Prostate Cancer

The 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.

Answer: A Research has found that prostate cancers that are diagnosed at a younger age tend to be more aggressive, and metastasis may have already occurred, given the advanced disease state at the time of diagnosis. Evidence has not yet shown whether prostate cancer grows more slowly in younger clients or responds to treatment better in younger clients.

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

Answer: A The greatest risk for developing prostate cancer is age. Prostate cancer affects one out of every eight men over the age of 70. Genetics, vasectomy, and a diet high in fat are also risk factors.

A 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."

Answer: D In an older man with a lower stage of cancer at diagnosis, the cancer is likely slow-growing, and he is more likely to die from other preexisting comorbidities than from the cancer itself. Therefore, the nurse cannot predict how long the client may live after diagnosis. Prostate cancer is usually aggressive in younger men, not older men. Early-stage prostate cancer in older men may not be treated aggressively. Instead, the healthcare team may take a more conservative "watchful waiting" approach, depending on other health conditions. It is not within the nurse's scope of practice to suggest aggressive treatment strategies. The nurse should not dismiss the client's or client's family's concerns by telling them to not worry.

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 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 When providing discharge instructions to the client with prostate cancer, the nurse will teach the client and his family 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

Answer: A, B 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 related to metastasis and metabolic changes.

A 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

Answer: A, C, D 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.

A nursing instructor is teaching a group of student nurses about the risk factors for prostate cancer. Which statement will the nursing instructor include? A) "African American men are at lowest risk for prostate cancer." B) "Asian American 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 African Americans are at a particularly high risk for developing 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 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 complications is the client likely to have that should be incorporated into his plan of care? Select all that apply. A) Constipation B) Gynecomastia C) Impaired Urinary Elimination D) Risk for Falls E) Sexual Dysfunction

Answer: C, E Following a prostatectomy, the client is most at risk for sexual dysfunction and urinary stress incontinence. There is no reason to suspect that this client is at risk for constipation or falls. Gynecomastia is a side effect of treatment with estrogen compounds, not surgery.

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

Answer: D Androgens are hormones synthesized in the testes and adrenal cortex in males that promote expression of male sex characteristics. They are believed to have a role in the development of prostate cancer. Estrogens, endorphins, and prolactin have not been linked to the development of prostate cancer.

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.

Answer: D Despite its proximity to the rectum, metastasis to the bowel is uncommon in prostate cancer, because a tough sheet of tissue, the Denonvilliers fascia, acts as an effective physical barrier between the bowel and prostate. A rectourethral fistula may develop as a result of treatment for prostate cancer. The inferior vesical artery and capsular artery provide blood to the prostate but not the bowel.

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.

Answer: D The National Cancer Institute used to consider a PSA level of 4.0 ng/mL or lower to be normal, but men with normal PSA levels may still have prostate cancer. PSA levels above 4.0 ng/mL or PSA levels that fluctuate could be an indication of prostate cancer, but it could also indicate prostatitis or urinary tract infection. Therefore, PSA levels must be interpreted in conjunction with the patient's health history and other diagnostic tests to confirm a diagnosis of prostate cancer.

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

Answer: D 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.