ch. 55 MJ

Question 0

To determine the severity of the symptoms for a patient with benign prostatic hyperplasia (BPH) the nurse will ask the patient about
a.
blood in the urine.
b.
lower back or hip pain.
c.
erectile dysfunction (ED).
d.
strength of the urinary stream.

Answer 0

d.

strength of the urinary stream.

Question 1

A patient who has been recently diagnosed with benign prostatic hyperplasia (BPH) tells the nurse that he does not want to have a transurethral resection of the prostate (TURP) because he is afraid it might affect his ability to have intercourse. Which action should the nurse take?
a.
Offer reassurance that sperm production is not affected by TURP.
b.
Discuss alternative methods of sexual expression besides intercourse.
c.
Provide education about the use of medications for erectile dysfunction (ED) occurring after TURP.
d.
Teach that ED is not a common complication following a TURP.

Answer 1

d.

Teach that ED is not a common complication following a TURP.

Question 2

The health care provider prescribes finasteride (Proscar) for a 56-year-old patient who has benign prostatic hyperplasia (BPH). When teaching the patient about the drug, the nurse informs him that
a.
he should change position from lying to standing slowly to avoid dizziness.
b.
his interest in sexual activity may decrease while he is taking the medication.
c.
improvement in the obstructive symptoms should occur within about 2 weeks.
d.
he will need to monitor his blood pressure frequently to assess for hypertension.

Answer 2

b.

his interest in sexual activity may decrease while he is taking the medication.

Question 3

A patient has an enlarged prostate detected by digital rectal examination (DRE) and an elevated prostate specific antigen (PSA) level. The nurse will anticipate that the patient will need teaching about
a.
cystourethroscopy.
b.
uroflowmetry studies.
c.
magnetic resonance imaging (MRI).
d.
transrectal ultrasonography (TRUS).

Answer 3

d.
transrectal ultrasonography (TRUS).

Question 4

When teaching a patient who is scheduled for a transurethral resection of the prostate (TURP) about continuous bladder irrigation, which information will the nurse include?
a.
Bladder irrigation decreases the risk of postoperative bleeding.
b.
Hydration and urine output are maintained by bladder irrigation.
c.
Bladder irrigation prevents obstruction of the catheter after surgery.
d.
Antibiotics are infused on a continuous basis with bladder irrigation.

Answer 4

c.

Bladder irrigation prevents obstruction of the catheter after surgery.

Question 5

A patient with symptomatic benign prostatic hyperplasia (BPH) is scheduled for photovaporization of the prostate (PVP) at an outpatient surgical center. The nurse will plan to teach the patient
a.
how to care for an indwelling urinary catheter.
b.
that the urine will appear bloody for several days.
c.
about complications associated with urethral stenting.
d.
that symptom improvement will occur in 2 to 3 weeks.

Answer 5

a.

how to care for an indwelling urinary catheter.

Question 6

A 51-year-old man is scheduled for an annual physical exam at the outpatient clinic. The nurse will plan to teach the patient about the purpose of
a.
urinalysis collection.
b.
uroflowmetry studies.
c.
prostate specific antigen (PSA) testing.
d.
transrectal ultrasound scanning (TRUS).

Answer 6

c.

prostate specific antigen (PSA) testing.

Question 7

A 64-year-old has a perineal radical prostatectomy for prostatic cancer. In the immediate postoperative period, the nurse establishes the nursing diagnosis of risk for infection related to
a.
urinary stasis.
b.
urinary incontinence.
c.
possible fecal contamination of the surgical wound.
d.
placement of a suprapubic catheter into the bladder.

Answer 7

c.

possible fecal contamination of the surgical wound.

Question 8

Following a radical retropubic prostatectomy for prostate cancer, the patient is incontinent of urine. The nurse will plan to teach the patient
a.
to restrict oral fluid intake.
b.
pelvic floor muscle exercises.
c.
the use of belladonna and opium suppositories.
d.
how to perform intermittent self-catheterization.

