Deck 48: Nursing Care of Men with Reproductive and Breast Disorders

Question 1

A patient comes into the emergency department with complaints of an erection that has lasted for more than four hours. Which of the following should the nurse include in the patient's assessment?

A)use of medications for erectile dysfunction
B)substance abuse
C)blood pressure
D)number of sexual partners

Answer 1

use of medications for erectile dysfunction

Question 2

A male patient who presents with the complaint of a "swollen" scrotum is found to have fluid within his scrotum. The nurse realizes that this finding is consistent with which of the following?

A)a hydrocele
B)a spermatocele
C)a variocele
D)scrotal cancer

Answer 2

a hydrocele

Question 3

A female patient asks the nurse for help because her husband has not been able to attain an erection in several months. Which of the following can the nurse do to help this patient?

A)Assess for the most recent sexual practices.
B)Suggest that she seek psychiatric counseling.
C)Suggest that they both see a marriage counselor.
D)Provide a prescription for tadalafil (Cialis).

Answer 3

Assess for the most recent sexual practices.

Question 4

A 65-year-old male patient complains of problems emptying his bladder, especially at night. The nurse realizes that the patient is demonstrating symptoms of which of the following?

A)benign prostatic hypertrophy
B)urinary tract infection
C)bladder cancer
D)testicular cancer

Question 5

A patient was diagnosed with benign prostatic hypertrophy. The nurse realizes that the blood pressure measurement of this patient will be beneficial to determine which of the following?

A)if the patient can tolerate doxazosin mesylate (Cardura)
B)if surgery is indicated
C)the volume of urine being retained in the bladder
D)the dose of finasteride (Proscar)

Question 6

A male patient with type I diabetes mellitus and coronary artery disease is able to achieve an erection but cannot maintain it. Which of the following could be done to assist this patient?

A)Suggest an "O" ring.
B)Provide tadalafil (Cialis) teaching material.
C)Provide sildenafil (Viagra) teaching material.
D)Discuss penile implant surgery.

Question 7

A male patient complains of frequently "not being able to hold urine" especially when the bladder is very full or when lifting objects. Which of the following interventions by the nurse is indicated? Select all that apply.

A)Instruct the patient how to do Kegel exercises.
B)Suggest that the patient ask the physician for medications to control this incontinence.
C)Suggest that the patient restrict fluids.
D)Suggest the patient wear a Texas catheter.
E)Suggest the patient wear adult absorbent briefs.

Question 8

A 40-year-old male is diagnosed with epididymitis. The nurse realizes that the most likely causes of this disorder for this patient are which of the following? Select all that apply. Select all that apply.

A)urinary tract infection
B)prostatitis
C)unprotected anal intercourse
D)gonorrhea
E)undiagnosed congenital disorder

Question 9

A 35-year-old male is concerned about his inability to sustain an erection. Appropriate assessment questions the nurse can ask this patient include which of the following?

A)substance use or abuse
B)marital status
C)employment history
D)education level

Question 10

The nurse is instructing a patient with benign prostatic hypertrophy about techniques to reduce urinary retention. These instructions should include which of the following?

A)Avoid alcoholic beverages.
B)Encourage ingesting large amounts of fluids at one time.
C)Urinate until all of the urine is drained from the bladder.
D)Over-the-counter cold remedies are permitted with other medications.

Question 11

A patient is diagnosed with asymptomatic inflammatory prostatitis. The nurse realizes that this diagnosis was made

A)after examining prostate tissue.
B)by testing the serum PSA (prostate-specific antigen) level.
C)according to the patient's symptoms.
D)after palpating the patient's prostate gland.

Question 12

A patient who is complaining of heaviness in his scrotum has learned that his serum lactic acid dehydrogenase level is normal. This information indicates that the patient

A)needs more diagnostic tests for testicular cancer.
B)has testicular cancer.
C)does not have testicular cancer.
D)has a spermatocele.

Question 13

A 55-year-old male patient has an abnormal digital rectal examination (DRE) with a PSA (prostate-specific antigen) level of 18 ng/mL. The nurse realizes that this patient might be scheduled next for which of the following?

