Deck 57: Nursing Management: Male Reproductive Problems

Question 1

The physician prescribes finasteride (Proscar)for a 56-year-old male patient who has a BPH symptom score of 12 on the AUA Symptom Index.When teaching the patient about the medication,of what should the nurse inform him?

A) His interest in sexual activity may decrease while he is taking the medication.
B) He should change position from lying to standing slowly to avoid dizziness.
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.

Answer 1

His interest in sexual activity may decrease while he is taking the medication.

Question 2

A patient with symptomatic BPH is undergoing visual laser ablation of the prostate at an outpatient surgical centre.Preoperatively,what should the nurse explain to the patient will occur after the procedure?

A) A urinary catheter will be necessary for up to a week.
B) He should expect to have blood clots in his urine for several days.
C) A three-way catheter with slow-drip irrigation will be needed for 6 to 8 hours.
D) His voiding patterns may persist,but the irritative symptoms will be improved immediately.

Answer 2

A urinary catheter will be necessary for up to a week.

Question 3

At the health clinic,a 22-year-old man tells the nurse that he has recently become unable to achieve an erection.The nurse assesses the patient with the knowledge that the increased incidence of erectile dysfunction in young men is related to which of the following factors?

A) Stress
B) Postpriapism
C) Recreational drug use
D) Social sexual expectation

Answer 3

Recreational drug use

Question 4

When performing discharge teaching for a patient who has undergone a vasectomy in the physician's office,what should the nurse instruct the patient about?

A) He will not be able to maintain an erection for about 2 months.
B) He should not have sexual intercourse until his 6-week follow-up visit.
C) He should continue the use of other methods of birth control for 6 weeks.
D) His ejaculate will be about half the previous volume.

Question 5

A patient undergoing a TURP returns from surgery with a three-way Foley catheter with continuous bladder irrigation in place.Other postoperative orders include morphine 8 mg intravenous every 3 to 4 hours as needed for pain,belladonna and opium suppository every 4 hours as needed,and strict intake and output.The patient is complaining of painful bladder spasms,and the nurse observes blood-tinged urine on his sheets.What is the most appropriate nursing action?

A) Administer the morphine.
B) Warm the irrigation solution to body temperature.
C) Administer the belladonna and opium suppository.
D) Manually instill 50 mL of saline and try to remove clots.

Question 6

The wife of a patient who has undergone a TURP and has continuous bladder irrigation asks the nurse whether the irrigation can be stopped because it seems to increase her husband's pain.What is the best response to the patient's wife?

A) "The bladder irrigation is needed to stop the bleeding in the bladder."
B) "The irrigation is needed to keep the catheter from being occluded by blood clots."
C) "Normal production of urine is maintained with the irrigations until healing occurs."
D) "Antibiotics are being administered into the bladder with the irrigation solution to prevent infection."

Question 7

A patient scheduled for a transurethral resection of the prostate (TURP)for BPH tells the nurse that he has delayed having surgery because he is afraid it will affect his sexual function.When responding to his concern,what should the nurse explain?

A) Many methods of sexual expression can be used as alternatives to sexual intercourse.
B) Sperm production is not affected by this surgery,so he should not worry about sterility.
C) With this type of surgery,erectile problems are rare,but retrograde ejaculation may occur.
D) Information about penile implants used for erectile dysfunction is available if he is interested.

Question 8

A married couple is seen at the infertility clinic because they have not been able to conceive.The nurse includes examination of the man's testicles early in the assessment of the couple based on the knowledge that which of the following testicular problems is related to infertility?

A) Hydrocele
B) Varicocele
C) Epididymitis
D) Spermatocele

Question 9

When obtaining a nursing history from a patient with benign prostatic hyperplasia (BPH),which of the following data would the nurse expect the patient to report?

A) Grossly bloody urine
B) Difficulty maintaining an erection
C) A weak urinary stream and dribbling at the end of urination
D) Lower back pain that radiates to the hips during urination

Question 10

In teaching a male patient to perform testicular self-examination,the nurse includes information about which of the following?

A) The only structure felt in the scrotal sac is the testis.
B) The examination should be done when the scrotum is warm.
C) If one testis is larger than the other,the patient should consult his physician.
D) Unlike breast self-examination,testicular self-examination should be performed every other month.

Question 11

A 53-year-old man tells the nurse he has not been able to function sexually for several years.He is now interested in using sildenafil (Viagra)to treat his erectile dysfunction.In responding to the patient's interest,what should the nurse explain?

A) Question the patient about any prescription medications he is taking.
B) Tell the patient that sildenafil is an appropriate treatment for only a few types of erectile dysfunction.
C) Ask the patient about any previous treatment for hydrocele.
D) Reassure the patient that a gradual decline in erectile function is common with aging.

Question 12

Following a radical retropubic prostatectomy for prostate cancer,the patient is incontinent of urine.What is an appropriate nursing intervention to teach this patient?

