Deck 75: Care of Male Patients With Reproductive Problems

Question 1

A client is scheduled for a prostatectomy for benign prostatic hyperplasia (BPH).On the morning of surgery,the laboratory report on the client's urine indicates the presence of red blood cells,white blood cells,and bacteria.Which is the nurse's highest priority action?

A) Document the report in the client's chart.
B) Insert a new Foley catheter before surgery.
C) Strain the client's urine.
D) Assess the client's vital signs and notify the health care provider.

Answer 1

Assess the client's vital signs and notify the health care provider.

Question 2

Which client diagnosed with prostate cancer is not a candidate for watchful waiting?

A) Client with very early cancer of the prostate
B) Client who is asymptomatic
C) Client who wants to avoid urinary incontinence as a result of treatment
D) Client who refuses frequent digital rectal examinations (DREs)

Answer 2

Client who refuses frequent digital rectal examinations (DREs)

Question 3

A client's laboratory findings reveal an elevated serum acid phosphatase level and a high-normal prostate-specific antigen level.How does the nurse interpret this information?

A) The client shows evidence of renal disease and should be evaluated further.
B) These results may indicate prostate cancer. He should be further evaluated.
C) These results are not abnormal. He does not need to be evaluated further.
D) These results may indicate an infection. He should be evaluated further.

Answer 3

These results may indicate prostate cancer. He should be further evaluated.

Question 4

Which client statement indicates understanding about a transrectal ultrasound?

A) "This will determine if the outlet of my bladder is obstructed."
B) "This will determine the amount of residual urine present."
C) "This is performed to view the interior of the bladder and urethra."
D) "This is performed to view the prostate and do a tissue biopsy."

Question 5

A client had a transurethral prostatectomy and has incontinence.Which statement by the client indicates a need for clarification about managing this condition?

A) "I will practice stopping the urine stream to strengthen my sphincter control."
B) "I will limit my fluid intake every day to prevent incontinence."
C) "I will avoid vigorous activity for the first 3 weeks after surgery."
D) "I will avoid caffeinated beverages and spicy foods."

Question 6

The nurse is assisting a client with limited mobility into position for examination of his prostate gland.How does the nurse best assist the client?

A) Assist the client to bend over the examination table.
B) Hold the client up as he bends over the bedside table.
C) Help the client lie down in a side-lying fetal position.
D) Assist the client to lie in a prone position.

Question 7

A client has been taking finasteride (Proscar)for 4 weeks and reports that he has not yet seen a reduction in symptoms.Which response by the nurse is most appropriate?

A) "Have you been taking the medication as ordered?"
B) "It may take several months to see results."
C) "It may not be the right drug for you."
D) "We can try dutasteride (Avodart) next."

Question 8

A client who was treated 1 year ago for testicular cancer now has an elevated serum alpha-fetoprotein level.Which topic is most important for the nurse to teach this client about?

A) Sperm banking options
B) Effects of chemotherapy
C) Hospice philosophy
D) Importance of yearly monitoring

Question 9

A client with a catheter in place after a suprapubic prostatectomy has decreased urinary output.Which action by the nurse is most appropriate?

A) Assess the client for bladder spasms.
B) Encourage the client to drink more water.
C) Administer pain medication.
D) Have the client try to void around the catheter.

Question 10

A client is going home after outpatient surgery for a hydrocele.Which information does the nurse emphasize in teaching this client?

A) "Report to the doctor immediately any drainage from your drain."
B) "Use a condom during intercourse to prevent incisional infection."
C) "Sit when you urinate until all swelling is gone and drainage has stopped."
D) "Wear the scrotal support device for at least 3 weeks after surgery."

Question 11

A client with prostate cancer reports pain in his lower back and legs.Which action by the nurse is most appropriate?

A) Discuss medications for arthritis.
B) Perform a bladder scan.
C) Facilitate imaging studies.
D) Encourage weight-bearing exercises.

Question 12

The nurse is assessing a client who has undergone a transurethral resection of the prostate (TURP).Which assessment finding requires immediate action by the nurse?

A) Passing small blood clots after catheter removal
B) Experiencing urinary frequency after catheter removal
C) Having bright red drainage with multiple blood clots
D) Having the urge to void continuously while the catheter is inserted

Question 13

Which client statement indicates understanding about post-orchiectomy care for testicular cancer?

A) "I will avoid contact sports to prevent injury and development of cancer in my remaining testis."
B) "I will always use a condom because I am at increased risk for acquiring a sexually transmitted disease."
C) "I will wear an athletic supporter and cup to prevent testicular cancer in my remaining testicle."
D) "I will continue to perform testicular self-examination (TSE) monthly on my remaining testicle."

Question 14

A client had a spermatocele removed in an outpatient surgical center.Which statement by the client indicates good understanding of discharge instructions?

A) "The heavy drainage will go away within a few days."
B) "I need to buy dressing supplies at the drugstore."
C) "I should report any redness or drainage from the incision."
D) "Because of all the narcotics I'll be taking, I will need laxatives."

Question 15

A client is scheduled for a penectomy for penile cancer.Which action by the nurse is most important?

A) Teaching the client to sit when he urinates
B) Demonstrating dressing changes and wound cleaning
C) Assessing the client's psychosocial status and support
D) Explaining the purpose of the in-dwelling catheter

Question 16

A client had a seminoma removed via an open procedure.The following day,the client's abdomen is soft and nontender,but no bowel sounds are present.Which action by the nurse is most appropriate?

