Cellular regulation Exemplar 2.G Prostate Cancer

Which hormone(s) is (are) believed to have a role in the development of prostate cancer? A) Prolactin B) Endorphins C) Estrogens D) Androgens

D

nurse is caring for a 42-year-old male client who was recently diagnosed with prostate cancer. What characteristic of the prostate cancer does the nurse need to be aware of for a client of this age compared to older men with prostate cancer? A) The cancer will likely be more aggressive for the younger client. B) The cancer will likely grow more slowly in the younger client. C) The cancer will likely be more responsive to treatment in the younger client. D) The cancer will likely not metastasize as quickly in the younger client.

A

The nurse is preparing an educational program on risk factors for the development of prostate cancer. Which information will the nurse include as being the greatest risk factor for developing prostate cancer? A) The client's age B) A family history C) A history of a vasectomy D) A diet high in fat

A Explanation: The greatest risk for developing prostate cancer is age. Prostate cancer affects one out of every eight men over the age of 60. Genetics, vasectomy, and a diet high in fat are also risk factors.

nurse is screening a client for prostate cancer. Which assessment findings would cause the nurse to suspect that the client has prostate cancer? Select all that apply. A) Fatigue B) Upper extremity weakness C) Back pain D) Hematuria E) Scrotal edema

ACD Explanation: Unfortunately, many clients with prostate cancer remain undiagnosed until the cancer is well established. Hematuria, back pain, bilateral lower extremity weakness, and fatigue are symptoms associated with prostate cancer.

The nurse is caring for a client who has a continuous bladder irrigation running following a prostatectomy. During the shift, a total of 1500 mL of irrigant is infused. The Foley bag is emptied twice for the shift with totals of 850 mL and 950 mL. What is the client's actual urine output for the shift? A) 300 mL B) 250 mL C) 100 mL D) 950 mL

Answer: A Explanation: The total infused is 1500 mL. The total drained is 1800 mL. The total, or true output, is 300mL greater than the input.

A client with prostate cancer is being discharged from the hospital. Which educational topic is inappropriate for this client? A) Provide information on doses of complementary herbs. B) Teach the client and his family noninvasive methods of pain control. C) Stress the importance of keeping client appointments with healthcare providers. D) Provide the client and the client's family information on support groups.

Answer: A Explanation: When providing discharge instructions to the client with prostate cancer, the nurse will teach the client and his family noninvasive methods of pain control and stress the importance of keeping client appointments with healthcare providers. The nurse will also provide the client and his family information on support groups. The nurse does not have authorization to provide information on doses of complementary herbs.

The nurse is assessing a client for symptoms of prostate cancer. Which symptoms would indicate the client is experiencing an enlarged prostate? Select all that apply. A) Hematuria B) Dysuria C) Weight loss D) Bone pain E) Fatigue F) Nerve Pain

Answer: A, B Explanation: Symptoms of an enlarged prostate include hematuria, dysuria, reduction in urinary stream, nocturia, frequency of urination, and abnormal size of prostate on digital exam. The other choices are nerve impingement or metastatic symptoms.

The nurse is planning care for a client scheduled for a prostatectomy. The client's spouse wants to know if the client will have any limitations after the surgery. Which diagnoses should the nurse use to plan this client's care? Select all that apply. A) Constipation B) Pain C) Impaired Urinary Elimination D) Risk for Falls E) Sexual Dysfunction

Answer: B, C, E Explanation: Following a prostatectomy, the client is most at risk for pain, sexual dysfunction, and urinary stress incontinence. There is no reason to suspect that this client is at risk for constipation or falls.

A nursing instructor is teaching a group of student nurses about the cultural implications of prostate cancer. Which statement will the nursing instructor include? A) "African-American men are at lowest risk for prostate cancer." B) "Asian- and Native American men have the highest risk for developing prostate cancer." C) "Approximately one in eight men ages 70 and older will be diagnosed with prostate cancer." D) "A diet low in dairy increases a man's risk for developing prostate cancer."

Answer: C Explanation: African-Americans have the highest incidence of prostate cancer in the United States and the world, with rates greater than 60% higher than those seen in Whites. Asian- and Native American men have the lowest risk for prostate cancer. Approximately one in eight men ages 70 and older will be diagnosed with prostate cancer. A diet high in dairy increases a man's risk for developing prostate cancer.

