Ch. 72: Male Repro (Nurs 309)
The emergency department nurse receives change-of-shift report about four clients. Which one should be assessed first? 1. A 19-year old client with scrotal swelling and severe pain that has not decreased with elevation of the scrotum. 2. A 25-year old client who has a painless indurated lesion o the glans penis. 3. A 44-year old client with an elevated temp, chills, and back pain associated with recurrent prostatitis. 4. A 77-year old client with abdominal pain and acute bladder distention.
1. A 19-year old client with scrotal swelling and severe pain that has not decreased with elevation of the scrotum.
A client had a suprapubic prostatectomy. Which type of tube can the nurse expect the client to have when he returns to his room from the PACU? 1. Cystostomy 2. NG 3. Nephrostomy 4. Ureterostomy
1. Cystostomy
After a radical prostatectomy, a client is ready to be discharged. Which nursing action included in the discharge plan should be delegated to an experienced LPN/LVN? 1. Reinforcing the client's need to check his temperature daily. 2. Teaching the client how to care for his retention catheter. 3. Documenting a discharge assessment in the client's chart. 4. Instructing the client about the prescribed narcotic analgesic.
1. Reinforcing the client's need to check his temperature daily.
A nurse caring for a client with an indwelling urinary catheter. What is the most important action for the nurse to implement when irrigating the bladder? 1. Use sterile equipment. 2. Instill the fluid under high pressure. 3. Warm the solution to body temperature. 4. Aspirate immediately to ensure return flow.
1. Use sterile equipment.
The nurse is caring for a 21-year old client who had a left orchiectomy for testicular cancer on the previous day. Which nursing activity will be best assigned to an LPN/LVN? 1. Educating the client about post-orchiectomy chemotherapy and radiation. 2. Administering the prescribed "as needed" oxycodone to the client. 3. Teaching the client how to do testicular self-examination on the remaining testicle. 4. Assessing the client's knowledge level about post-orchiectomy fertility.
2. Administering the prescribed "as needed" oxycodone to the client.
The nurse is caring for a client who has just returned to the surgical unit after transurethral resection of the prostate. Which assessment finding will require the most immediate action? 1. Blood pressure reading of 153/88 mmhg. 2. Catheter is draining deep red blood. 3. Client not wearing anti embolism stockings. 4. Client report of abdominal cramping.
2. Catheter is draining deep red blood.
Which is most important for the nurse to do when providing care to a client who has had a transurethral resection of the prostate? 1. Maintain patency of the cystostomy tube. 2. Ensure the patency of the indwelling catheter. 3. Keep the abdominal dressing clean and dry. 4. Observe the wound for hemorrhage and infection.
2. Ensure the patency of the indwelling catheter.
A client who has just returned to the surgical unit after a transurethral resection of the prostate reports acute bladder spasms. In which order will the nurse perform these prescribed actions? 1. Administer acetaminophen/oxycodone 325mg/5mg. 2. Irrigate the retention catheter with 30 to 50 mL of sterile saline. 3. Infuse 500 mL of 5% dextrose in Lactated Ringer's solution over 2 hours. 4. Offer the client oral fluids to at least 2500 to 3000 mL per day.
2. Irrigate the retention catheter with 30 to 50 mL of sterile saline. 1. Administer acetaminophen/oxycodone 325mg/5mg. 3. Infuse 500 mL of 5% dextrose in Lactated Ringer's solution over 2 hours. 4. Offer the client oral fluids to at least 2500 to 3000 mL per day.
A client who had a suprapubic prostatectomy returns from the PACU and accidentally pulls out the urethral catheter. What should the nurse do first? 1. Reinsert the catheter. 2. Notify the health care provider. 3. Check for bleeding by irrigating the suprapubic tube. 4. Take no immediate action if the suprapubic tube is draining.
