Exam 4 (Ch 55 & 59) (Mod 15)

Question 1

Male Reproductive System

What are the 3 main roles of the male reproductive system?

Answer 1

1. Sperm production and transportation
2. Deposition of sperm in the female reproductive tract
3. Hormone secretion

Question 2

Male Reproductive System

What are the primary reproductive organs of males?

Answer 2

The testes

Secondary reproductive organs include ducts (epididymis, ductus deferens, ejaculation duct, urethra), sex glands (prostate gland, Cowper’s glands, seminal vesicles) and the external genitalia (scrotum, penis)

Question 3

Assessment

What are some symptoms related to urinary obstruction?

Answer 3

Increased urinary frequency
Decreased force of stream
“Double” or “triple” voiding
Nocturia, dysuria, hematuria, hematospermia

Questions to ask: Usual state of health? Recent changes in general health? Recent changes in sexual activity?

Question 4

Assessment

Presence of what conditions may affect sexual function?

Answer 4

diabetes, cardiac disease, multiple sclerosis

Question 5

Table 55.5 The 5 Ps of Taking a Sexual History

What are the 5 Ps of Taking a Sexual History

Answer 5

1. Partners (Gender, Number)
2. Practices (Genital, Anal, Oral)
3. Protection from STIs (Kind, Frequency)
4. Past history of STIs (When, What, Treated)
5. Prevention of pregnancy

Question 6

Physical Assessment

In addition to normal aspects of physical exam, include what 2 exams?

Answer 6

Digital recatl exam
Testicular exam

Question 7

Physical Assessment

What does a digital rectal exam (DRE) allow for?
Who is it recommended for?

Answer 7

Allows for posterior surface of prostate gland to be assessed for size, symmetry, shape and consistency; also assess for any tenderness and nodules
Recommended annually for men >50 years old
Recommended >45 years of age for high risk; African American and men with family history

Question 8

Physical Assessment

How is a testicular exam preformed?
What can it identify?

Answer 8

Testicles and penis are palpated for abnormalities and masses
Can identify conditions such as hydrocele, hernia, tumor

Instruct on testicular self-examination (TSE)

Question 9

Gerontologic ConsiderationsEffects of Aging on Reproductive

What happens to the testiron levels as a man ages?
Prostate size?
Sperm production?
Scrotal muscle tone?
Size & firmness of testicles?

Answer 9

Decline
Increase
Decrease
Decrease
Decrease

Erectile and sexual problems may occur

Question 10

Diagnostic Tests

What are some diagnostic test of the male reproductive system?

4

Answer 10

Prostate-specifc antigen
Ultransonography
Prostate fluid or tissue analysis
Tests of male sexual function

Question 11

Diagnostic Tests

What is the prostate-specific anitgen (PSA) used to test?

Answer 11

Sensitive test for prostate cancer

Values less than 4 ng/mL are considered normal

Question 12

Diagnostic Tests

What type of pt has transrectal ultrasonography
done?

Answer 12

Transrectal for those with abnormal DRE or PSA

Question 13

Diagnostic Tests

How can prostate fluid or tissue analysis be obtained?

Answer 13

Can be obtained during a prostatectomy or a TRUS

Question 14

Diagnostic Tests

What is one test used to diagnose male sexual function?

Answer 14

Sleep studies for penile function

Nocturnal penile tumescence (NPT) studies can help evaluate erectile function.

Question 15

Disorders of Male Sexual Function

What is erectile dysfunction?
What does the assessment require?

Answer 15

Inability to achieve or maintain an erect penis
Assessment requires physical exam, neuro exam, assessment of meds and labs

Also called impotence

Question 16

Disorders of Male Sexual Function

What are some psychological causes of ED?
Organic causes?

Answer 16

Psychological causes: anxiety, fatigue, depression, absence of desire
Organic causes: vascular, endocrine, hematologic, and neurologic disorders; trauma; alcohol; medications; and drug abuse

Question 17

Disorders of Male Sexual Function

What are some ejaculation problems?

Answer 17

Premature ejaculation
Inhibited ejaculation
Retrograde ejaculation

Question 18

Disorders of Male Sexual Function

What are some potential contributing factors to premature ejaculation?

