NUR 304 Chapter 64: Care of Patients with Male Reproductive Problems

The nurse is conducting a history on a male client to determine the severity of symptoms associated with prostate enlargement. Which finding is cause for prompt action by the nurse?

a. Cloudy urine

b. Urinary hesitancy

c. Post-void dribbling

d. Weak urinary stream

a

A client is diagnosed with benign prostatic hyperplasia and seems sad and irritable. After assessing the clients behavior, which statement by the nurse would be the most appropriate?

a. The urine incontinence should not prevent you from socializing.

b. You seem depressed and should seek more pleasant things to do.

c. It is common for men at your age to have changes in mood.

d. Nocturia could cause interruption of your sleep and cause changes in mood.

d

A 55-year-old African-American client is having a visit with his health care provider. What test should the nurse discuss with the client as an option to screen for prostate cancer, even though screening is not routinely recommended?

a. Complete blood count

b. Culture and sensitivity

c. Prostate-specific antigen

d. Cytoscopy

c

The nurse is teaching a client with benign prostatic hyperplasia (BPH). What statement indicates a lack of understanding by the client?

a. There should be no problem with a glass of wine with dinner each night.

b. I am so glad that I weaned myself off of coffee about a year ago.

c. I need to inform my allergist that I cannot take my normal decongestant.

d. My normal routine of drinking a quart of water during exercise needs to change.

a

A client has returned from a transurethral resection of the prostate with a continuous bladder irrigation. Which action by the nurse is a priority if bright red urinary drainage and clots are noted 5 hours after the surgery?

a. Review the hemoglobin and hematocrit as ordered.

b. Take vital signs and notify the surgeon immediately.

c. Release the traction on the three-way catheter.

d. Remind the client not to pull on the catheter.

b

A nurse and an unlicensed assistive personnel (UAP) are caring for a client with an open radical prostatectomy. Which comfort measure could the nurse delegate to the UAP?

a. Administering an antispasmodic for bladder spasms

b. Managing pain through patient-controlled analgesia

c. Applying ice to a swollen scrotum and penis

d. Helping the client transfer from the bed to the chair

d

A client is diagnosed with metastatic prostate cancer. The client asks the nurse the purpose of his treatment with the luteinizing hormone releasing hormone(LH-RH) agonist leuprolide(Lupron) and the bisphosphonate pamidronate (Aredia). Which statement by the nurse is most appropriate?

a. The treatment reduces testosterone and prevents bone fractures.

b. The medications prevent erectile dysfunction and increase libido.

c. There is less gynecomastia and osteoporosis with this drug regimen.

d. These medications both inhibit tumor progression by blocking androgens.

a

The nurse is administering sulfamethoxazole-trimethoprim(Bactrim) to a client diagnosed with bacterial prostatitis. Which finding causes the nurse to question this medication for this client?

a. Urinary tract infection

b. Allergy to sulfa medications

c. Hematuria

d. Elevated serum white blood cells

b

A 55-year-old male client is admitted to the emergency department with symptoms of a myocardial infarction. Which question by the nurse is the most appropriate before administering nitroglycerin?

a. On a scale from 0 to 10, what is the rating of your chest pain?

b. Are you allergic to any food or medications?

c. Have you taken any drugs like Viagra recently?

d. Are you light-headed or dizzy right now?

c

A 34-year-old client comes to the clinic with concerns about an enlarged left testicle and heaviness in his lower abdomen. Which diagnostic test would the nurse expect to be ordered to confirm testicular cancer?

a. Alpha-fetoprotein (AFP)

b. Prostate-specific antigen (PSA)

c. Prostate acid phosphatase (PAP)

d. C-reactive protein (CRP)

a

A 25-year-old client has recently been diagnosed with testicular cancer and is scheduled for radiation therapy. Which intervention by the nurse is best?

a. Ask the client about his support system of friends and relatives.

b. Encourage the client to verbalize his fears about sexual performance.

c. Explore with the client the possibility of sperm collection.

d. Provide privacy to allow time for reflection about the treatment.