A)transrectal ultrasonography (TRUS)
B)bone scan
C)MRI
D)CT scan of the spine

Question 14

A male patient is concerned about ongoing premature ejaculation. Which of the following can the nurse do to assist this patient?

A)Suggest that the patient wear a condom with sexual activity.
B)Suggest that the patient talk with the physician about medication choices.
C)Tell the patient that the condition is temporary and will disappear in time.
D)Review any newly prescribed medications, and check for side effects.

Question 15

A male patient is diagnosed with stage 1 testicular cancer. The nurse realizes that the first step in the treatment for this patient is which of the following?

A)surgical removal of the testicle
B)aspiration of the enlarged testicle
C)chemotherapy
D)radiation

Question 16

A 55-year-old patient with a history of angina, and is being treated with nitroglycerin, asks for a prescription to aid with erectile dysfunction. Which of the following should be done to assist this patient?

A)Explain why the erectile dysfunction medication is not a good idea with the heart medication.
B)Provide education about the medication once the prescription is provided.
C)Remind the patient to stop taking the heart medication when planning to take the erectile dysfunction medication.
D)Suggest a behavioral health consult to analyze the reason for the erectile dysfunction.

Question 17

A patient is planning to have surgery for the treatment of benign prostatic hypertrophy. The procedure that has the fewest postoperative complications is which of the following?

A)transurethral needle ablation (TUNA)
B)transurethral incision of the prostate (TURP)
C)perineal prostatectomy
D)suprapubic prostatectomy

Question 18

The nurse is planning instructions for a patient diagnosed with prostatitis. Which of the following should be included in these instructions? Select all that apply.

A)Increase fluid intake up to 3 liters per day.
B)Adhere to a daily bowel movement regime.
C)Remind the patient that the condition does not cause cancer.
D)Only take antibiotics when symptoms are present.
E)Withhold voiding for as long as possible.

Question 19

A patient who is being treated for epididymitis stops taking his antibiotics. The nurse realizes that this patient is at risk for developing which of the following?

A)orchitis
B)priapism
C)hydrocele
D)spermatocele

Question 20

A patient is recovering from a penile implant procedure. Which of the following should be included in the care of and teaching about the implant? Select all that apply.

A)Encourage the patient to practice inflating and deflating the device during the recovery period.
B)Suggest wearing snug-fitting underwear and loose-fitting trousers to conceal the semi-erection.
C)Encourage the patient to resume sexual activity within three weeks.
D)Remind the patient to not inflate or deflate the device for at least four weeks.
E)Suggest wearing loose-fitting underwear and trousers.

Question 21

While providing care to the parents of a baby boy who has the chromosomal makeup of XXY, which of the following should be included in the teaching plan?

A)The child might have altered development of secondary sex characteristics.
B)The boy will have an enlarged penis and scrotum.
C)The boy will be at increased risk for the development of testicular cancer.
D)The child has an increased chance of being sterile.

Question 22

Which of the following nursing actions should be in the plan of care of a patient who had a prostatectomy and whose urine in the urinary irrigation drainage bag is very dark red? Select all that apply.

A)Check for catheter occlusion.
B)Increase the flow rate of irrigant solution.
C)Check vital signs
D)Ask the patient to drink more oral fluids.
E)Assess the patient for hyponatremia.

Question 23

Which of the following are risk factors for the development of cancer of the penis? Select all that apply.

A)phimosis
B)human papilloma virus (HPV)
C)HIV infection
D)excessive ultraviolet light exposure
E)being Jewish or Muslim

Question 24

Teaching for the patient who is going home with an indwelling urinary catheter should include which of the following? Select all that apply.

A)Use the larger urinary drainage bag at night.
B)Keep the larger urinary drainage bag at a level that permits gravity drainage.
C)Do not strap the leg bag too tightly.
D)Place a soft cloth between the leg bag and the skin.
E)Empty the leg bag at least twice a day.