A) Pelvic floor muscle training
B) The use of herbal saw palmetto
C) How to perform intermittent self-catheterization
D) To avoid heavy lifting,which increases the incidence of incontinence

Question 13

Leuprolide and bicalutamide (Casodex)are prescribed for a patient with cancer of the prostate.In teaching the patient about these drugs,the nurse informs the patient that which of the following side effects may occur?

A) Low blood pressure
B) Decreased sexual drive
C) Urinary incontinence
D) Frequent infections

Question 14

The physician orders a blood test for PSA when an enlarged prostate is palpated during a routine examination of a 56-year-old man.When the patient asks the nurse the purpose of the test,the nurse's response is based on what knowledge?

A) PSA levels may be elevated in patients with cancer of the prostate.
B) Elevated levels of PSA are indicative of metastatic cancer of the prostate.
C) Variations in PSA levels can be used to differentiate between BPH and prostatic cancer.
D) Baseline PSA levels are necessary to evaluate the success of treatment of prostatic cancer.

Question 15

Following discharge teaching for a patient who has had a TURP for BPH,the nurse determines that additional instruction is needed when the patient gives which of the following responses?

A) "I will increase fibre and fluids in my diet to prevent constipation."
B) "I should notify my physician if I experience incontinence at home."
C) "I will avoid heavy lifting or driving until I get approval from my physician."
D) "I will have an annual prostate examination because I have prostatic tissue that could enlarge or become malignant."

Question 16

A patient with irritative and obstructive bladder symptoms has an enlarged prostate on a digital rectal examination (DRE).To differentiate BPH from prostate cancer,which of the following tests should the nurse anticipate that the patient would be scheduled to undergo?

A) Uroflowmetry
B) Cystourethroscopy
C) Transrectal ultrasonography
D) Prostate-specific antigen (PSA)testing

Question 17

Which of the following will the nurse teach to a patient with chronic bacterial prostatitis?

A) PSA elevation indicates that he has concurrent prostate cancer.
B) Nonsteroidal anti-inflammatory drugs usually provide adequate pain control.
C) Sexual intercourse and masturbation will relieve symptoms.
D) Antibiotics should be taken for 7 to 10 days.

Question 18

A 32-year-old man scheduled for a unilateral orchiectomy for testicular cancer is admitted to the hospital the morning of surgery.He is accompanied by his wife but does not talk to her and does not initiate interaction with the nurse.What is the most appropriate nursing action?

A) Assess the patient's concerns related to his diagnosis and treatment.
B) Ask the patient's wife whether he is worried about his future sexual functioning.
C) Set a patient outcome that the patient will verbalize his concerns about his diagnosis.
D) Identify the patient's problem with the nursing diagnosis of impaired communication related to diagnosis of cancer.

Question 19

A 41-year-old man asks the nurse what he can do to decrease the risk of BPH.What should the nurse explain?

A) Foods high in zinc have been shown to delay the development of BPH.
B) Decreasing butter and margarine and increasing fruits in the diet may help.
C) He can do nothing to prevent the disease because it is a fact of aging.
D) Taking a daily vitamin E supplement has reduced prostate size in some men.

Question 20

Which medication does the nurse anticipate will be ordered for the patient to block the action of testosterone by competing with receptor sites for the treatment of prostate cancer?

A) Goserelin (Zoladex)
B) Buserelin (Suprefact)
C) Leuprolide (Lupron)
D) Flutamide (Euflex)

Question 21

What of the following does the nurse tell a patient who asks what the best treatment option is for treating BPH?

A) Transurethral incision of the prostate
B) TURP
C) Transurethral microwave thermotherapy
D) Transurethral needle ablation

Question 22

When counselling a First Nations patient about male reproductive cancers,the nurse tells the patient that First Nations men have a higher mortality than the overall Canadian population from which following type of cancer?

A) Penile cancer
B) Testicular cancer
C) Prostate cancer
D) Scrotal cancer

Question 23

Which of the following is the term given to a narrowing of the retracted uncircumcised foreskin that prevents its normal return over the glans and can cause strangulation?

A) Phimosis
B) Priapism
C) Paraphimosis
D) Hypospadias

Question 24

A patient has been diagnosed with prostate cancer.He has large tumours involving the seminal vesicle and adjacent structures.According to the Whitmore-Jewett staging classification of prostate cancer,what stage would the nurse document this patient as currently experiencing?

A) Stage A2
B) Stage B1
C) Stage C2
D) Stage D1

Question 25

A patient with a spinal cord tumour has developed a priapism that has lasted for 8 hours.The nurse notifies the physician,recognizing that the disorder can cause which of the following complications?

A) Epididymitis
B) Renal artery sclerosis
C) Penile tissue necrosis
D) Decreased production of sperm

Question 26

The doctor is considering whether to prescribe testosterone replacement therapy for a 62-year-old man who is concerned about a gradual decrease in sexual performance.Which information obtained from the patient is most important to communicate to the doctor?

A) States that he has noticed a decrease in energy level for a few years
B) Has had a gradual decrease in the force of his urinary stream
C) Has been using sildenafil several times every week
D) Says that symptoms have increased steadily over the last few years