Question 1

The nurse is providing education for a client who has been diagnosed with orchitis. Which of the following information should the nurse include in the teaching plan?

Accepted Answer

Orchitis is very painful and effective pain management will be needed. The other therapies will not be used to treat orchitis.

Question 2

The nurse is preparing a teaching plan for a client with symptomatic benign prostatic hyperplasia (BPH) who is scheduled for photovaporization of the prostate (PVP) at an outpatient surgical centre. Which of the following information should the nurse include in the teaching plan?

Accepted Answer

The client will have an in-dwelling catheter for 24-48 hours and will need teaching about catheter care. There is minimal bleeding with this procedure. Symptom improvement is almost immediate after PVP. Stent placement is not included in the procedure.

Question 3

The nurse is assessing a client with benign prostatic hyperplasia (BPH). Which of the following symptoms should the nurse assess to determine the severity of the BPH?

Accepted Answer

The American Urological Association (AUA) Symptom Index (used in Canada) for a client with BPH asks questions about the force and frequency of urination, nocturia, etc. Blood in the urine, ED, and back or hip pain are not typical symptoms of BPH.

Question 4

The nurse is caring for a client recently diagnosed with benign prostatic hyperplasia (BPH) who tells the nurse that he does not want to have a transurethral resection of the prostate (TURP) because he is afraid it might affect his ability to have intercourse.Which of the following actions should the nurse take?

Accepted Answer

ED is not a concern with TURP, although retrograde ejaculation is likely and the nurse should discuss this with the client. Erectile function is not usually affected by a TURP, so the client will not need information about penile implants or reassurance that other forms of sexual expression may be used. Because the client has not asked about fertility, reassurance about sperm production does not address his concerns.

Question 5

Which of the following information should the nurse include when teaching a client who has a diagnosis of chronic prostatitis?

Accepted Answer

Ejaculation helps drain the prostate and relieve pain. Warm baths are recommended to reduce pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently prescribed but usually do not offer adequate pain relief. Antibiotics for chronic prostatitis are taken for 4-12 weeks.

Question 6

The nurse is teaching a client who is scheduled for a transurethral resection of the prostate (TURP) about continuous bladder irrigation. Which of the following information should the nurse include?

Accepted Answer

The purpose of bladder irrigation is to remove clots from the bladder and to prevent obstruction of the catheter by clots. The irrigation does not decrease bleeding or improve hydration. Antibiotics are given by the IV route, not through the bladder irrigation.

Question 7

The nurse is assessing a couple at the infertility clinic because they have not been able to conceive. When performing a focused examination to determine possible causes for infertility, which of the following risk factors should the nurse assess in themaleclient?

Accepted Answer

Persistent varicoceles are commonly associated with infertility. Hydrocele, epididymitis, and paraphimosis are not risk factors for infertility.

Question 8

A51-year-old male client is scheduled for an annual physical exam at the outpatient clinic. Which of the following diagnostic tests should the nurse plan to teach to the client?

Accepted Answer

An annual digital rectal exam (DRE) is recommended starting at age 50 for men who have an average risk for prostate cancer. Urinalysis and uroflowmetry studies are done if clients have symptoms of urinary tract infection or changes in the urinary stream. TRUS may be ordered if the DRE or PSA is abnormal.

Question 9

The nurse is preparing a teaching plan for a client who has an enlarged prostate detected by digital rectal examination (DRE) and an elevated prostate specific antigen (PSA) level. Which of the following procedures should the nurse include in the teaching plan?

Accepted Answer

In a client with an abnormal DRE and elevated PSA, transrectal ultrasound is used to visualize the prostate for biopsy. Uroflowmetry studies help determine the extent of urine blockage and treatment, but there is no indication that this is a problem for this client.
Cystoscopy may be used before prostatectomy but will not be done until after the TRUS and biopsy. MRI is used to determine whether prostatic cancer has metastasized but would not be ordered at this stage of the diagnostic process.

Question 10

The nurse is caring for a client who had a perineal radical prostatectomy for prostatic cancer. In the immediate postoperative period, which of the following etiologies best relates to the nursing diagnosis of risk for infection?

Accepted Answer

The perineal approach increases the risk for infection because the incision is located close to the anus and contamination with feces is possible. Urinary stasis and incontinence do not occur because the client has a retention catheter in place for 1-2 weeks. A urethral catheter is used after the surgery.

Question 11

Which of the following information should the nurse plan to include when teaching a client to perform testicular self-examination?