Question 25

Bases on a review of this patient's record, what does the nurse suspect as the cause of this patient's condition? $\begin{array}{|l|l|l|}\hline \text { History } & \text { Objective Data } & \text { Subjective Data } \\\hline \text { Denies trauma to the scrotal } & \text { T: } 102 & \text { "My ears and throat hurt a } \\\text { area, recent urinary tract } & \text { WBC results: } 20,000 / \mathrm{mm}^{3} & \text { couple of days ago." } \\\text { infection, STls, or rashes. } & \text { Bilateral scrotal swelling } & \text { "My kids were sick, too,, } \\\text { States he uses condoms. } & \text { and redness. } & \text { with the same thing." } \\& \begin{array}{l}\text { Lung sounds clear } \\\text { bilaterally. }\end{array} & \\\hline\end{array}$

A)mumps
B)scarlet fever
C)pneumonia
D)orchitis

Question 26

The nurse is placing an indwelling urinary catheter in an uncircumcised male patient and replaces the foreskin after insertion. What is the rationale for this nursing action?

A)Paraphimosis may occur as a result of long-term retraction of the foreskin causing ischemia of the glans.
B)Phimosis may occur due to chronic infections and adhesions under the foreskin which results in constriction of the foreskin.
C)Priapism may occur as a result of impaired blood flow in the penis.
D)Replacement of the foreskin prevents malignant changes of the penis.

Question 27

The patient undergoing radiation therapy for prostate cancer is being given instructions for home care. Which of the following statements by the patient indicates a need for clarification?

A)"It will be nice to sleep in the same bed as my partner."
B)"Guess I'll have to go buy a box of condoms."
C)"I'll be disappointed about not seeing my grandkids."
D)"I'll make an appointment for my next PSA exam."

Question 28

Based on a review of the patient's record, which manifestation confirms a diagnosis of prostatodynia? $$\begin{array} { | l | l | l | } \hline \text { History } & \text { Objective Data } & \text { Subjective Data } \\\hline \text { Denies history of urinary } & \text { T: } 98.7 & \text { "My lower back hurts." } \\\text { tract infection or STDs. } & \text { Urine culture negative } & \text { "I just feel such a heaviness } \\\text { Prostatic secretions clear. } & & \text { in my rectum." } \\& & \text { "It feels like something is } \\& & \text { stopping my urine when I } \\& & \text { have to urinate." } \\& & \text { Rates pain } 4 \text { on pain scale } \\& & \text { of } 1 / 10 . \\\hline\end{array}$$

A)negative urine culture
B)denies history of STIs
C)patient manifests lower back pain
D)fever is absent

Question 29

Which of the following conditions does the nurse suspect is occurring in this patient? $$\begin{array} { | l | l | l | } \hline \text { History } & \text { Objective Data } & \text { Subjective Data } \\\hline \text { Client: age } 18 & \text { T: } 98.8 & \text { Rates pain as } 7 \text { on } 1 / 10 \text { pain } \\\text { Had been playing soccer } & \text { P: } 88 & \text { scale. } \\\text { and described being kicked } & \text { R: } 18 & \\\text { in the scrotum. } & \text { BP: } 112 / 68 & \\\text { Was not wearing a scrotal } & \text { Bruising noted on inner } & \\\text { support or protective } & \text { aspect of right thigh and } & \\\text { device. } & \text { right groin area. } & \\\text { Denies recent sexual } & \text { Cleat marks apparent in } & \\\text { activity or use of condoms. } & \text { areas of bruising. } & \\\text { No history of recent illness. } & \text { Scrotum edematous, dark } \\& \text { blue in color on right side } & \\& \text { and painful to palpation. } & \\\hline\end{array}$$

A)testicular torsion
B)varicocele
C)orchitis
D)indirect inguinal hernia

Question 30

A patient reports to the clinic with an open area on his penis. Which question is most important for the nurse to include in the data collection?

A)"When did you initially notice this open area?"
B)"Do you think you have a disease?"
C)"Are you promiscuous?"
D)"Have you had sexual intercourse recently?"

Question 31

The nurse is caring for a patient who had a prostatectomy and is now having bladder spasms. What are appropriate actions by the nurse? Select all that apply.

