with a history of cryptorchidism

Which of the following involves implantation of interstitial radioactive seeds under anesthesia to treat prostate cancer?

Brachytherapy

Which of the following is inconsistent with a digital rectal examination?

Can reveal a hydrocele

Which of the following patient populations have the highest risk for developing testicular cancer?

Caucasian American

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?

Check BP

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?

Cryptorchidism

Which of the following is a failure of one or both or both of the testes to descend into the scrotum?

Cryptorchidism

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 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.

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 leave the constricting band in place for longer than 1 hour to avoid penile injury.

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.

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.

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?

Escherichia coli

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 I.V. 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

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?

Gynecomastia

Which of the following is a component of the patient teaching that helps the nurse assist a patient 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.

Which of the following may result if prostate cancer invades the urethra or bladder?

Hematuria

Which of the following should nurses teach all men, especially those who have had cryptorchidism?

How to perform a testicular self-examination

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

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?

Ibuprofen

When assessing a client with benign prostatic hypertrophy, which of the following would the nurse expect the client to report as the initial complaint?

Increased effort to void

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."

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?

Light yellow and clear

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?

Maintaining optimal bladder emptying

Which of the following terms refers to the surgical removal of one of the testes

Orchiectomy

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?

Plasma testosterone levels decrease

Which of the following are age-related changes affecting the male reproductive system?

Plasma testosterone levels decrease.

Which of the following cancers rank second as the cause of death in American men?

Prostate

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?

TURP

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 exhale when the physician inserts a gloved finger into the rectum

Which of the following should be included as part of the home care instructions for a patient with epididymitis and orchitis?

Take prescribed antibiotics.

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.

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."

Which of the following instructions regarding future sexual activity should a nurse give a patient with a vasectomy?

Use a reliable method of contraception until the physician ensures that sperm no longer are present

Following a vasectomy, which is the most important instruction to provide to the client?

Use another form a birth control until further notice.

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?

Use of radioactive seeds implanted into the prostate

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.

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 must be sure to use a condom for 2 weeks after implantation and then it will no longer be necessary."

A 51-year-old 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 your client education session, which of the following recommendations do you make?

all options are correct

An 80-year-old client is being seen by the urologist because of erectile dysfunction. This client has a history of hypertension and heart disease. Which of the following would be the most likely cause of his erectile dysfunction?

all options are correct

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?

breast tenderness

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.

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 fat diet

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 may experience headache and some flushing with this drug."

The nurse is teaching a client with acute prostatitis about measures to promote comfort and self-care. Which of the following would the nurse include in the teaching plan? Select all that apply.

• Avoid drinking coffee, tea, and colas. • Avoid sitting for prolonged periods. • Use hot sitz baths several times a day.

The nurse is providing instruction for testicular self-examination to a group of young adolescents. Which is the most correct examination technique?

Palpate each testicle separately, following a warm shower.

A young client is admitted with torsion of the spermatic cord. Which is the most appropriate action to be taken by the nurse?

Keep the client NPO.

A 57-year-old client is being seen at the free clinic where you practice nursing. He has an edematous glans penis, pain, and an extremely constricted foreskin. What treatment would you expect the physician to prescribe?

Circumcision

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

What should a male client older than age 50 do to help ensure early identification of prostate cancer?

Have a digital rectal examination and prostate-specific antigen (PSA) test done yearly.

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

TURP

Consuming a diet high in which of the following has been found to increase the risk for prostate cancer?

Red meats

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) 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 antimuscarinic, antispasmodic drug used for treatment of overactive bladder.