Deck 54: Male Reproductive and Genital Problems

Question 1

The nurse will anticipate that a 61-yr-old patient who has an enlarged prostate detected by digital rectal examination (DRE)and an elevated prostate specific antigen (PSA)level will need teaching about

A)cystourethroscopy.
B)uroflowmetry studies.
C)magnetic resonance imaging (MRI).
D)transrectal ultrasonography (TRUS).

Answer 1

transrectal ultrasonography (TRUS).

Question 2

A 27-yr-old patient who has testicular cancer is being admitted for a unilateral orchiectomy. The patient does not talk to his wife and speaks to the nurse only to answer the admission questions. Which action is appropriate for the nurse to take?

A)Teach the patient and the wife that impotence is unlikely after unilateral orchiectomy.
B)Ask the patient if he has any questions or concerns about the diagnosis and treatment.
C)Inform the patient's wife that concerns about sexual function are common with this diagnosis.
D)Document the patient's lack of communication on the health record and continue preoperative care.

Answer 2

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

Question 3

Which information will the nurse plan to include when teaching a young adult who has a family history of testicular cancer about testicular self-examination?

A)Testicular self-examination should be done at least weekly.
B)Testicular self-examination should be done in a warm room.
C)The only structure normally felt in the scrotal sac is the testis.
D)Call the health care provider if one testis is larger than the other.

Answer 3

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

Question 4

The nurse will plan to teach a 67-yr-old patient who has been diagnosed with orchitis about

A)pain management.
B)emergency surgery.
C)application of heat to the scrotum.
D)aspiration of fluid from the scrotal sac.

Question 5

When performing discharge teaching for a patient after a vasectomy,the nurse instructs the patient that he

A)should continue to use other methods of birth control for 6 weeks.
B)should not have sexual intercourse until his 6-week follow-up visit.
C)may have temporary erectile dysfunction (ED) because of swelling.
D)will notice a decrease in the appearance and volume of his ejaculate.

Question 6

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)force of urinary stream.
D)erectile dysfunction (ED).

Question 7

The plan of care for a patient immediately after a perineal radical prostatectomy will include decreasing the risk for infection related to

A)urinary incontinence.
B)prolonged urinary stasis.
C)fecal wound contamination.
D)suprapubic catheter placement.

Question 8

The nurse will plan to teach the patient who is incontinent of urine following a radical retropubic prostatectomy to

A)restrict oral fluid intake.
B)do pelvic muscle exercises.
C)perform intermittent self-catheterization.
D)use belladonna and opium suppositories.

Question 9

Which information about continuous bladder irrigation will the nurse teach to a patient who is being admitted for a transurethral resection of the prostate (TURP)?

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.

Question 10

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)sexually transmitted infection (STI).

Question 11

Which information will the nurse teach a patient who has chronic prostatitis?

A)Ibuprofen (Motrin) should provide good pain control.
B)Prescribed antibiotics should be taken for 7 to 10 days.
C)Intercourse or masturbation will help relieve symptoms.
D)Cold packs used every 4 hours will decrease inflammation.

Question 12

A 53-yr-old patient is scheduled for an annual physical examination. 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).

Question 13

The nurse will inform a patient with cancer of the prostate that side effects of leuprolide (Lupron)may include

A)flushing.
B)dizziness.
C)infection.
D)incontinence.

Question 14

The health care provider prescribes finasteride (Proscar)for a 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.

Question 15

A 70-yr-old patient who has had a transurethral resection of the prostate (TURP)for benign prostatic hyperplasia (BPH)is being discharged from the hospital today. Which patient statement indicates a need for the nurse to provide additional instruction?

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 should schedule yearly appointments for prostate examinations."
D)"I will increase fiber and fluids in my diet to prevent constipation."

Question 16

The nurse performing a focused examination to determine possible causes of infertility will assess for

A)hydrocele.
B)varicocele.
C)epididymitis.
D)paraphimosis.

Question 17

A patient with urinary obstruction from benign prostatic hyperplasia (BPH)tells the nurse,"My symptoms are much worse this week." Which response by the nurse is appropriate?

A)"Have you taken any over-the-counter (OTC) medications recently?"
B)"I will talk to the doctor about a prostate specific antigen (PSA) test."
C)"Have you talked to the doctor about surgery such as transurethral resection of the prostate (TURP)?"
D)"The prostate gland changes in size from day to day, and this may be making your symptoms worse."

Question 18

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 it might affect his ability to have sexual intercourse. Which action should the nurse take?

A)Discuss alternative methods of sexual expression.
B)Teach about medication for erectile dysfunction (ED).
C)Clarify that TURP does not commonly affect erection.
D)Offer reassurance that fertility is not affected by TURP.

Question 19

The nurse will plan to teach the patient scheduled for photovaporization of the prostate (PVP)

A)that urine will appear bloody for several days.
B)how to care for an indwelling urinary catheter.
C)that symptom improvement takes 2 to 3 weeks.
D)about complications associated with urethral stenting.

Question 20

A patient tells the nurse that he decided to seek treatment for erectile dysfunction (ED)because his wife "is losing patience with the situation." The nurse's follow-up questions should focus on the man's identified concern with

A)low self-esteem.
B)role performance.
C)increased anxiety.
D)infrequent intercourse.

Question 21

After a transurethral resection of the prostate (TURP),a 64-yr-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)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.

Question 22

The following male patients recently arrived in the emergency department. Which one should the nurse assess first?

