Prostate Cancer NCLEX Qs

The client diagnosed with cancer of the prostate is scheduled to have radiation brachytherapy. Which precautions should the nurse implement? Select all that apply. 1. Place the client in a private room. 2. Wear a dosimeter when entering the room. 3. Encourage visitors to come and stay with the client. 4. Plan to spend extended time with the client. 5. Notify the nuclear medicine technician.

Correct Answer: 1,2, 5. 1. Brachytherapy is the direct implantation of radioactive seeds. The client should be in a private room at the end of the hall to prevent radiation exposure to the rest of the unit. 2. Nurses wear a dosimeter registering the amount of radiation they have been exposed to. When a certain level is reached, the nurse is no longer allowed to care for clients undergoing internal radiation therapy. 3. Visitors are limited while the radiation is in place. 4. In this case, spending extra time with a client is not done. The nurse does only what must be done and leaves the room. 5. The nuclear medicine technician will assist with the placement of the implants and will deliver the implants in a lead-lined container. The technician will also scan any items (linens and wastes) leaving the room for radiation contamination.

4. When a client is receiving hormone replacement for prostate cancer, the nurse should do which of the following? Select all that apply. 1. Inform the client that increased libido is expected with hormone therapy. 2. Reassure the client that erectile dysfunction will not occur as a consequence of hormone therapy. 3. Provide the client the opportunity to communicate concerns and needs. 4. Gynecomastia may occur as a consequence of hormone therapy. 5. Lupron: a gonadotrophic releasing hormone does not decrease testosterone.

Correct Answer: 3, 4. Hormone manipulation deprives tumor cells of androgens or their byproducts and, thereby, alleviates symptoms and retards disease progression. Complications of hormonal manipulation include hot flashes, nausea and vomiting, gynecomastia, and sexual dysfunction. As part of supportive care, provide explanations of diagnostic tests and treatment options and help the client gain some feeling of control over his disease and decisions related to it. To help achieve optimal sexual function, give the client the opportunity to communicate his concerns and sexual needs. Inform the client that decreased libido is expected after hormonal manipulation therapy, and that impotence may result from some surgical procedures and radiation. A psychiatrist is not needed.

The nurse instructs the patient that the most definitive way of diagnosing prostate cancer is... 1. Trans rectal Ultrasonography 2. PSA screening greater than 4 ng/mL 3. Prostate gland with palpable irregularities or induration is suspected to be malignant 4. Prostate Biopsy 5. CT scan followed by and MRI for confirmation.

Correct Answer: 3. All of the techniques are useful in diagnosing however the most definitive way to diagnose all cancer is with a biopsy. CT scan and MRI are useful to determine metastasis

4. The nurse is caring for a client who will have a bilateral orchiectomy. The client asks what is involved with this procedure. The nurse's most appropriate response would be? "The surgery: 1. Removes the entire prostate gland, prostatic capsule, and seminal vesicles." 2. Tends to cause urinary incontinence and impotence." 3. Freezes prostate tissue, killing cells." 4. Results in reduction of the major circulating androgen, testosterone."

Correct Answer: 4. Bilateral orchiectomy (removal of testes) results in reduction of the major circulating androgen, testosterone, as a palliative measure to reduce symptoms and progression of prostate cancer.

4. Which of the following assessment data would the nurse need to consider to plan appropriate interventions for this diagnosis? a Client had a Foley catheter in the past b Client's previous urinary patterns c Type of surgery being performed d Client's pain tolerance

Correct Answer: B Before the nurse can plan interventions for this diagnosis, the nurse would need to know what the client's previous urinary patterns were. Having a Foley catheter in the past does not affect this diagnosis. Any type of prostate surgery will impact urinary continence. Pain is not associated with incontinence in this surgery.

4. The nurse is providing discharge teaching for a 74-year-old client with prostate cancer that has metastasized to other areas of the body. His family will be providing care to the client at home. Which of the following is a priority teaching point for this family? a Call the doctor before giving narcotics. b Administer pain medication at ordered frequency. c Assess the client's pain level using the pain scale. d Administer pain medication when the client states the pain is severe.

Correct Answer: BThe family is taught to give the medication at ordered intervals whether or not the client states there is pain. Since the cancer has spread, pain control is a priority; waiting until the level is severe will make control more difficult. The family would be told to call the physician if the medication is given appropriately and the pain continues to be severe. The family is not taught how to use the hospital pain a

4. When conducting an interview with a client who has had surgery for prostate cancer, which of the following statements by the nurse would most likely elicit information about the client's sexual concerns? a. "Do you miss having sex? "b. "Following your prostate surgery, when did you first notice you had problems with sexual intercourse?" c. "Tell me about your experience with sexual function since you were diagnosed with cancer." d. "Why do you think you should be sexually active at your age?"