Answer 18

Smoking, use of illegal drugs, poor physical/mental health, lack of experience

Question 19

Disorders of Male Sexual Function

What are the causes of inhibited ejaculation?

Answer 19

Caused by psychological and neurological factors

Question 20

Disorders of Male Sexual Function

What is retrograde ejaculation?
What are some potential causes?

Answer 20

Semen travels in opposite direction (towards bladder)
Can occur after prior prostate or ureteral surgery

Question 21

Disorders of Male Sexual Function

What are some treatments for ejaculation problems?

Answer 21

Treatment: combination of behavioral and pharmacological therapy; electroejaculation

Question 22

Medical Management

What are some pharmacologic therapy for secual dysfunction?
Side effects/complications?
Any cautions or contraindications?

Answer 22

Oral medications—sildenafil (Viagra)
* Side effects include headache, flushing, dyspepsia
* Caution with retinopathy
* Contraindicated with nitrate use

Injected vasoactive agents
* Complications include priapism (persistent abnormal erection)

Urethral gel

Additional medical management includes: Penile implants & transplants & negative pressure devices

Question 23

Conditions of the Prostate: Prostatitis

What is prostatitis?

Answer 23

Inflammation typically caused by an infectious agent

Question 24

Conditions of the Prostate: Prostatitis

What is type I prostatitis?

Answer 24

Acute bacterial:
* Characterized by a sudden onset of symptoms.
* Symptoms include fever, dysuria (painful urination), and perineal/prostatic pain.
* E. coli is the most common causative agent.

Question 25

# Conditions of the Prostate: Prostatitis What is Type II prostatitis?

Answer 25

Chronic bacterial: Typically asymptomatic (without symptoms).

Question 26

# Conditions of the Prostate: Prostatitis What is Type III prostatitis?

Answer 26

Chronic prostatitis/chronic pelvic pain syndrome: * Patients experience genitourinary symptoms. * Notably, there is no bacteria present in the urine.

Question 27

# Conditions of the Prostate: Prostatitis What is Type VI prostatitis?

Answer 27

Asymptomatic inflammatory prostatitis: * Diagnosed incidentally. * May be indicated by elevated PSA (prostate-specific antigen) levels.

Question 28

# Prostatitis Treatment What does treatment for prostatitis include? Examples?

Answer 28

Includes appropriate anti-infective agents and measures to alleviate pain and spasm * Bactrim (Trimethoprim/Sulfamethoxazole), Cipro (Ciproflocacin) * NSAIDS for Type III * Flomax (Tamsulosin) (to promote bladder and prostate relaxation) * Follow up for 6mo-1yr (due to reoccurrence of bacteria)

Question 29

# Conditions of the Prostate: BPH What is BPH? Who is it most common in?

Answer 29

Benign prostatic hyperplasia (BPH) * Noncancerous enlargement of prostate * One of the most common diseases in aging men * Half of men will have signs of BPH bye age 50; increases to more than 70% for men 60 to 69 years old

Question 30

# BPH cont.. What are the manifestations of BPH?

Answer 30

Manifestations are those of urinary obstruction, urinary retention, and urinary tract infections * Develops over a period of time; changes in urinary tract slow and insidious * Symptoms depend on severity: dysuria, hesitancy, decreased urine stream, sensation of incomplete bladder emptying, bladder pain, nocturia, incontinence

Question 31

# BPH cont. How is BPH diagnosed?

Answer 31

Diagnosis Via DRE, history, and rule-out of other conditions

Question 32

# Complications What are some complications BPH?

Answer 32

Some men have acute urinary retention UTIs (infection can spread to kidneys and cause pyelonephritis and in severe cases can spread to the bloodstream) Renal failure caused by hydronephrosis

Question 33

# Management of BPH What are some medical treatments of BPH?

Answer 33

Alpha-adrenergic blockers (afluzosin, tamsulosin & terazosin) Measures to reduce pain and spasms Catheter for acute condition; unable to void (curved or use of stylet)

Question 34

# Management of BPH What are some surgical treaments of BPH?

Answer 34

Minimal invasive therapy (microwave waves to destroy tissue) Surgical resection: TURP (removal of inner portion of prostate through ureteral endoscope)