A) Encourage the client to ambulate several times a day.
B) Reassess the client's abdomen in 4 hours.
C) Document the finding and call the surgeon immediately.
D) Give the client a laxative and encourage high-fiber food.

Question 17

A client diagnosed with early prostate cancer is confused that surgery has not been planned.Which is the nurse's best response?

A) "The disease is slow-growing. The risks of surgery at your age are not justified by the outcome."
B) "Your disease is so advanced that surgery at this point would not increase your chances of cure."
C) "Your disease is in a very early stage and is slow-growing. Your doctor will monitor you."
D) "This stage indicates that you do not really have cancer, so surgery is not necessary."

Question 18

Which statement indicates that a client understands the most appropriate time of day to take an alpha blocker drug for treatment of benign prostatic hyperplasia (BPH)?

A) "I'll take my medication at bedtime."
B) "As soon as I get up, I will take my medication."
C) "I will take my medication with food or milk."
D) "I'll take my medication on an empty stomach."

Question 19

A client's prostate-specific antigen (PSA)level is 2.0 ng/mL.Which action by the nurse is most appropriate?

A) Inform the client that the results are normal and no cancer has been detected.
B) Inform the client that results are normal and schedule a digital rectal examination.
C) Let the client know that the results are elevated and he is at risk for prostate cancer.
D) Tell the client that cancer is indicated and that the health care provider recommends watchful waiting.

Question 20

Which client is most likely to have organic erectile dysfunction?

A) Middle-aged man who first had sexual intercourse at age 15
B) Middle-aged man who has had diabetes mellitus for 25 years
C) Young man who had a myocardial infarction 2 years ago
D) Young man who has a job that causes him high stress levels

Question 21

A client with BPH asks why his enlarged prostate is causing difficulty with urination.Which is the nurse's most accurate response?

A) "It compresses the urethra, blocking the flow of urine."
B) "It presses on the kidneys, decreasing urine formation."
C) "It secretes acids that weaken the bladder, causing dribbling."
D) "It destroys nerves, decreasing awareness of a full bladder."

Question 22

Which symptoms are expected in orchitis?

A) Scrotal pain
B) Dysuria
C) Scrotal edema
D) Priapism
E) Penile discharge
F) Inability to ejaculate

Question 23

An older client with benign prostatic hyperplasia (BPH)and hypertension is being treated with doxazosin (Cardura)while staying in the hospital.Which activity does the nurse delegate to the unlicensed assistive personnel (UAP)as a priority?

A) Helping the client choose low-sodium meal items
B) Assisting the client whenever he gets out of bed
C) Encouraging the client to use the spirometer hourly
D) Frequently re-orienting the client to his surroundings

Question 24

A client has returned to the nursing unit after a prostatectomy.Which activities does the nurse delegate to the unlicensed assistive personnel (UAP)?

A) Demonstrating how to use the incentive spirometer
B) Measuring and recording output from the in-dwelling catheter
C) Encouraging the client to get out of bed and into the chair
D) Irrigating the catheter with normal saline for blood clots
E) Re-taping the catheter tape if the client reports pain

Question 25

The client with sickle cell anemia has had an erection for longer than 4 hours.How does the nurse intervene?

A) Administer a diuretic to increase urine output.
B) Attempt to relieve pressure by catheterizing the client.
C) Document the finding and reassess in 4 hours.
D) Notify the health care provider and prepare to give meperidine (Demerol).

Question 26

A client is taking goserelin (Zoladex).What periodic assessment does the nurse plan for this client?

A) Weight and abdominal girth
B) Pulmonary function tests
C) Bone density testing
D) Abdominal ultrasound

Question 27

Which intervention helps the client with chronic prostatitis prevent spread of infection to other areas of the urinary tract?

A) "Wear a condom during intercourse."
B) "Avoid alcohol and caffeinated beverages."
C) "Be sure to empty your bladder completely at each voiding."
D) "Sexual intercourse or masturbation can help drain the prostate."

Question 28

The nurse is caring for a young adult who just got married and has been diagnosed with testicular cancer.To which community resource does the nurse refer him?

A) American Cancer Society
B) Red Cross
C) Sperm bank
D) Public Health Department

Question 29

The nurse is performing a psychosocial assessment of a young man diagnosed with testicular cancer.Which does the nurse include as a priority in the assessment?

A) Encouraging the client to verbalize his thoughts and feelings to his health care provider
B) Assisting the client in locating a support group for men with testicular cancer
C) Asking the client to rate his fears of sexual deficiency on a scale of 1 to 10
D) Identifying all components of his support system, including his partner

Question 30

A client has decided to treat his enlarged prostate with saw palmetto.Which is the nurse's best response?

A) "You'll need to get permission from your health care provider to make that decision."
B) "Saw palmetto is a well-respected alternative therapy for benign prostatic hyperplasia."
C) "Have you discussed this decision with your family?"
D) "What has your health care provider told you about this choice of therapy?"

Question 31

A client is receiving brachytherapy for prostate cancer.Which intervention is most important for the nurse to include in the client's care plan?

A) Reassure the client that erectile dysfunction does not occur with brachytherapy.
B) Help the client plan activities interspersed with rest periods during the day.
C) Remind the client that while hospitalized, he cannot have any visitors.
D) Discuss hospice philosophy and availability with the client and family.