Answer 8

b.

pelvic floor muscle exercises.

Question 9

Following discharge teaching for a patient who has had a transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH), the nurse determines that additional instruction is needed when the patient says,
a.
“I will avoid driving until I get approval from my doctor.”
b.
“I should call the doctor if I have any incontinence at home.”
c.
“I will increase fiber and fluids in my diet to prevent constipation.”
d.
“I should continue to schedule yearly appointments for prostate exams.”

Answer 9

b.

“I should call the doctor if I have any incontinence at home.”

Question 10

Leuprolide (Lupron) is prescribed for a patient with cancer of the prostate. In teaching the patient about this drug, the nurse informs the patient that side effects may include
a.
dizziness.
b.
hot flashes.
c.
urinary incontinence.
d.
increased infection risk.

Answer 10

b.

hot flashes

Question 11

Which information will the nurse include when teaching a patient who has a diagnosis of chronic prostatitis?
a.
Ibuprofen (Motrin) should provide good pain control.
b.
Prescribed antibiotics should be taken for 7 to 10 days.
c.
Sexual intercourse and masturbation will help relieve symptoms.
d.
Cold packs should be used every 4 hours to reduce inflammation.

Answer 11

c.

Sexual intercourse and masturbation will help relieve symptoms.

Question 12

A couple is seen at the infertility clinic because they have not been able to conceive. When performing a focused examination to determine any possible causes for infertility, the nurse will check the man for the presence of
a.
hydrocele.
b.
varicocele.
c.
epididymitis.
d.
paraphimosis.

Answer 12

b.

varicocele.

Question 13

Which information will the nurse plan to include when teaching a 19-year-old to perform testicular self-examination?
a.
Testicular self-examination should be done in a warm area.
b.
The only structure normally felt in the scrotal sac is the testis.
c.
Testicular self-examination should be done at least every week.
d.
Call the health care provider if one testis is larger than the other.

Answer 13

a.

Testicular self-examination should be done in a warm area.

Question 14

A 32-year-old man who is being admitted for a unilateral orchiectomy for testicular cancer does not talk to his wife and speaks to the nurse only to answer the admission questions. Which action is best for the nurse to take?
a.
Ask the patient if he has any questions or concerns about the diagnosis and treatment.
b.
Document the patient’s lack of communication on the chart and continue preoperative care.
c.
Assure the patient’s wife that concerns about sexual function are common with this diagnosis.
d.
Teach the patient and the wife that impotence is rarely a problem after unilateral orchiectomy.

Answer 14

a.

Ask the patient if he has any questions or concerns about the diagnosis and treatment.

Question 15

A 46-year-old man who has erectile dysfunction (ED) tells the nurse that he decided to seek treatment because his wife “is losing patience with the situation.” The most appropriate nursing diagnosis for the patient is
a.
ineffective role performance related to effects of ED.
b.
anxiety related to inability to have sexual intercourse.
c.
situational low self-esteem related to decrease in sexual activity.
d.
ineffective sexuality patterns related to frequency of intercourse.

Answer 15

a.

ineffective role performance related to effects of ED.

Question 16

A patient with benign prostatic hyperplasia (BPH) with mild obstruction tells the nurse, “My symptoms have gotten a lot worse this week.” Which response by the nurse is most appropriate?
a.
“I will talk to the doctor about ordering a prostate specific antigen (PSA) test.”
b.
“Have you been taking any over-the-counter (OTC) medications recently?”
c.
“Have you talked to the doctor about surgical procedures such as transurethral resection of the prostate (TURP)?”
d.
“The prostate gland changes slightly in size from day to day, and this may be making your symptoms worse.”

Answer 16

b.

“Have you been taking any

Question 17

When obtaining a focused health history for a patient with possible testicular cancer, the nurse will ask the patient about any history of
a.
sexually transmitted disease (STD) infection.
b.
testicular trauma.
c.
testicular torsion.
d.
undescended testicles.

Answer 17

d.

undescended testicles.