Question 35

# TURP What is TURP?

Answer 35

Transurethral resection of the Prostate (TURP) is a surgical procedure involving the removal of prostate tissue using a resectoscope inserted through the urethra. | Considered the gold standard for surgical standard for BPH. ## Footnote Most patients have marked improvement in symptoms and urinary flow rates. Many TURP procedures are done as an outpatient. (No external surgical incisions are made)

Question 36

# TURP Continued What are some postop TURP care? What are some complications?

Answer 36

A 3-way indwelling catheter is inserted into the bladder after to provide homeostasis and to facilitate urinary drainage. If there is a large amount of hematuria with clots after surgery, the bladder can be irrigated either continuously or intermittently for the first 24 hours to prevent obstruction from blood clots. Other complications include bleeding and clot retention

Question 37

# Nursing Key Problems & Goals What are the 3 key problems TURP? What are the goals for each?

Answer 37

ACUTE PAIN Goal: The goal is to effectively manage the patient's pain and promote comfort RISK FOR INFECTION Goal: The goal is to prevent infection. IMPAIRED URINARY SYSTEM FUNCTION Goal: The goal is to restore and maintain optimal urinary system function.

Question 38

# Prostate Cancer What is prostate cancer? What are some risk factors?

Answer 38

Definition: Prostate cancer is a malignant tumor that originates in the prostate gland. Risk factors include increasing age, familial predisposition, and African American race Dietary factory and obesity may be related to prostate cancer (diet high in red meat, processed meat and high-fat dairy along with low intake of vegetables and fruits may increase risk) ## Footnote Second most common cancer and the second most common cause of cancer death in men

Question 39

# Prostate Cancer Manifestations & Diagnosis What are some manifestations of prostate cancer? How is it diagnosed?

Answer 39

Manifestations: * Early disease has few or no symptoms * Symptoms of urinary obstruction, blood in urine or semen (if urethra or bladder is involved), and painful ejaculation occur with advanced disease * Symptoms of metastasis may be the first manifestations (backache, hip pain, perineal/rectal discomfort, anemia, weight loss, oliguria) Diagnosis DRE, serum PSA, TRUS with biopsy

Question 40

# Prostate Cancer Assessment What does the assessment for prostate cancer involve?

Answer 40

Assess how the underlying disorder (BPH or prostate cancer) has affected the patient’s lifestyle Urinary and sexual function Health history Nutritional status Activity level and abilities

Question 41

# Prostate Cancer: Management What is the treatment for prostate cancer based on?

Answer 41

Based upon symptoms and grading of tumor (Gleason score: primary grade of 1-5 & secondary grade of 1-5; combined for score of 2-10; lower scores are less aggressive)

Question 42

# Prostate Cancer: Management What are some treatments for prostate cancer?

Answer 42

Treatment may include therapeutic vaccine, prostatectomy, radiation therapy, hormonal therapy, or chemotherapy Nonsurgical * Therapeutic vaccine: Kills existing cancer cells and builds immunity against further cancer development (Provenge, Zytiga and Jevtana)

Question 43

# Surgical Therapy What are some forms of surgical therapy for prostate cancer?

Answer 43

Radical Prostatectomy Laparoscopic and robotic-assisted Nerve-sparing procedure Cryotherapy Drug therapy Radiation therapy * External Beam Radiation * Brachytherapy

Question 44

# Prostate Cancer Management cont. What are the differences between external and internal radiation?

Answer 44

External: teletherapy/external-beam radiation therapy (EBRT) (specific number of treatments over a specific timeframe; for use with low-risk prostate cancer) Internal: brachytherapy (radiation seeds are implanted) ## Footnote Can be used alone, together or in conjunction with hormonal therapy (ADT: Androgen deprivation therapy; reduces levels of testosterone; induces medical castration)

Question 45

# Nursing Process: The Care of the Pt Undergoing Prostatectomy- Diagnoses What are some challenges patients undergoing prostatectomy might face? What are tne nursing focuses for each?

