Question 1

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?

Accepted Answer

Lupron,an LH-RH agonist,stimulates the pituitary gland to release luteinizing hormone (LH)to the point that the gland is depleted of LH and testosterone production is lessened.This may decrease the prostate cancer since it is hormone dependent.Lupron can cause osteoporosis,which results in the need for Aredia to prevent bone loss.Erectile dysfunction,decreased libido,and gynecomastia are side effects of the LH-RH medications.Antiandrogen drugs inhibit tumor progression by blocking androgens at the site of the prostate.

Question 2

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?

Accepted Answer

Phosphodiesterase-5 inhibitors such as sildenafil (Viagra)relax smooth muscles to increase blood flow to the penis for treatment of erectile dysfunction.In combination with nitroglycerin,there can be extreme hypotension with reduction of blood flow to vital organs.The other questions are appropriate but not the highest priority before administering nitroglycerin.

Question 3

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?

Accepted Answer

The prostate-specific antigen test should be discussed as an option for prostate cancer screening.A complete blood count and culture and sensitivity laboratory test will be ordered if infection is suspected.A cystoscopy would be performed to assess the effect of a bladder neck obstruction.

Question 4

Post transurethral resection of the prostate,a client has a three-way catheter with a continuous bladder irrigation.Over the last 12 hours,there has been 1400 mL of irrigation solution infused and 2000 mL measured in output from the drainage bag.What is the recording of the urinary output for the 12-hour period? (Record your answer using a whole number.)____ mL

Accepted Answer

The answer of Post transurethral resection of the prostate,a client...

Question 5

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

Accepted Answer

Frequent visits to the bathroom during the night could cause sleep interruptions and affect the client's mood and mental status.Incontinence could cause the client to feel embarrassment and cause him to limit his activities outside the home.The social isolation could lead to clinical depression and should be treated professionally.The nurse should not give advice before exploring the client's response to his change in behavior.The statement about age has no validity.

Question 6

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:

What action by the nurse is the most appropriate?

Accepted Answer

The serum sodium is decreased due to large-volume bladder irrigation (normal is 136 to 145 mEq/L).By slowing the irrigation,there will be less fluid overload and sodium dilution.The hemoglobin and hematocrit values are a low normal,with a slight decrease in the red blood cell count.Therefore,a blood transfusion or frequent vital signs should not be necessary.Immediate report to the surgeon is not necessary.

Question 7

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?

Accepted Answer

The UAP could aid the client in transferring from the bed to the chair and with ambulation.The nurse would be responsible for medication administration,assessment of swelling,and the application of ice if needed.

Question 8

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?

Accepted Answer

Cloudy urine could indicate infection due to possible urine retention and should be a priority action.Common symptoms of benign prostatic hyperplasia are urinary hesitancy,post-void dribbling,and a weak urinary stream due to the enlarged prostate causing bladder outlet obstruction.

Question 9

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?

Accepted Answer

The first few inches of the catheter must be washed daily starting at the penis and washing outward with soap and water.The other options are correct for self-management of a urinary catheter in the home setting.

Question 10

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

Accepted Answer

This client did not associate wine with the avoidance of alcohol,and requires additional teaching.The nurse must teach a client with BPH to avoid alcohol,caffeine,and large quantities of fluid in a short amount of time to prevent overdistention of the bladder.Decongestants also need to be avoided to lower the chance for urinary retention.

Question 11

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?

Accepted Answer

AFP is a glycoprotein that is elevated in testicular cancer.PSA and PAP testing is used in the screening of prostate cancer.CRP is diagnostic for inflammatory conditions.

Question 12

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?

Accepted Answer

Sperm collection is a viable option for a client diagnosed with testicular cancer and should be completed before radiation therapy,chemotherapy,or radical lymph node dissection.The other options would promote psychosocial support but are not the priority intervention.

Question 13

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.)

Accepted Answer

Advanced family history of prostate cancer,age,a diet high in animal fat,and race are all risk factors for prostate cancer.Smoking and obesity are not known risk factors.

Question 14

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.)

Accepted Answer

Both the 5-alpha-reductase inhibitor (5-ARI)and the alpha₁-selective blocking agents can cause orthostatic (postural)hypotension and liver dysfunction.The 5-ARI agent (Proscar)can cause a decreased libido rather than an increased sexual drive.The alpha-blocking drug (Cardura)can cause tachycardia rather than bradycardia.

Question 15

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?

Accepted Answer

Before administering sulfamethoxazole-trimethoprim,the nurse must assess if the client is allergic to sulfa drugs.Urinary tract infection,hematuria,and elevated serum white blood cells are common problems associated with bacterial prostatitis that require long-term antibiotic therapy.

Question 16

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?

Accepted Answer

Bright red urinary drainage with clots may indicate arterial bleeding.Vital signs should be taken and the surgeon notified.The traction on the three-way catheter should not be released since it places pressure at the surgical site to avoid bleeding.The nurse's review of hemoglobin and hematocrit and reminding the client not to pull on the catheter are good choices,but not the priority at this time.

Question 17

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 that apply.)

Accepted Answer

Organic erectile dysfunction can be caused by surgical procedures,hypertension and its treatment,diabetes mellitus,and alcohol consumption.There is no evidence that exercise is related to this problem.

Quiz 72: Care of Patients with Male Reproductive Problems

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

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: What action by the nurse is the most appropriate?

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?