Accepted Answer

The testes will hang lower in the scrotum when the temperature is warm (e.g., during a shower), and it will be easier to palpate. The epididymis is also normally palpable in the scrotum. One testis is normally larger. The client should perform testicular self-examination monthly.

Question 12

The nurse has completed discharge teaching for a client who had a transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH). Which of the following client statements indicate that additional instruction is required?

Accepted Answer

Since urinary incontinence is common for several weeks after a TURP, the client does not need to call the health care provider if this occurs. The other client statements indicate that the client has a good understanding of post-TURP instructions.

Question 13

The nurse is conducting discharge teaching with a client who has undergone a vasectomy in the health care provider's office. Which of the following information should the nurse include in the discharge instructions?

Accepted Answer

Because it takes about 6 weeks to evacuate sperm that are distal to the vasectomy site, the client should use contraception for 6 weeks. ED that occurs after vasectomy is psychological in origin and not related to postoperative swelling. The client does not need to abstain from intercourse. The appearance and volume of the ejaculate are not changed because sperm are a minor component of the ejaculate.

Question 14

The nurse is conducting a focused health history for a client with possible testicular cancer. Which of the following topics should the nurse include in the assessment?

Accepted Answer

Cryptorchidism is a risk factor for testicular cancer if it is not corrected before puberty. STIs, testicular torsion, and testicular trauma are risk factors for other testicular conditions but not for testicular cancer.

Question 15

The nurse is caring for a client with erectile dysfunction (ED) following treatment for benign prostatic hyperplasia (BPH) who tells the nurse that he decided to seek treatment because his wife "is losing patience with the situation." Which of the following nursing diagnoses is best for the client?

Accepted Answer

The client's statement indicates that the relationship with his wife is his primary concern. Although anxiety, low self-esteem, and ineffective sexuality patterns also may be concerns, the client information suggests that addressing the role performance problem will lead to the best outcome for this client.

Question 16

The nurse is admitting a client scheduled for a unilateral orchiectomy for testicular cancer. The nurse notes that the client does not talk to his partner and speaks to the nurse only to answer the admission questions. Which of the following actions isbest for the nurse to take?

Accepted Answer

The initial action by the nurse should be assessment for any anxiety or questions about the surgery or postoperative care. The nurse should address the client, not the spouse, when discussing the diagnosis and any possible concerns. Without further assessment of client concerns, the nurse should not offer education about complications after orchiectomy.
Documentation of the client's lack of interaction is not an adequate nursing action in this situation.

Question 17

The nurse is caring for a client following a radical retropubic prostatectomy for prostate cancer and is incontinent of urine. Which of the following information should the nurse include in the teaching plan?

Accepted Answer

Pelvic floor muscle training (Kegel) exercises are recommended to strengthen the pelvic floor muscles and improve urinary control. Belladonna and opium suppositories are used to reduce bladder spasms after surgery. Intermittent self-catheterization may be taught before surgery if the client has urinary retention, but it will not be useful in reducing incontinence after surgery. The client should have a daily oral intake of 2-3 L.

Question 18

The nurse is providing teaching for a client with cancer of the prostate who has been prescribed leuprolide. Which of the following adverse effects should the nurse include in the teaching plan about this drug?

Accepted Answer

Hot flashes may occur with decreased testosterone production. Dizziness may occur with the ?-blockers used for benign prostatic hyperplasia (BPH). Urinary incontinence may occur after prostate surgery, but it is not an expected medication adverse effect. Risk for infection is increased in clients receiving chemotherapy.

Question 19

The health care provider prescribes finasteride for a client who has benign prostatic hyperplasia (BPH). Which of the following information should the nurse include when teaching the client about the drug?

Accepted Answer

A decrease in libido is an adverse effect of finasteride because of the androgen suppression that occurs with the drug. Although orthostatic hypotension may occur if the client also is taking a medication for erectile dysfunction (ED), it should not occur with finasteride alone. Improvement in symptoms of obstruction takes about 6 months. The medication does not cause hypertension.

Question 20

The nurse is caring for a client who has benign prostatic hyperplasia (BPH) with mild obstruction and tells the nurse, "My symptoms have gotten a lot worse this week." Which of the following responses by the nurse is best?

Accepted Answer

Because the client's increase in symptoms has occurred abruptly, the nurse should ask about OTC medications (such as decongestants and anticholinergics) that might cause contraction of the smooth muscle in the prostate and worsen obstruction. The prostate gland does not vary in size from day to day. A TURP may be needed, but more assessment about possible reasons for the sudden symptom change is a more appropriate first response by the nurse. PSA testing is done to differentiate BPH from prostatic cancer.

Quiz 57: Nursing Management Male Reproductive Problems