Answer 45

Anxiety about surgery outcome: Nursing Focus: Provide emotional support, education about the procedure and expected outcomes, and address patient concerns. Acute pain preoperatively/acute pain postoperatively: Nursing Focus: Assess and manage pain effectively using pharmacological and non-pharmacological interventions, both before and after surgery. Risk for imbalanced fluid volume postoperatively: Nursing Focus: Monitor intake and output, assess for signs of dehydration or fluid overload, and manage fluid replacement as prescribed. Deficient knowledge: Nursing Focus: Provide comprehensive education about the prostatectomy procedure, post-operative care, medications, activity restrictions, catheter care (if applicable), and potential complications.

Question 46

# Nursing Process: The Care of the Pt Undergoing Prostatectomy—Planning What are the major goals of preoperative care of prostatectomy?

Answer 46

Adequate preparation * Assess understanding of procedure Reduction of anxiety and pain * Assess for bladder distention

Question 47

# Nursing Process: The Care of the Post-operative Prostatectomy—Planning What are the 4 major goals of postoperative care of prostatectomy?

Answer 47

Maintenance of fluid volume balance Relief of pain and discomfort Ability to perform self-care activities Absence of complications

Question 48

# Postoperative Care What are the main complications of prostatectomy? What is done to prevent them?

Answer 48

Hemorrhage, bladder spasms, urinary incontinence and infection. Continuous Bladder Irrigation (CBI)

Question 49

# Post-Op: Fluid Volume Balance Why might fluid be lost after TURP? What should the nurse be sure to monitor? What will the urine initially look like?

Answer 49

Loss of fluid related to continuous bladder irrigation Monitor/Keep accurate I/O record (subtract irrigation amount from total output=urine output) Monitor urinary drainage and keep catheter patent Urine will initially be bloody/red; should clear to light pink within 24 hrs

Question 50

# Post-Op: Relief of Pain What is a common source of pain post-prostatectomy?

Answer 50

Bladder Spasms Symptoms: Bladder spasms can cause feelings of pressure, fullness, urgency to void, and bleeding from the urethra around the catheter.

Question 51

# Post-Op: Relief of Pain What are some interventions for post-prostatectomy pain?

Answer 51

Medications Comfort Measures Activity and Positioning Prevent Constipation Catheter Irrigation

Question 52

# Continouse Bladder Irrigation (CBI) What should be include in the education after removing the catheter?

Answer 52

Kegel exercises

Question 53

# Collaborative Problems and Potential Complications What are some Collaborative Problems and Potential Complications of prostatectomy | 7 (8)

Answer 53

Hemorrhage and shock Infection Venous thromboembolism Catheter obstruction Complications with catheter removal Urinary incontinence Sexual dysfunction

Question 54

# Interventions What are some key nursing interventions post-prostatectomy?

Answer 54

Reduction of anxiety Provide patient education, including explanations of anatomy and function, diagnostic tests and surgery, and the surgical experience

Question 55

# Rehabilitation and Home Care What does patient and family education for home care include?

Answer 55

Care of urinary drainage devices and recognition and prevention of complications (hemorrhage, infection, venous thromboembolism, catheter problems, urinary incontinence, sexual dysfunction)

Question 56

# Rehabilitation and Home Care What should the pt/caregiver be taught in regareds to regaining bladder continence?

Answer 56

Gradual Process: Explain that regaining bladder control is a gradual process. Recovery Timeline: Inform that dribbling may continue for up to 1 year, depending on the type of surgery. Perineal Exercises (Kegels): Teach perineal exercises to strengthen pelvic floor muscles and improve bladder control.

Question 57

# Rehabilitation and Home Care What should the pt/caregiver be taught in regareds to activity restriction?

Answer 57

Avoid Straining: Advise against straining during bowel movements. Heavy Lifting: Instruct to avoid heavy lifting for 6 to 8 weeks. Prolonged Sitting: Advise against long car trips or prolonged sitting for 6 to 8 weeks.

Question 58

# Rehabilitation and Home Care What should be taught/done in regareds to diet and sexual issues post-prostatectomy?

Answer 58

Dietary Recommendations: Fluids: Encourage adequate fluid intake. Avoid Irritants: Advise against coffee, alcohol, and spicy foods, as they can irritate the bladder. Sexual Issues: Assessment and Referral: Assess for sexual concerns and refer to specialists as needed (e.g., urologist, sex therapist).

Question 59

# Disorders Affecting the Testes and Adjacent Structures What is Orchitis? Cause?

Answer 59

Definition: Rare, acute inflammation of the testes. Cause: Typically due to infection.