A)Administer belladonna and opium (B&O) suppositories as prescribed.
B)Check to see if the urinary catheter is draining.
C)Ask the patient if he feels the need to have a bowel movement.
D)Increase the rate of flow of urinary catheter irrigation solution.
E)Assess the patient's temperature.

Question 32

When teaching a community education class on prostate cancer, the nurse asks which of the following menus would reflect a diet consistent with lowering the risk of prostate cancer?

A) $\begin{array}{|llcc|} \hline \text { Breakfast:}\\ \text {tomato juice}\\ \text {\(1 / 2\) pink grapefruit}\\ \text {cooked oatmeal with raisins and brown sugar}\\\\ \text {Lunch:}\\ \text {spaghetti with vegetable pasta}\\ \text {sauce}\\ \text {Apple, walnut, celery salad with }\\ \text {non-fat mayonnaise}\\ \text {iced tea}\\\\ \text {Dinner:}\\ \text {egg salad sandwich}\\ \text {slice of watermelon}\\ \text {glass of skim milk}\\ \hline\end{array}$

B) $\begin{array}{|llcc|} \hline \text { Breakfast:}\\ \text {coffee}\\ \text {bran flakes cereal with skim}\\ \text { milk}\\ \text {small, fresh orange}\\\\ \text {Lunch:}\\ \text {\( 3 \mathrm{oz} \). petite filet }\\ \text {baked potato with 1 tsp. butter}\\ \text {slice of apple pie }\\\\ \text {Dinner:}\\ \text {large lettuce salad with chicken }\\ \text {strips}\\ \text {caffeine-free cola}\\ \hline\end{array}$

C) $\begin{array}{|llcc|} \hline \text { Breakfast:}\\ \text {glass of orange}\\ \text {2 pieces of white toast }\\ \text { \( 1 \mathrm{oz} \). cream cheese }\\ \\ \text {Lunch:}\\ \text {\( 3 \mathrm{oz} \). cheddar cheese }\\ \text {celery sticks}\\ \text {fruit punch }\\ \text {box of raisins}\\\\ \text {Dinner:}\\ \text {ground beef and noodle}\\ \text {casserole}\\ \text {green beans}\\ \text {I cup vanilla ice cream}\\ \hline\end{array}$

D) $\begin{array}{|llcc|}\hline \text {Breakfast:}\\\text {pancakes with sugar-free syrup}\\\text { glass of milk }\\\text {cup of coffee}\\\\\text {Lunch:}\\\text {roast beef sandwich on wheat }\\\text {bread bag of potato chips}\\\text { apple}\\\\\text {Dinner:}\\\text {slice of ham}\\\text {peas}\\\text {dinner roll}\text {iced tea}\\ \hline\end{array}$

Question 33

A patient is scheduled to undergo a prostate biopsy. When providing education concerning postoperative care related to a prostate biopsy, which of the following information should the nurse include?

A)There may be discomfort for 24-48 hours after the procedure.
B)The patient should avoid strenuous activity for 24 hours.
C)The patient can immediately return to his pre-procedure activity level.
D)The names of sexual contacts must be collected.

Question 34

A patient who was recently diagnosed with prostate cancer comes to the clinic with his wife. She says, "My husband said he has a stage 1 tumor. Can you explain what this means?" What is the most appropriate response by the nurse?

A)"Stage I means the cancer involves only the prostate and surgery and radiation treatments will be needed."
B)"Staging involves a definition of the type of tumor and the treatment plan."
C)"Did your husband tell you he had a stage I tumor?"
D)"Let's wait until the doctor comes and you can talk with him."

Question 35

Which information should the nurse provide to the patient learning to perform a testicular self-examination?

A)Any painful lump should be reported immediately.
B)Tenderness of the scrotal sac contents should be reported.
C)Most men have one testicle that is significantly larger than the other.
D)It is best to do the examination upon arising on the designated day.

Question 36

A male patient reports concern about his recent increase in breast tissue. The nurse can best assist this patient by doing which of the following?

