Question 1

The nurse in a health clinic receives requests for appointments from several patients.Which patient should be seen by the health care provider first?

Accepted Answer

Priapism can cause complications such as necrosis or hydronephrosis,and this patient should be treated immediately.The other patients do not require immediate action to prevent serious complications.

Question 2

After reviewing the electronic medical record shown in the accompanying figure for a patient who had transurethral resection of the prostate the previous day,which information requires the most rapid action by the nurse?

Accepted Answer

Bladder spasms and lack of urine output indicate that the nurse needs to assess the continuous bladder irrigation for kinks and may need to manually irrigate the patient's catheter.The other information will also require actions,such as having the patient take deep breaths and cough and discussing the need for antihypertensive medication prescriptions with the health care provider,but the nurse's first action should be to address the problem with the urinary drainage system.

Question 3

The following male patients recently arrived in the emergency department.Which one should the nurse assess first?

Accepted Answer

The patient's age and symptoms suggest possible testicular torsion,which will require rapid treatment in order to prevent testicular necrosis.The other patients also require assessment by the nurse,but their history and symptoms indicate nonemergent problems (acute prostatitis,cancer of the penis,and radiation-associated urinary tract irritation)

Question 4

A 58-year-old man with erectile dysfunction (ED)tells the nurse he is interested in using sildenafil (Viagra).Which action should the nurse take first?

Accepted Answer

Because some medications can cause ED and patients using nitrates should not take sildenafil,the nurse should first assess for prescription drug use.The nurse may want to teach the patient about realistic expectations and adverse effects of sildenafil therapy,but this should not be the first action.Although ED does increase with aging,it may be secondary to medication use or cardiovascular disease.

Question 5

When obtaining the pertinent health history for a man who is being evaluated for infertility,which question is most important for the nurse to ask?

Accepted Answer

Testosterone or testosterone-like medications may adversely affect sperm count.The other information will be obtained in the health history but does not affect the patient's fertility.

Question 6

A 22-year-old man tells the nurse at the health clinic that he has recently had some problems with erectile dysfunction.Which question should the nurse ask first to assess for possible etiologic factors?

Accepted Answer

A common etiologic factor for erectile dysfunction (ED)in younger men is use of recreational drugs or alcohol.Stress,priapism,and cardiovascular illness also contribute to ED,but they are not common etiologic factors in younger men.

Question 7

Several patients call the urology clinic requesting appointments with the health care provider as soon as possible.Which patient will the nurse schedule to be seen first?

Accepted Answer

The patient's age and symptoms suggest possible testicular cancer.Some forms of testicular cancer can be very aggressive,so the patient should be evaluated by the health care provider as soon as possible.Varicoceles do require treatment,but not emergently.Ongoing pelvic pain is common with chronic prostatitis.Urinary dribbling is a common problem after prostatectomy.

Question 8

Which action by the unlicensed assistive personnel (UAP)who are assisting with the care of patients with male reproductive problems indicates that the nurse should provide more teaching?

Accepted Answer

Paraphimosis can be caused by failing to replace the foreskin back over the glans after cleaning.The other actions by UAP are appropriate.

Question 9

A 71-year-old patient who has benign prostatic hyperplasia (BPH)with urinary retention is admitted to the hospital with elevated blood urea nitrogen (BUN)and creatinine.Which prescribed therapy should the nurse implement first?

Accepted Answer

The patient data indicate that the patient may have acute kidney injury caused by the BPH.The initial therapy will be to insert a catheter.The other actions are also appropriate,but they can be implemented after the acute urinary retention is resolved.

Question 10

A 76-year-old patient who has been diagnosed with stage 2 prostate cancer chooses the option of active surveillance.The nurse will plan to

Accepted Answer

Patients who opt for active surveillance need to have annual digital rectal exams and prostate-specific antigen testing.Vaccination with sipuleucel-T,cryotherapy,and stent placement are options for patients who choose to have active treatment for prostate cancer.

Question 11

Which assessment information is most important for the nurse to report to the health care provider when a patient asks for a prescription for testosterone replacement therapy (TRT)?