Question 60

# Disorders Affecting the Testes and Adjacent Structures What is Epididymitis? Cause? Symptoms?

Answer 60

Definition: Infection of the epididymis (the tube that carries sperm from the testicle). Cause: Usually spreads from infection in surrounding areas (e.g., urethra, bladder). Symptoms: Pain and swelling, which can progress to the point where the epididymis and testis are indistinguishable.

Question 61

# Disorders Affecting the Testes and Adjacent Structures What is testicular torsion? Consequences?

Answer 61

Definition: Surgical emergency involving the rotation of the testis, twisting the blood vessels and impeding blood flow. Consequences: Can lead to testicular damage or loss if not treated promptly.

Question 62

# Disorders Affecting the Testes and Adjacent Structures What is testicular cancer? Risk factors? Symptoms?

Answer 62

Definition: Malignant tumor that develops in the tissues of the testicle. Risk Factors: undescended testicle (cryptorchidism), positive family history, cancer of one testicle, Caucasian American race Symptoms: Painless lump or swelling in the testicle, heaviness in the scrotum, dull ache in the abdomen or groin.

Question 63

# Testicular Cancer What age group is testicular cancer the most common cancer? What are some early diagnosis?

Answer 63

Men ages 15-40 years Monthly testicular self-exam (TSE) and annual testicular exam

Question 64

# Testicular Cancer Treatment How is testicular cancer treated?

Answer 64

Orchidectomy (removal of testicle), retroperitoneal lymph node dissection (open or laparoscopic)(to diagnose lymph node involvement), radiation therapy, chemotherapy

Question 65

# Nursing Management What are some aspects of nursing management of testicular cancer?

Answer 65

Assessment of physical and psychological status Support of coping (Treatment may be lengthy) Address issues of body image and sexuality Encourage a positive attitude Patient education TSE and follow-up care

Question 66

# Disorders affecting testes What is hydrocele? Causes? Management?

Answer 66

Definition: Accumulation of fluid in the tunica vaginalis (a membrane surrounding the testicle). Causes: Congenital (present at birth), radiation therapy, local injury. Management: Can be self-limiting (resolve on its own) or require removal of fluid (aspiration or surgery).

Question 67

# Disorders affecting testes What is varicocele? Cause? Laterality? Management?

Answer 67

Definition: Dilation (enlargement) of the spermatic vein within the scrotum. Cause: Incompetent valves within the vein, leading to blood pooling. Laterality: More common on the left side. Management: Scrotal support (e.g., supportive underwear) can help alleviate discomfort.

Question 68

# Disorders affecting testes What is a vasectomy? Purpose? Mechanism?

Answer 68

Definition: Bilateral surgical ligation or resection of the ductus deferens (vas deferens). Purpose: Male sterilization procedure. Mechanism: Involves cutting or blocking the vas deferens (the tubes that carry sperm from the testicles).

Question 69

# Conditions Affecting the Penis What is Hypospadias and Epispadias? Management?

Answer 69

Definition: Congenital conditions where the urethral opening is located in an abnormal position. Hypospadias: Urethra opens on the underside (ventral surface) of the penis. Epispadias: Urethra opens on the top (dorsal surface) of the penis. Management: Surgical repair is typically required.

Question 70

# Conditions Affecting the Penis What is phimosis? Management?

Answer 70

Definition: Inability to retract the foreskin over the glans penis. Management: May require manual retraction and cleansing, or in severe cases, circumcision.

Question 71

# Conditions Affecting the Penis What is penile cancer? Manifestation?

Answer 71

Definition: Rare malignancy of the penis. Manifestation: Usually presents with a lesion or growth on the penis.

Question 72

# Conditions Affecting the Penis What is priapism? Association? Management?

Answer 72

Definition: Prolonged, painful erection unrelated to sexual stimulation. Association: Can be associated with sickle cell disease. Management: Aspiration of blood from the corpora cavernosa (erectile tissue) or injection of sympathomimetic agents (to constrict blood vessels).

Question 73

# Conditions Affecting the Penis cont. What is peyronie's disease? Effect?

Answer 73

Definition: Acquired, benign condition characterized by the development of plaques (fibrous scar tissue) within the tunica albuginea (the covering of the corpora cavernosa).   Effect: Causes curvature or bending of the penis during erection.  