A)A 19-yr-old patient who is complaining of severe scrotal pain
B)A 60-yr-old patient with a nontender ulceration of the glans penis
C)A 64-yr-old patient who has dysuria after brachytherapy for prostate cancer
D)A 22-yr-old patient who has purulent urethral drainage and severe back pain

Question 23

When caring for a patient with continuous bladder irrigation after having transurethral resection of the prostate,which action could the nurse delegate to unlicensed assistive personnel (UAP)?

A)Teach the patient how to perform Kegel exercises.
B)Report any complaints of pain or spasms to the nurse.
C)Monitor for increases in bleeding or presence of clots.
D)Increase the flow rate of the irrigation if clots are noted.

Question 24

A 22-yr-old patient tells the nurse at the health clinic that he has recently had some problems with erectile dysfunction. Which question should the nurse ask to assess for possible etiologic factors in this age group?

A)"Do you use recreational drugs or drink alcohol?"
B)"Do you experience an unusual amount of stress?"
C)"Do you have cardiovascular or peripheral vascular disease?"
D)"Do you have a history of an erection that lasted for 6 hours or more?"

Question 25

Which assessment information collected by the nurse may present a contraindication to a testosterone replacement therapy (TRT)?

A)The patient has noticed a decrease in energy level for a few years.
B)The patient's symptoms have increased steadily over the past few years.
C)The patient has been using sildenafil (Viagra) several times every week.
D)The patient has had a gradual decrease in the force of his urinary stream.

Question 26

A patient who has been diagnosed with stage 2 prostate cancer chooses the option of active surveillance. The nurse will plan to

A)vaccinate the patient with sipuleucel-T (Provenge).
B)provide the patient with information about cryotherapy.
C)teach the patient about placement of intraurethral stents.
D)schedule the patient for annual prostate-specific antigen testing.

Question 27

Which action by the unlicensed assistive personnel (UAP)who are assisting with the care of male patients with reproductive problems indicates that the nurse should provide more teaching?

A)The UAP apply a cold pack to the scrotum for a patient with mumps orchitis.
B)The UAP help a patient who has had a prostatectomy to put on antiembolism hose.
C)The UAP leave the foreskin pulled back after cleaning the glans of a patient who has a retention catheter.
D)The UAP encourage a high oral fluid intake for patient who had transurethral resection of the prostate yesterday.

Question 28

Several patients call the urology clinic requesting appointments with the health care provider as soon as possible. Which patient will the nurse schedule to be seen first?

A)A 22-yr-old patient who has noticed a firm, nontender lump on his scrotum
B)A 35-yr-old patient who is concerned that his scrotum "feels like a bag of worms"
C)A 40-yr-old patient who has pelvic pain while being treated for chronic prostatitis
D)A 70-yr-old patient who is reporting frequent urinary dribbling after a prostatectomy

Question 29

The health care provider prescribes the following interventions for a patient with acute prostatitis caused by Escherichia coli. Which intervention should the nurse question?

A)Give trimethoprim/sulfamethoxazole 1 tablet daily for 28 days.
B)Administer ibuprofen 400 mg every 8 hours as needed for pain.
C)Instruct patient to avoid sexual intercourse until treatment is complete.
D)Catheterize the patient as needed if symptoms of urinary retention develop.

Question 30

After reviewing the electronic medical record shown in the accompanying figure for a patient who had transurethral resection of the prostate the previous day,which information requires the most rapid action by the nurse?

A)Elevated temperature and pulse
B)Bladder spasms and urine output
C)Respiratory rate and lung crackles
D)No prescription for antihypertensive drugs

Question 31

The nurse in a health clinic receives requests for appointments from several patients. Which patient should be seen by the health care provider first?

A)A 48-yr-old patient who has perineal pain and a temperature of 100.4° F
B)A 58-yr-old patient who has a painful erection that has lasted more than 6 hours
C)A 38-yr-old patient who reports that he had difficulty maintaining an erection twice last week
D)A 68-yr-old patient who has pink urine after a transurethral resection of the prostate (TURP) 3 days ago

Question 32

The nurse is obtaining the pertinent health history for a man who is being evaluated for infertility. Which question focuses on a possible cause of infertility?

A)"Are you circumcised?"
B)"Have you had surgery for phimosis?"
C)"Do you use medications to improve muscle mass?"
D)"Is there a history of prostate cancer in your family?"

Question 33

A 58-yr-old patient with erectile dysfunction (ED)tells the nurse he is interested in using sildenafil (Viagra). Which action should the nurse take first?

A)Assure the patient that ED is common with aging.
B)Ask the patient about any prescription drugs he is taking.
C)Tell the patient that Viagra does not always work for ED.
D)Discuss the common adverse effects of erectogenic drugs.

Question 34

A patient who has benign prostatic hyperplasia (BPH)with urinary retention is admitted to the hospital with elevated blood urea nitrogen (BUN)and creatinine. Which prescribed therapy should the nurse implement first?

A)Infuse normal saline at 50 mL/hr.
B)Insert a urinary retention catheter.
C)Draw blood for a complete blood count.
D)Schedule pelvic magnetic resonance imaging

Question 35

The nurse in the clinic notes elevated prostate specific antigen (PSA)levels in the laboratory results of these patients. Which patient's PSA result is not expected to be elevated?

A)A 38-yr-old patient who is being treated for acute prostatitis
B)A 48-yr-old patient whose father died of metastatic prostate cancer
C)A 52-yr-old patient who goes on long bicycle rides every weekend
D)A 75-yr-old patient who uses saw palmetto to treat benign prostatic hyperplasia (BPH)