2. Notify the health care provider.
A nurse is caring for a client with a continuous bladder irrigation. Which is the most important nursing action? 1. Monitoring urinary specific gravity. 2. Subtracting irrigant from output to determine urine volume. 3. Recording urinary output every hour to determine kidney function. 4. Obtaining a 24-hour urine specimen to determine urine concentration.
2. Subtracting irrigant from output to determine urine volume.
A client has a needle biopsy of the prostate gland using the transurethral approach. Which statement is most important to include in the teaching plan? 1. "The health care provider will call you about the test results." 2. "Serious infections may occur as a complication of this test." 3. "You will need to call the HCP if you develop fever or chills." 4. "It is normal to have a small amount of rectal bleeding after the test."
3. "You will need to call the HCP if you develop fever or chills."
A nurse is caring for a client with a diagnosis of benign prostatic hyperplasia. Which information about this condition is important for the nurse to consider when caring for this client? 1. It is a congenital abnormality. 2. A malignancy usually results. 3. It predisposes to hydronephrosis. 4. An increase in phosphatase level occurs.
3. It predisposes to hydronephrosis.
A client with cancer of the prostate requests the urinal at frequent intervals but either does not void or voids in very small amounts. What does the nurse conclude is most likely the causative factor? 1. Edema 2. Dysuria 3. Retention 4. Suppression
3. Retention
What should the nurse do to obtain an accurate urine output for a client with a continuous bladder irrigation? 1. Measure the contents of the bedside drainage bag. 2. Stop the irrigation and determine the urine output. 3. Subtract the volume of irrigant from the total drainage. 4. Ensure the urine and irrigant drain into two seperate bags.
3. Subtract the volume of irrigant from the total drainage.
A client with BPH has a new prescription for tamsulosin. Which statement about tamsulosin is most important to include when teaching this client? 1. "This medication with improve your symptoms by shrinking your prostate." 2. "The force of your urinary stream will probably increase." 3. " Your blood pressure may decrease as a result of taking this medication." 4. "You should avoid sitting up or standing up too quickly."
4. "You should avoid sitting up or standing up too quickly."
Which nursing action can best prevent infection from a urinary retention catheter? 1. Cleansing the perineum. 2. Encouraging adequate fluids. 3. Irrigating the catheter once daily. 4. Cleansing around the meatus routinely.
4. Cleansing around the meatus routinely.
A client is admitted to the hospital with a tentative diagnosis of urinary retention related to benign prostatic hyperplasia. There is a secondary diagnosis of delirium related to urosepsis. The health care provider prescribes the insertion of a urinary retention catheter. What nursing action is most important for this client's safety? 1. Secure an order for wrist restraints. 2. Orient the client to time, place, and person. 3. Involve family members in the client's care. 4. Determine if any unsafe behavior patterns exist.
4. Determine if any unsafe behavior patterns exist.
The day after a radical prostatectomy, a client has blood clots in the urinary catheter and reports bladder spasms. The client says that his right calf is sore and that he feels short of breath. Which action will you take first? 1. Irrigate the catheter with 50 mL of sterile saline. 2. Administer oxybutynin 5 mg orally. 3. Apply warm packs to the client's right calf. 4. Measure oxygen saturation using pulse oximetry.
4. Measure oxygen saturation using pulse oximetry.
A nurse is caring for a client with a diagnosis of cancer of the prostate. Which serum level should the nurse teach the client to have monitored to follow the course of the disease? 1. Serum creatinine 2. Blood urea nitrogen 3. Nonprotein nitrogen 4. Prostate-specific antigen
4. Prostate-specific antigen
The nurse obtains the following assessment data about a client who has had a transurethral resection of the prostate and has continuous bladder irrigation. Which finding indicates the most immediate need for nursing intervention? 1. The client states that he feels a continuous urge to void. 2. The catheter drainage is light pink with occasional clots. 3. The catheter is taped to the client's thigh. 4. The client reports painful bladder spasms.
4. The client reports painful bladder spasms.