Question 18

When caring for a patient who has been diagnosed with orchitis, the nurse will plan to provide teaching about
a.
pain management.
b.
emergency surgical repair.
c.
aspiration of fluid from the scrotal sac.
d.
application of warm packs to the scrotum.

Answer 18

a.

pain management.

Question 19

A patient with benign prostatic hyperplasia (BPH) is admitted to the hospital with urinary retention and new onset elevations in the blood urea nitrogen (BUN) and creatinine. Which of these prescribed therapies should the nurse implement first?
a.
Schedule an abdominal computed tomography (CT) scan.
b.
Insert a urinary retention catheter.
c.
Draw blood for a complete blood count.
d.
Infuse normal saline at 50 mL/hr.

Answer 19

b.

Insert a urinary retention catheter.

Question 20

When reviewing patient laboratory results, the nurse in the clinic notes elevated prostate specific antigen (PSA) levels in the following four patients. Which patient’s PSA result is most important to report to the health care provider?
a.
A 75-year-old who uses saw palmetto to treat benign prostatic hyperplasia (BPH)
b.
A 38-year-old who is being treated for acute prostatitis
c.
A 48-year-old whose father died of metastatic prostate cancer
d.
A 52-year-old who goes on long bicycle rides every weekend

Answer 20

c.

A 48-year-old whose father died of metastatic prostate cancer

Question 21

After a transurethral resection of the prostate (TURP), a patient with continuous bladder irrigation complains of painful bladder spasms. The nurse observes a decrease in urine output and clots in the urine. Which action should the nurse take first?
a.
Increase the flow rate of the bladder irrigation.
b.
Administer the prescribed IV morphine sulfate.
c.
Give the patient the prescribed belladonna and opium suppository.
d.
Manually instill and then withdraw 50 mL of saline into the catheter.

Answer 21

d.

Manually instill and then withdraw 50 mL of saline into the catheter.

Question 22

A 22-year-old man tells the nurse at the health clinic that he has recently had some problems with erectile dysfunction. When assessing for possible etiologic factors, which question should the nurse ask first?
a.
“Are you using any recreational drugs or drinking a lot of alcohol?”
b.
“Have you been experiencing an unusual amount of anxiety or stress?”
c.
“Do you have any history of an erection that lasted for 6 hours or more?”
d.
“Do you have any chronic cardiovascular or peripheral vascular disease?”

Answer 22

a.

“Are you using any recreational drugs or drinking a lot of alcohol?”

Question 23

A 53-year-old man tells the nurse he has been having increasing problems with erectile dysfunction (ED) for several years but is now interested in using Viagra (sildenafil). Which action should the nurse take first?
a.
Ask the patient about any prescription drugs he is taking.
b.
Tell the patient that Viagra does not always work for ED.
c.
Discuss the common adverse effects of erectogenic drugs.
d.
Assure the patient that ED is commonly associated with aging.

Answer 23

a.

Ask the patient about any prescription drugs he is taking.

Question 24

The nurse working in a health clinic receives calls from all these patients. Which patient should be seen by the health care provider first?
a.
A 44-year-old man who has perineal pain and a temperature of 100.4° F
b.
A 66-year-old man who has a painful erection that has lasted over 7 hours
c.
A 62-year-old man who has light pink urine after having a transurethral resection of the prostate (TURP) 3 days ago
d.
A 23-year-old man who states he had difficulty maintaining an erection last night

Answer 24

b.

A 66-year-old man who has a painful erection that has lasted over 7 hours

Question 25

Which assessment information about a 62-year-old man is most important for the nurse to report to the health care provider when the patient is asking for a prescription for testosterone replacement therapy?
a.
The patient’s symptoms have increased steadily over the last few years.
b.
The patient has been using sildenafil (Viagra) several times every week.
c.
The patient has had a gradual decrease in the force of his urinary stream.
d.
The patient states that he has noticed a decrease in energy level for a few years.

Answer 25

c.

The patient has had a gradual decrease in the force of his urinary stream.