Accepted Answer

The decrease in urinary stream may indicate benign prostatic hyperplasia (BPH)or prostate cancer,which are contraindications to the use of testosterone replacement therapy (TRT).The other patient data indicate that TRT may be a helpful therapy for the patient.

Question 12

The nurse in the clinic notes elevated prostate specific antigen (PSA)levels in the laboratory results of these patients.Which patient's PSA result is most important to report to the health care provider?

Accepted Answer

The family history of prostate cancer and elevation of PSA indicate that further evaluation of the patient for prostate cancer is needed.Elevations in PSA for the other patients are not unusual.

Question 13

The health care provider prescribes the following interventions for a patient with acute prostatitis caused by E.coli.Which intervention should the nurse question?

Accepted Answer

Although acute urinary retention may occur,insertion of a catheter through an inflamed urethra is contraindicated and the nurse will anticipate that the health care provider will need to insert a suprapubic catheter.The other actions are appropriate.

Question 14

When caring for a patient with continuous bladder irrigation after having transurethral resection of the prostate,which action could the nurse delegate to unlicensed assistive personnel (UAP)?

Accepted Answer

UAP education and role includes reporting patient concerns to supervising nurses.Patient teaching,assessments for complications,and actions such as bladder irrigation require more education and should be done by licensed nursing staff.

Question 15

After a transurethral resection of the prostate (TURP),a 64-year-old patient with continuous bladder irrigation complains of painful bladder spasms.The nurse observes clots in the urine.Which action should the nurse take first?

Accepted Answer

The assessment suggests that obstruction by a clot is causing the bladder spasms,and the nurse's first action should be to irrigate the catheter manually and to try to remove the clots.IV morphine will not decrease the spasm,although pain may be reduced.Increasing the flow rate of the irrigation will further distend the bladder and may increase spasms.The belladonna and opium suppository will decrease bladder spasms but will not remove the obstructing blood clot.

Quiz 51: Nursing Management: Male Reproductive Problems

The nurse in a health clinic receives requests for appointments from several patients.Which patient should be seen by the health care provider first?

After reviewing the electronic medical record shown in the accompanying figure for a patient who had transurethral resection of the prostate the previous day,which information requires the most rapid action by the nurse?

The following male patients recently arrived in the emergency department.Which one should the nurse assess first?

A 58-year-old man with erectile dysfunction (ED) tells the nurse he is interested in using sildenafil (Viagra) .Which action should the nurse take first?

When obtaining the pertinent health history for a man who is being evaluated for infertility,which question is most important for the nurse to ask?

A 22-year-old man tells the nurse at the health clinic that he has recently had some problems with erectile dysfunction.Which question should the nurse ask first to assess for possible etiologic factors?

Several patients call the urology clinic requesting appointments with the health care provider as soon as possible.Which patient will the nurse schedule to be seen first?

Which action by the unlicensed assistive personnel (UAP) who are assisting with the care of patients with male reproductive problems indicates that the nurse should provide more teaching?

A 71-year-old patient who has benign prostatic hyperplasia (BPH) with urinary retention is admitted to the hospital with elevated blood urea nitrogen (BUN) and creatinine.Which prescribed therapy should the nurse implement first?

A 76-year-old patient who has been diagnosed with stage 2 prostate cancer chooses the option of active surveillance.The nurse will plan to

Which assessment information is most important for the nurse to report to the health care provider when a patient asks for a prescription for testosterone replacement therapy (TRT) ?

The nurse in the clinic notes elevated prostate specific antigen (PSA) levels in the laboratory results of these patients.Which patient's PSA result is most important to report to the health care provider?

The health care provider prescribes the following interventions for a patient with acute prostatitis caused by E.coli.Which intervention should the nurse question?

When caring for a patient with continuous bladder irrigation after having transurethral resection of the prostate,which action could the nurse delegate to unlicensed assistive personnel (UAP) ?

After a transurethral resection of the prostate (TURP) ,a 64-year-old patient with continuous bladder irrigation complains of painful bladder spasms.The nurse observes clots in the urine.Which action should the nurse take first?