Hinkle 59 Assessment and Management of Problems Related to Male Reproductive Processes

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.

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 17-year-old Caucasian man A 60-year-old Asian American man A 56-year-old African American man A 35-year-old African American man

A 56-year-old African American man

A client who is diagnosed with stage II prostate cancer asks the nurse if a transurethral resection of the prostate (TURP) can be done for this disorder. Which is the best response by the nurse?

"A TURP is a removal of only a portion of the prostate gland."

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

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.

Which of the following involves implantation of interstitial radioactive seeds under anesthesia to treat prostate cancer? -Hormone therapy -Chemotherapy -Brachytherapy -Teletherapy

Brachytherapy

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 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. Watch for the development of infection. Watch for erosion of the prosthesis through the skin. Do not use the device while taking nitrates

Do not leave the constricting band in place for longer than 1 hour to avoid penile injury.

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 48-year-old man recently diagnosed with benign prostatic hyperplasia (BPH), reports taking Serenoa repens (saw palmetto berry). The nurse needs to intervene if the physician orders which of the following treatments?

Finasteride (Proscar)

Which of the following may result if prostate cancer invades the urethra or bladder? -Rectal discomfort -Hip pain -Backache -Hematuria

Hematuria Hematuria may result if the cancer invades the urethra or bladder. Symptoms related to metastases include backache, hip pain, perineal and rectal discomfort, anemia, weight loss, weakness, nausea, and oliguria.

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

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

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

The nurse is preparing a presentation for a men's community group about health promotion. Which of the following would the nurse include as a current recommendation for screening?

Monthly testicular self-examination (TSE)

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? -Waiting to urinate for 5 to 10 minutes after feeling the initial urge -Using a bearing down motion to promote complete bladder emptying when voiding -Engaging in strenuous exercise to strengthen abdominal muscles -Performing perineal exercises frequently throughout the day

Performing perineal exercises frequently throughout the day

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? -Increased prostate secretion -Testes become soft -Decreased plasma testosterone levels -Increased patency

Plasma testosterone levels decrease.

Which of the following should be included as part of the home care instructions for a patient with epididymitis and orchitis? -Resume sexual intercourse -Apply ice to the area after scrotal swelling subsides -Take prescribed antibiotics -Undertake lifting exercises

Take prescribed antibiotics

Which of the following is not a definition of erectile dysfunction?

The inability to achieve an erection after sexual activity

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 are no longer present.

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."

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

A patient is suspected to have prostate cancer related to observed clinical symptoms. What definitive test can the nurse assist with to confirm a diagnosis of prostate cancer?

Prostate biopsy

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.

Robert James is a 71-year-old man with erectile dysfunction. His healthcare provider prescribed a PDE5 inhibitor to treat his dysfunction. The nurse is meeting with Robert to review the newly prescribed medication. Which of the following would the nurse include in the client education?

Depending on the drug, most are taken "on demand" 15 minutes, 1/2 hour, to 1 hour before sexual activity.

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 should nurses teach all men, especially those who have had cryptorchidism? -Importance of regular monitoring of prostate-specific antigen (PSA) levels. -Need for blood tests to measure serum acid phosphatase levels. -Need to undergo a baseline and follow up lymph node biopsies. -How to perform a testicular self-examination.

How to perform a testicular self-examination.

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

Caucasian American

Which of the following recommendations would a nurse advocate during infancy and childhood to help reduce potential adult complications such as orchitis? Urge the limited intake of foods and fluids containing caffeine. Ensure immunizations against infectious diseases such as mumps. Encourage the consumption of foods that are rich in fat and starch. Engage in activities and exercises that minimize heavy lifting.

Ensure immunizations against infectious diseases such as mumps Nurses should advocate for infant and childhood immunizations against infectious diseases such as mumps to reduce potential adult complications such as orchitis. Minimizing activities involving heavy lifting or urging limited intake of caffeine have no effect on the potential for adult complications such as orchitis. The nurse should encourage foods that are low in fat and starch; however, this also would have no effect on the potential for orchitis.

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."

Medical management of BPH includes pharmacologic therapy. Which of the following medications would the nurse expect the health care provider to prescribe for this diagnosis?

Alpha-adrenergic blocker

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 nursing assessment finding is most significant in determining the plan of care in a client with erectile dysfunction?

Medication use

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

A group of students are reviewing information about the classifications of testicular cancer. The students demonstrate understanding of the information when they describe which of the following?

Choriocarcinoma is an example of a nonseminoma.

A nurse is teaching a male client to perform monthly testicular self-examinations. Which point is appropriate to make? Testicular cancer is more common in older men. Testicular cancer is the number one cause of cancer deaths in males. Testicular cancer is very difficult to diagnose. Testicular cancer is a highly curable type of cancer.

Testicular cancer is a highly curable type of cancer.

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? hypertension medication depression atherosclerosis All options are correct.

All options are correct.

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

Prostate

A client underwent a transurethral resection of the prostate gland 24 hours ago and is on continuous bladder irrigation. Which nursing intervention is appropriate?

Use sterile technique when irrigating the catheter.