A)reviewing the patient's health history
B)telling him that it is self-limiting and will go away in time
C)suggesting that the patient has a mammogram to ensure he does not have breast cancer
D)recommending a breast biopsy to find out the reason for the increase in breast tissue

Question 37

The nurse is completing the health history of a patient with documented androgen deficiency and erectile dysfunction (ED). Which patient response would be a contraindication for this patient's use of hormone replacement therapy to treat his ED?

A)"I am being treated for prostate cancer."
B)"I hate the idea of having an injection directly in my penis."
C)"I am currently taking antibiotics."
D)"Yes, I have a lot of hair on my chest to wear a patch."

Question 38

Which of the following discharge instructions should be given to the patient following prostate surgery? Select all that apply.

A)Do not drive for two weeks.
B)Sexual intercourse should not occur for six weeks.
C)Call the physician if the scrotum becomes swollen and tender.
D)Take Aspirin or NSAIDs for discomfort.
E)You may return to work in two weeks.

Question 39

Which patient in this illustration has a hydrocele? Mark an "X" on the appropriate image.

Question 40

During a health history interview of a patient complaining of recent-onset impotence, which question is most appropriate for the nurse to ask to identify a potential cause of the manifestation?

A)"Have you been treated for disorders in the past?
B)"Does this occur often?"
C)"How does your partner feel about this problem?"
D)"Are you on any medications?

Question 41

The wife of a patient who is scheduled for a radical prostatectomy calls the clinic to ask the nurse if this impending surgery is going to affect "their sex life." What is the nurses' most appropriate response?

A)"The incidence of sexual dysfunction varies considerably among patients having this surgery.Why don't you and your husband make an appointment so we can discuss this together?"
B)"No, it shouldn't, but you need to talk to the surgeon.You should come to the office when you can."
C)"I can't answer any of your questions without first talking to your husband.Have him call me so I can get his permission."
D)"Don't worry; the hospital staff will review everything with you the morning of your husband's surgery."

Question 42

A patient comes to a free clinic with repeated bouts of epididymitis and is adamant that he always takes the medication he is given. What additional Select all that apply.

A)"Are you sexually active?"
B)"Do you use condoms?"
C)"Do you practice unprotected anal intercourse?"
D)"Do you do any heavy lifting?"
E)"Do you use any drugs or alcohol?"

Question 43

A male patient with breast cancer is being seen at the cancer center and one of the nurses says, "I'm not sure what to do for this patient. He doesn't have the same issues as a woman!" What is the most appropriate response?

A)Caring for the man with breast cancer is essentially the same as for the woman with breast cancer.
B)Most issues are the same for men and women except he probably won't die because of his disease.
C)There are different types of cancers in men than women and that needs to be reviewed.
D)Treatments are different so you will need to explain these.

Question 44

A patient who was recently diagnosed with hypertension and placed on propranolol (Inderal) is seen in the clinic for an unrelated issue. When the nurse notes that his blood pressure is elevated, she asks if the patient has been taking his medication and he says he quit because "I didn't like how I felt when I took it." Based on this statement, what would be an appropriate response?

A)"Many male patients can experience side effects of this drug, which include altered libido and impotence.This is common.Tell me how you felt when you took the drug."
B)"You shouldn't stop taking the drug without first talking to the doctor!"
C)Write a note in the patient's record but say nothing to the patient.
D)"I'm going to give you some information about this medication for you to take home and read.At your next visit, I'll have the doctor talk to you about it."

Question 45

The term _____________ refers to the condition in which one or both of the testicles fail to move into the ________before birth. The testicle cannot be found. This condition is a risk factor for testicular cancer.

A)cryptorchidism, scrotal sac
B)inguinal hernia, inguinal canal
C)spermatocele, tunica vaginalis
D)phimosis, vas deferens

Question 46

A client seen in the emergency department for priapism is sent to the medical unit. The admitting nurse should anticipate the following actions as part of the nursing care plan? Select all that apply.

A)Assess the penis to include color changes and degree of erection.
B)Palpate the penis for firmness and rigidity.
C)Analgesic as prescribed for pain.
D)Iced saline enemas as prescribed.
E)Push oral fluids.