The nursing is preparing to discharge a client recovering from prostate surgery for cancer. What should the nurse emphasize when teaching this client? A) "You may drive yourself home." B) "Avoid strenuous activity and heavy lifting for 2 weeks." C) "It is quite common to notice blood in your urine following this type of surgery." D) "Reduce your fluid intake so you won't need to void as often."

Answer: C Explanation: Blood in the urine is fairly common after surgery. The healing period after prostate surgery is 4-8 weeks, and the client should avoid strenuous activity during this time. Continued increase in fluid intake will help the urine to remain dilute and reduce the risk of clot formation. The client should not drive after surgery for at least 2 weeks.

A client is scheduled to undergo a prostate biopsy. The client asks the nurse what is expected immediately following the procedure. Which response by the nurse is the most appropriate? A) "You will need to avoid strenuous activity for 24 hours." B) "Your sexual partners will need to be notified." C) "You will likely experience discomfort for 24-48 hours after the procedure." D) "You will not have any restrictions following the biopsy."

Answer: C Explanation: The client may experience discomfort for 1-2 days after the procedure. Strenuous activity is avoided only for about 4 hours. The client must restrict activity for only a short period after the procedure. There is no need to notify sexual partners following the procedure.

The nurse is caring for a client who returns to the unit following transurethral resection of the prostate due to prostate cancer with a three-way Foley catheter in place. The client states that he has the urge to urinate and wants the catheter removed. The nurse knows that this feeling is caused by spasms. Which response by the nurse is the most appropriate? A) "This must be a complication, because the Foley catheter is supposed to evacuate clots that cause the sensation you are describing." B) "The spasm is an unexpected finding because the procedure does not invade the urethra." C) "The sensation is caused by the silicone used in the catheter. I will speak to the doctor about switching to a different catheter." D) "This is an expected sensation, but the Foley catheter must remain in place."

Answer: D Explanation: Clients with a three-way Foley catheter usually complain of sensations of having to void despite the presence of the catheter. This urge to void is caused by the pressure exerted by the balloon in the internal sphincter of the bladder and the wide diameter of the catheter that is used for the purpose of irrigation. Antispasmodics may be prescribed for the client with a three-way irrigation catheter. Spasms are not a complication of the catheter but rather an expected finding. The procedure does invade the urethra. The substance that the catheter is made of does not affect spasms.

73-year-old man was just diagnosed with stage II prostate cancer. The client's wife hears the word "cancer" and immediately begins crying. She says, "How long does he have to live?" Which response by the nurse is appropriate? A) "Don't worry about how long he will live. Just live every day to the fullest and enjoy the time you have left together." B) "If we treat the cancer aggressively with surgery and radiation, he should live several more years." C) "Prostate cancer is usually aggressive in older men, so he may only have a short time to live." D) "Older men who are diagnosed with prostate cancer usually die from causes other than the cancer."

D

What approach is appropriate for interpreting the prostate-specific antigen (PSA) level as a diagnostic factor for prostate cancer? A) A PSA level higher than 4.0 ng/mL indicates prostate cancer. B) A PSA level lower than 4.0 ng/mL indicates prostate cancer. C) A fluctuating PSA level indicates prostate cancer. D) An abnormal PSA level alone is not enough to diagnose prostate cancer.

D

What is the primary reason that prostate cancer rarely metastasizes to the bowel? A) The capsular artery supplies blood to the bowel before the prostate. B) The inferior vesical artery supplies blood to the bowel before the prostate. C) The rectourethral fistula acts as a physical barrier to metastasis. D) The Denonvilliers fascia acts as a physical barrier to metastasis.

D

While receiving discharge teaching, an adult client recovering from a prostatectomy is distressed to learn that episodes of incontinence may occur. Which should the nurse teach the client to help minimize incontinence? A) Proper administration of incontinence medication B) Steps to change the Foley catheter bag every day C) Fluid restriction D) Kegel exercises

D Explanation: Urinary incontinence after surgery is not unexpected. Teaching the client Kegel exercises is the best way to help him eliminate or reduce occasions of stress incontinence. Restricting fluids may cause further urinary problems and is not advised. Medication and Foley catheters are not appropriate long-term treatments for this complication.