Review Questions from Class Flashcards
The Following male patients recently arrived in the emergency department. Which one should the nurse assessed first?
A. 64-year-old who has dysuria after Brachytherapy for prostate cancer
B. 22-year-old who has purulent urethral drainage and back pain
C. 19-year-old who is complaining of severe scrotal pain
D. 60-year-old with and nontender alteration of the glans penis
ANS: C
The patient’s age and symptoms suggest possible testicular torsion, which will require rapid treatment in order to prevent testicular necrosis. The other patients also require assessment by the nurse, but their history and symptoms indicate nonemergent problems (acute prostatitis, cancer of the penis, and radiation-associated urinary tract irritation)
Several patients call the urology clinic requesting appointments with the healthcare provider as soon as possible. Which patient will the nurse scheduled to be seen first?
A. 22-year-old who has noticed a firm nontender lump on his scrotum
B. 35-year-old who is concerned that his scrotum feels like a bag of worms
C.40-year-old who has pelvic pain while being treated for chronic prostatitis
D. 70-year-old who is reporting frequent urinary dribbling after a prostatectomy
ANS: A
The patient’s age and symptoms suggest possible testicular cancer. Some forms of testicular cancer can be very aggressive, so the patient should be evaluated by the health care provider as soon as possible. Varicoceles do require treatment, but not emergently. Ongoing pelvic pain is common with chronic prostatitis. Urinary dribbling is a common problem after prostatectomy.
The nurse a health clinic receives request for appointments from several patients. Which patient should be seen by the healthcare provider first?
A. 48-year-old man who has perineal pain at a temperature of 100.4°F
B. a 58-year-old man who has a painful erection that has lasted over six hours
C. a 38-year-old man he states he has difficulty maintaining an erection last night
D. a 68-year-old man who has pink urine after transurethral resection of the prostate three days ago
ANS: B
Priapism can cause complications such as necrosis or hydronephrosis, and this patient should be treated immediately. The other patients do not require immediate action to prevent serious complications.
After a transurethral resection of the prostate, a 64-year-old patient with continuous bladder irrigation complains of painful bladder spasms. The nurse observes clots in the urine. Which action should the nurse take first?
A. is the flow rate of the bladder irrigation
B. Administer the prescribed IV morphine sulfate
C. The patient the prescribed belladonna an opium suppository
D. Manually instill and then withdraw 50 mils of sailine into the catheter
ANS: D
The assessment suggests that obstruction by a clot is causing the bladder spasms, and the nurse’s first action should be to irrigate the catheter manually and to try to remove the clots. IV morphine will not decrease the spasm, although pain may be reduced. Increasing the flow rate of the irrigation will further distend the bladder and may increase spasms. The belladonna and opium suppository will decrease bladder spasms but will not remove the obstructing blood clot.
The nurse taking a focused health history for a patient with possible testicular cancer will ask the patient about a history of A. testicular torsion B. testicular trauma C. undescended testicles D. recent sexually transmitted disease
ANS: C
Cryptorchidism is a risk factor for testicular cancer if it is not corrected before puberty. STI, testicular torsion, and testicular trauma are risk factors for other testicular conditions but not for testicular cancer.
which Information will the nurse plan to include when teaching a community health group about testicular self examination?
A. Testicular self-examination should be done in a warm room
B. the only structure normally felt in the scrotal sac is the testes
C. testicular self exam should be done at least every week
D. call the health provider if one testis is larger than the other
ANS: A
The testes will hang lower in the scrotum when the temperature is warm (e.g., during a shower), and it will be easier to palpate. The epididymis is also normally palpable in the scrotum. One testis is normally larger. The patient should perform testicular self-examination monthly.
The nurse performing a focused examination to determine possible causes of infertility will assess for A. Hydrocele B.Variocele C.epididymitis D. paraphimosis
ANS: B
Persistent varicoceles are commonly associated with infertility. Hydrocele, epididymitis, and paraphimosis are not risk factors for infertility.
A 70-year-old patient who has had a transurethral resection of the prostate for benign prostatic hyperplasia and is being discharged from the hospital today the nurse determines that additional instructions are needed when the patient says which of the following?
A. I should call the doctor if I have incontinence at home
B.I will avoid driving until I get approval from my doctor
C.I will increase fiber and fluids in my diet to prevent constipation
D.I should continue to schedule yearly appointments for prostate exams
ANS: A
Because incontinence is common for several weeks after a TURP, the patient does not need to call the health care provider if this occurs. The other patient statements indicate that the patient has a good understanding of post-TURP instructions.
A 57-year-old patient is in continent of urine following a radical retro pubic prostatectomy the nurse will plan to teach the patient to A.restrict oral fluid intake
B.pelvic floor muscle exercises
C.to perform intermittent self-catheterization
D.the use of belladonna an opium suppositories
ANS: B
Pelvic floor muscle training (Kegel) exercises are recommended to strengthen the pelvic floor muscles and improve urinary control. Belladonna and opium suppositories are used to reduce bladder spasms after surgery. Intermittent self-catheterization may be taught before surgery if the patient has urinary retention, but it will not be useful in reducing incontinence after surgery. The patient should have a daily oral intake of 2 to 3 L.
Which information about continuous bladder irrigation well the nurse teach to the patient being admitted for transurethral resection of the prostate?
A. Bladder irrigation decreases the risk of postoperative bleeding
B. hydration and urine output are maintained by bladder irrigation
C. antibiotics are infused continuously through the bladder irrigation
D. bladder irrigation prevents obstruction of the catheter after surgery
ANS: D
The purpose of bladder irrigation is to remove clots from the bladder and to prevent obstruction of the catheter by clots. The irrigation does not decrease bleeding or improve hydration. Antibiotics are given by the IV route, not through the bladder irrigation.
A 58-year-old patient who has been recently diagnosed with benign prostatic hyperplasia tells the nurse that he does not want to have a trans urethral resection of the prostate because it might affect his ability to maintain an erection during intercourse. Which action should the nurse take?
A. provide teaching about medications for erectile dysfunction
B. discuss that transurethral resection of the prostate is not commonly affects erectile function
C. discuss alternative methods of sexual expression besides intercourse
D.offer reassurance that sperm production is not affected by transurethral resection of the prostate
ANS: B
ED is not a concern with TURP, although retrograde ejaculation is likely and the nurse should discuss this with the patient. Erectile function is not usually affected by a TURP, so the patient will not need information about penile implants or reassurance that other forms of sexual expression may be used. Because the patient has not asked about fertility, reassurance about sperm production does not address his concerns.
A 49-year-old man who has type two diabetes high blood pressure hyperlipidemia and gastroesophageal reflux and tells the nurse that he has had recent difficulty in achieving an erection. Which of the following drugs from his current medications list may cause erectile dysfunction? A.Ranitidine B.atorvastatin C. propranolol D. Metformin
C. propranolol
The nurse will plan to teach a 51-year-old man who is scheduled for an annual physical exam about a A. increased risk for testicular cancer B.possible changes in erectile function C.digital rectal examination D.prostate specific antigen testing
ANS: D
An annual digital rectal exam (DRE) and PSA are usually recommended starting at age 50 for men who have an average risk for prostate cancer. Urinalysis and uroflowmetry studies are done if patients have symptoms of urinary tract infection or changes in the urinary stream. TRUS may be ordered if the DRE or PSA is abnormal.