c

A 70-year-old client returned from a transurethral resection of the prostate 8 hours ago with a continuous bladder irrigation. The nurse reviews his laboratory results as follows:Sodium 128mEq/L, Hemoglobin 14 g/dL Hematocrit 42% Red blood cell count4.5 What action by the nurse is the most appropriate?

a. Consider starting a blood transfusion.

b. Slow down the bladder irrigation if the urine is pink.

c. Report the findings to the surgeon immediately.

d. Take the vital signs every 15 minutes.

b

The nurse is teaching an uncircumcised 65-year-old client about self-management of a urinary catheter in preparation for discharge to his home. What statement indicates a lack of understanding by the client?

a. I only have to wash the outside of the catheter once a week.

b. I should take extra time to clean the catheter site by pushing the foreskin back.

c. The drainage bag needs to be changed at least once a week and as needed.

d. I should pour a solution of vinegar and water through the tubing and bag.

a

A client is interested in learning about the risk factors for prostate cancer. Which factors does the nurse include in the teaching? (Select all that apply.)

a. Family history of prostate cancer

b. Smoking

c. Obesity

d. Advanced age

e. Eating too much red meat

f. Race

a,d,e,f

The nurse is administering finasteride(Proscar) and doxazosin(Cardura) to a 67-year- old client with benign prostatic hyperplasia. What precautions are related to the side effects of these medications? (Select all that apply.)

a. Assessing for blood pressure changes when lying, sitting, and arising from the bed

b. Immediately reporting any change in the alanine aminotransferase laboratory test

c. Teaching the client about the possibility of increased libido with these medications

d. Taking the client's pulse rate for a minute in anticipation of bradycardia

e. Asking the client to report any weakness, light-headedness, or dizziness

a,b,e

A client came to the clinic with erectile dysfunction. What are some possible causes of this condition that the nurse could discuss with the client during history taking? (Select all thatapply.)

a. Recent prostatectomy

b. Long-term hypertension

c. Diabetes mellitus

d. Hour-long exercise sessions

e. Consumption of beer each night

a,b,c,e

The nurse notes bright red urinary drainage from a client who had a transurethral resection of the prostate (TURP) with continuous bladder irrigation yesterday. What is the appropriate initial nursing action?

A. Calculate intake and output.

B. Monitor hemoglobin and hematocrit.

C. Increase the rate of the bladder irrigation.

D. Document findings in the electronic health record.

c

Which assessment finding will the nurse report to the health care provider for a client who had an orchiectomy and laparoscopic radical retroperitoneal lymph node dissection this morning?

A. BP 130/80 mm Hg, T 98.9°F, R 16, P 70

B. Urinary catheter draining clear yellow urine

C. Expresses fearfulness of inability to perform sexually

D. Reports pain of 9 on a 0-10 scale after receiving pain medication

d

The nurse is teaching a client with erectile dysfunction about taking sildenafil to achieve an erection. Which client statement demonstrates an understanding of this drug?

A. "I can have sex up to 8 hours after taking the drug."

B. "I might get a headache or stuffy nose when this drug is used."

C. "Taking this with a drink or two of alcohol will enhance my performance."

D. "If one pill doesn't work, it is acceptable for me to quickly take another pill."

b

A client with a history of BPH calls the telehealth nurse reporting the sudden onset of testicular pain after moving heavy furniture. What is the appropriate nursing response?

A. "Taking ibuprofen may help alleviate the pain."

B. "Please go to your closest emergency department right away."

C. "This is a common reaction when performing labor; the pain will go away."

D. "Your BPH is probably giving you difficulty because you were moving furniture."

Which criteria will the nurse assess in a client with benign prostatic hyperplasia that may indicate the need for surgical intervention? Select all that apply.

a. Hematuria

b. Hydronephrosis

c. Acute urinary retention resulting from obstruction

d. Acute urinary infection unresponsive to first-line antibiotics

e. Chronic urinary tract infection secondary to residual urine in bladder

a,b,c,e

Which symptom does the nurse expect will be present when admitting a client diagnosed with benign prostatic hyperplasia?

a. Constipation

b. Scrotal discomfort

c. Erectile dysfunction

d. Difficulty urinating

d