Correct Answer: C This statement is stated in a way that allows the client to feel free to ask questions and express feelings about his sexual concerns. The other statements assume problems or contain judgmental attitudes.

4. A 68-year-old client has prostate cancer that has metastasized. When assessing pain levels with this client, the nurse is aware of which of the following? a Elders experience pain the same as younger people. b Elders are not as sensitive to pain as younger people .c Pain levels in elders are elevated. d Pain levels in elders may be exacerbated by pre-existing conditions.

Correct Answer: DWhen assessing pain levels in this client, the nurse is aware that the client's pain from metastasis may be augmented by pre-existing conditions such as osteoarthritis, which can make pain relief more challenging for the healthcare team. Pain is an individual experience, so it is not accurate to state that one group experiences pain more than another. However, due to poor circulation or peripheral neuropathy, pain sensations may be diminished in elders. The client's perception of pain is paramount when determining pain levels.

The client underwent prostate cancer surgery is approaching the time of d/c. What instruction should the nurse provide to this client? select all a. maintain a high fluid intake after you go home b. call the doc immediately if you notice blood in urine c. you may drive yourself homed. avoid strenuous activity for 4-8 weeks d. avoid strenuous lifting for 4-8 weeks e. avoid heavy lifting for 2-4 weeks

Correct Answer: a, fluids d. avoid strenuous activity. Lifting should be avoided for 4-6 weeks

4. Which of the following diagnostic tests are used to differentiate benign prostatic hypertrophy (BPH) from prostate cancer? (Select all that apply.) a. Digital rectal examination b. Prostate-specific antigen (PSA) level c. Skin integrity d. Pelvic ultrasound e. Urinary elimination

Correct Answer: a. DREb. PSAIn a digital rectal exam for BPH, the prostate is asymmetrical and enlarged, while in prostate cancer the exam shows nodules and a fixed position. PSA is specific to the prostate gland and is released by both benign and malignant cells; however, in BPH the amounts of the free form of PSA and complex PSA would be different. The other tests are not helpful in differentiating prostate cancer from BPH.

1. A client returns to the medical unit after a TURP. The client says he wants the catheter removed because it is causing him to have bladder spams. What is the best response by the nurse? a. spasms are painful but expected because of the wide diameter catheter and retention balloon in the bladder b. this must be a complication because the catheter is supposed to evacuate clots that cause the spasms c. the spasm is an unexpected finding because the procedure does not invade the urethra d. foley catheters tend to cause bladder spasms because of the silicone used in the catheter

Correct Answer: a. expected finding

4. A nurse is providing a program for older men in a senior community about measures that can be taken to reduce the risk for prostate cancer. Which of the following would the nurse include in the program? a. Decrease red meat and fat intake. b. Decrease lycopene intake. c. Increase fiber intake. d. Avoid foods high in sodium.

Correct Answer: a. red meat and fat Some studies have shown an increase of prostate cancer in societies with diets high in red meats and fats. The other options have not been shown to impact the incidence of prostate cancer.

1. A client is brought to the surgical unit after a suprapubic prostatectomy. He has a 3 way foley catheter. The nurse notices a very dark red output via the catheter. What is the priority nursing intervention? a. report to the physician b. increase the irrigation flow rate c. check the latest hemoglobin and hematocritd. chart the observation d. chart the observation

Correct Answer: b. increase the irrigation flow rate to prevent occlusion of the catheter

4. A client with prostate cancer is having the urinary catheter removed by the nurse. The nurse will evaluate which of the following outcome goals for this client? a. Client will verbalize that follow-up care is not needed. b. Client will verbalize less pain. c. Client will regain urinary continence. d. Client will have no bleeding or clots in the urine.

Correct Answer: c The client who has had a prostatectomy will very likely experience some form of incontinence after the urinary catheter is removed. The outcome goal after removal of the catheter is to regain continence of urine. Pain does not affect incontinence. Bleeding and clots are expected for 2 weeks after surgery. The client should verbalize the need for follow-up care.

4. A client with prostate cancer is having the urinary catheter removed by the nurse. The nurse will evaluate which of the following outcome goals for this client? a Client will verbalize that follow-up care is not needed. b Client will verbalize less pain. c Client will regain urinary continence. d Client will have no bleeding or clots in the urine.

Correct Answer: cThe client who has had a prostatectomy will very likely experience some form of incontinence after the urinary catheter is removed. The outcome goal after removal of the catheter is to regain continence of urine. Pain does not affect incontinence. Bleeding and clots are expected for 2 weeks after surgery. The client should verbalize the need for follow-up care.