Question 74

# Conditions Affecting the Penis cont. What is urethral stricture? Causes? Consequences?

Answer 74

Definition: Narrowing of a section of the urethra.   Causes: Can be congenital or acquired due to injury, infection, or inflammation.   Consequences: Can lead to difficulty urinating, pain, and urinary tract infections.  

Question 75

# Conditions Affecting the Penis cont. What is circumcision?

Answer 75

Surgical removal of the foreskin.  

Question 76

# Vasectomy (1 of 3) What are some of the procedure details of vasectomy? Reversibility?

Answer 76

Local anesthesia is used. Outpatient procedure (patient goes home the same day). Takes 15 to 30 minutes to perform. Reversibility: * Although vasectomy is intended to be a permanent form of contraception, reversals are common. * Reversal procedures are called vasovasotomy or vasoepididymostomy.

Question 77

# Vasectomy (2 of 3) What does ejaculate look/feel like after a vasectomy? What are some key educational points post op?

Answer 77

Ejaculate has similar look and feel; made of seminal and prostatic fluid Education: Alternate contraception required until no sperm in semen ## Footnote Sperm cells are made but stored in epididymis and reabsorbed by the body

Question 78

# Vasectomy (3 of 3) What effect does a vasectomy has on hormone? Ability to ejaculate? Erection/Orgasm?

Answer 78

Vasectomy does not affect hormone production, ability to ejaculate or physiologic mechanisms for erection or orgasm

Question 78

# Vasectomy (3 of 3) What are some psychologic adjectments that may be a concern post-vastectomy? | 3

Answer 78

Consider vasectomy as castration Psychogenic ED Increased sexual activity to prove masculinity

Question 79

Which of the following are common symptoms of benign prostatic hyperplasia (BPH)? Select all that apply. A. Increased urinary frequency B. Nocturia C. Decreased force of urine stream D. Erectile dysfunction E. Hematuria F. Testicular pain

Answer 79

A, B, C, E Rationale: The document lists increased frequency, nocturia, decreased force of stream, and hematuria as potential symptoms associated with prostate issues, including BPH.

Question 80

A 68-year-old African American man with a family history of prostate cancer is undergoing a routine screening. Which of the following is the most sensitive test for detecting prostate cancer in its early stages? A. Digital rectal exam (DRE) B. Transrectal ultrasound (TRUS) C. Prostate-specific antigen (PSA) test D. Testicular self-examination (TSE)

Answer 80

C. Prostate-specific antigen (PSA) test Rationale: While all options are relevant, the PSA test is highlighted as being sensitive for detecting prostate cancer.

Question 81

A 62-year-old man, who is a smoker with a history of hypertension, reports difficulty achieving and maintaining an erection. He expresses concern about his sexual function. Which of the following is the most appropriate initial nursing intervention? A. Reassure the patient that erectile dysfunction is a normal part of aging. B. Instruct the patient on the use of phosphodiesterase inhibitors. C. Assess the patient's cardiovascular risk factors and medication use. D. Recommend the patient consult a psychiatrist. Correct Answer

Answer 81

C. Assess the patient's cardiovascular risk factors and medication use. Rationale: Given the patient's history, a thorough assessment of potential physical causes is critical before addressing psychological aspects or prescribing medications.

Question 82

A 70-year-old man is scheduled for a transrectal ultrasound (TRUS) and prostate biopsy. Which of the following nursing interventions are essential before the procedure? Select all that apply. A. Administer a laxative or enema as prescribed. B. Ensure the patient has received antibiotic prophylaxis. C. Instruct the patient to maintain a full bladder. D. Explain the procedure and obtain informed consent. E. Encourage the patient to ambulate immediately after the procedure. F. Monitor for signs of infection post-procedure.

Answer 82

A, B, D, F Rationale: These interventions are crucial for preparing the patient for the procedure, ensuring safety, and monitoring for complications.