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 client diagnosed with prostate cancer is to receive brachytherapy. Which of the following would the nurse include when discussing this therapy with the client? Need for daily treatments over a 7- to 8-week period Surgical castration to decrease the level of circulating testosterone Use of probes inserted using ultrasound to freeze the tissue Use of radioactive seeds implanted into the prostate

Use of radioactive seeds implanted into the prostate Brachytherapy involves the implantation of interstitial radioactive seeds under anesthesia. External beam radiation therapy (teletherapy) involves the use of radiation treatments, usually 5 days/week over 7 to 8 weeks. Surgical castration is a type of androgen-deprivation therapy. Cryosurgery invovles the insertion of transperineal probes into the prostate to freeze the tissue directly.

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 be performed in high-risk males over age 30." "It should begin in adolescence." "It should begin at age 40." "It should begin in men over age 50."

"It should begin in adolescence."

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 client is undergoing a diagnostic workup for suspected testicular cancer. When obtaining the client's history, the nurse checks for known risk factors for this type of cancer. Testicular cancer has been linked to:

cryptorchidism.

Testicular cancer risk is highest for adolescents and men younger than age 35. To specifically address testicular cancer risk, a nurse should modify client teaching for male clients to include:

testicular self-examination

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

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

Orchiectomy

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? Counter-balancing the I.V. pole Collecting a urine specimen before beginning irrigation Attaching the infusion set to an infusion pump Evaluating patency of the drainage lumen

Evaluating patency of the drainage lumen The nurse should evaluate patency of the drainage tubing before leaving the client's room. If the lumen is obstructed, the solution infuses into the bladder but isn't eliminated through the drainage tubing, a situation that may cause client injury. Balancing the pole is important; however, the nurse would have had to address this issue immediately after hanging the 2 L bag. Using an I.V. pump isn't necessary for continuous bladder irrigation. Unless specifically ordered, obtaining a urine specimen before beginning continuous bladder irrigation isn't necessary.

A patient with an indwelling catheter after a radical prostatectomy is having bladder spasms. What medication prescribed by the physician can the nurse administer to help alleviate the discomfort?

Oxybutynin (Ditropan)

All prostatectomies include the risk of damage to the pudendal nerve. Therefore, postoperatively, the nurse assesses for:

Impotence.

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 Dark amber with copious mucous Reddish-pink with numerous clots Light pink with few red streaks

Light yellow and clear

Assessment of a patient diagnosed with epididymitis reveals the findings listed. Place the findings in the order in which they most likely occurred. Testicular tendernesss to pressure Swelling of the scrotum Low-grade fever Severe pain in the lower abdomen

Low-grade fever Testicular tendernesss to pressure Swelling of the scrotum Severe pain in the lower abdomen Epididymitis develops slowly over 1 to 2 days, beginning with a low-grade fever, chills, and heaviness in the affected testicle. The testicle then becomes increasingly tender to pressure and traction. The patient may report unilateral pain, soreness in the inguinal canal along the course of the vas deferens, and pain and swelling in the scrotum and groin. The epididymis becomes increasingly swollen with extreme pain in the lower abdomen and pelvis.

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 patient is undergoing treatment for prostate cancer. He has chemotherapy sessions regularly. However, of late he is showing symptoms of food allergy and loss of appetite. He has lost considerable weight due to this. Which of the following is an appropriate nursing task in this situation?

The nurse should ask the patient to keep a diet diary.

Which of the following is the only definitive way to diagnose testicular cancer?

Tissue biopsy

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? -Transurethral resection of the prostate (TURP) -Suprapubic prostatectomy -Retropubic prostatectomy -Transurethral laser incision of the prostate

Transurethral resection of the prostate (TURP)

Which assessment finding would create the greatest risk to a client ordered a phosphodiesterase inhibitor such as sildenafil? Use of nitrates Type 2 diabetes History of hypertension Use of diuretics

Use of nitrates PDE5 inhibitors facilitate penile erection by producing smooth muscle relaxation in the corpora cavernosa via vasodilation of the blood vessels. If a client is using nitrates (which also exhibit vasodilation) hypotension is likely to occur. History of hypertension and diabetes does not interfere with the administration of PDE5 inhibitors. Use of diuretics is not significant.

Which of the following would be most important to include in a teaching plan for a client who has had a vasectomy? Taking a prescribed opioid analgesic for pain relief. Resuming sexual activity in 24 to 48 hours. Applying warm compresses to the scrotum for the first 24 hours. Using a reliable method of contraception for several weeks.

Using a reliable method of contraception for several weeks. It may take several weeks or more after surgery before the ejaculatory fluid is free of sperm, and the client is informed to use a reliable method of contraception until sperm no longer are present. The client should apply ice packs to the scrotum to reduce swelling and use a mild analgesic such as aspirin or acetaminophen for pain relief. The client typically can resume sexual activity when comfortable, usually in 1 week.

A nurse is obtaining a male client's health history before performing a physical examination. Which information would most likely not be obtained? pain during sexual intercourse premature ejaculation or other concerns of a sexual nature contraceptive practices age of first ejaculate

age of first ejaculate Age of first ejaculate would most likely not be asked. Premature ejaculation or other concerns of a sexual nature, pain during sexual intercourse, and contraceptive practices would most likely be included in the health history.