Question 83

A 35-year-old man is diagnosed with retrograde ejaculation. Which treatment option is most likely to be considered? A. Radical prostatectomy B. Alpha-adrenergic antagonists C. Electroejaculation D. Testosterone replacement therapy

Answer 83

C. Electroejaculation

Question 84

A 65-year-old male patient with benign prostatic hyperplasia (BPH) reports difficulty initiating urination and a weak urine stream. Which of the following medications would be most appropriate to address these symptoms? A. Ciprofloxacin B. Flomax (tamsulosin) C. Sildenafil (Viagra) D. NSAIDs

Answer 84

B. Flomax (tamsulosin) Rationale: Flomax (tamsulosin) is an alpha-blocker used to promote prostate relaxation and improve urine flow, as mentioned in the document.

Question 85

What is the primary mechanism of action of alpha-adrenergic blockers, such as tamsulosin (Flomax), in treating BPH? A. Inhibits 5-alpha reductase B. Relaxes smooth muscle in the prostate and bladder neck C. Reduces prostate size D. Inhibits bacterial growth

Answer 85

B. Relaxes smooth muscle in the prostate and bladder neck Rationale: The document mentions "Alpha-adrenergic blockers (alfuzosin, tamsulosin & terazosin): relaxes muscles to reduce pain and spasms."

Question 86

What is the purpose of continuous bladder irrigation (CBI) after prostatectomy? A. To prevent constipation B. To maintain fluid balance C. To prevent blood clot formation D. To relieve pain

Answer 86

C. To prevent blood clot formation

Question 87

A patient who underwent a prostatectomy reports severe bladder spasms and pain. Which of the following nursing interventions is most appropriate? A. Administer a laxative to prevent constipation. B. Encourage the patient to ambulate frequently. C. Irrigate the catheter with warm saline. D. Administer analgesics and antispasmodics as prescribed.

Answer 87

D. Administer analgesics and antispasmodics as prescribed.

Question 88

A patient scheduled for a prostatectomy expresses anxiety about the surgery and potential changes to his sexual function. Which of the following nursing interventions are appropriate to reduce his anxiety? Select all that apply. A. Provide privacy for the patient to verbalize concerns. B. Be sensitive to potentially embarrassing and culturally charged issues. C. Establish a professional, trusting relationship. D. Avoid discussing sexual function to prevent further anxiety. E. Provide patient education, including explanations of anatomy and function. F. Encourage the patient to avoid asking questions to reduce anxiety.

Answer 88

A, B, C, E Rationale: These interventions help create a supportive environment and address the patient's concerns.

Question 89

A patient is diagnosed with epididymitis. Which of the following nursing interventions is most appropriate? A. Application of cold packs to the scrotum. B. Encouraging ambulation to promote drainage. C. Elevation of the scrotum with scrotal support. D. Limiting fluid intake to reduce swelling.

Answer 89

C. Elevation of the scrotum with scrotal support.

Question 90

A patient who underwent a vasectomy expresses concern about his sexual function. Which of the following nursing interventions are appropriate? Select all that apply. A. Reassure the patient that sexual function is not affected. B. Explain the procedure and its effects on fertility. C. Instruct the patient to use alternate contraception until semen is sperm-free. D. Encourage the patient to avoid sexual activity for several weeks. E. Provide information on potential complications, such as hematoma or infection. F. Suggest the patient consider sperm banking.

Answer 90

A, B, C, E Rationale: These interventions address the patient's concerns and provide necessary information.

Question 91

Which of the following are symptoms of priapism? Select all that apply. A. Prolonged erection B. Painful erection C. Decreased libido D. Urinary incontinence E. Abdominal pain F. Swelling of the scrotum

Answer 91

A, B

Question 92

Which of the following are potential complications of a varicocele? Select all that apply. A. Infertility B. Testicular atrophy C. Scrotal pain D. Hydrocele E. Epididymitis F. Priapism

Answer 92

A, B, & C

Question 93

Which of the following are potential complications associated with catheter removal after prostatectomy? Select all that apply? A. Urinary incontinence B. Sexual dysfunction C. Infection D. Venous thromboembolism E. Bowel obstruction F. Improved bladder control

Answer 93

A, B, C, D

Question 94

Which of the following are potential symptoms of advanced prostate cancer? Select all that apply. A. Early ejaculation B. Backache C. Hip pain D. Perineal/rectal discomfort E. Weight loss F. Oliguria

Answer 94

B, C, D, E, F