Ch.55

Question 1

To determine the severity of the symptoms for a 68-year-old patient with benign prostatic hyperplasia (BPH) the nurse will ask the patient about

a. blood in the urine.
b. lower back or hip pain.
c. erectile dysfunction (ED).
d. force of the urinary stream.

Answer 1

d. force of the urinary stream.

Question 2

A 58-year-old patient who has been recently diagnosed with benign prostatic hyperplasia (BPH) tells the nurse that he does not want to have a transurethral resection of the prostate (TURP) be-cause it might affect his ability to maintain an erection during intercourse. Which action should the nurse take?

a. Provide teaching about medications for erectile dysfunction (ED).
b. Discuss that TURP does not commonly affect erectile function.
c. Offer reassurance that sperm production is not affected by TURP.
d. Discuss alternative methods of sexual ex-pression besides intercourse.

Answer 2

b. Discuss that TURP does not commonly affect erectile function.

Question 3

The health care provider prescribes finasteride (Proscar) for a 67-year-old patient who has benign prostatic hyperplasia (BPH). When teaching the patient about the drug, the nurse informs him that

a. he should change position from lying to standing slowly to avoid dizziness.
b. his interest in sexual activity may de-crease while he is taking the medication.
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 3

b. his interest in sexual activity may de-crease while he is taking the medication.

Question 4

The nurse will anticipate that a 61-year-old patient who has an enlarged prostate detected by digital rectal examination (DRE) and an elevated prostate specific antigen (PSA) level will need teaching about

a. cystourethroscopy.
b. uroflowmetry studies.
c. magnetic resonance imaging (MRI).
d. transrectal ultrasonography (TRUS).

Answer 4

d. transrectal ultrasonography (TRUS).

Question 5

Which information about continuous bladder irrigation will the nurse teach to a patient who is being admitted for a transurethral resection of the prostate (TURP)?

a. Bladder irrigation decreases the risk of postoperative bleeding.
b. Hydration and urine output are maintained by bladder irrigation.
c. Antibiotics are infused continuously through the bladder irrigation.
d. Bladder irrigation prevents obstruction of the catheter after surgery.

Answer 5

d. Bladder irrigation prevents obstruction of the catheter after surgery.

Question 6

The nurse will plan to teach the patient scheduled for photovaporization of the prostate (PVP)

a. that urine will appear bloody for several days.
b. how to care for an indwelling urinary catheter.
c. that symptom improvement takes 2 to 3 weeks.
d. about complications associated with ure-thral stenting.

Answer 6

b. how to care for an indwelling urinary catheter.

Question 7

A 53-year-old man is scheduled for an annual physical exam. The nurse will plan to teach the patient about the purpose of

a. urinalysis collection.
b. uroflowmetry studies.
c. prostate specific antigen (PSA) testing.
d. transrectal ultrasound scanning (TRUS).

Answer 7

c. prostate specific antigen (PSA) testing.

Question 8

A patient returning from surgery for a perineal radical prostatectomy will have a nursing diagnosis of risk for infection related to

a. urinary incontinence.
b. prolonged urinary stasis.
c. possible fecal wound contamination.
d. placement of a suprapubic bladder cathe-ter.

Answer 8

c. possible fecal wound contamination.

Question 9

A 57-year-old patient is incontinent of urine following a radical retropubic prostatectomy. The nurse will plan to teach the patient

a. to restrict oral fluid intake.
b. pelvic floor muscle exercises.
c. to perform intermittent self-catheterization.
d. the use of belladonna and opium supposi-tories.

Answer 9

b. pelvic floor muscle exercises.

Question 10

A 70-year-old patient who has had a transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH) is being discharged from the hospital today, The nurse determines that additional instruction is needed when the patient says which of the following?

a. “I should call the doctor if I have inconti-nence at home.”
b. “I will avoid driving until I get approval from my doctor.”
c. “I will increase fiber and fluids in my diet to prevent constipation.”
d. “I should continue to schedule yearly ap-pointments for prostate exams.”

Answer 10

a. “I should call the doctor if I have inconti-nence at home.”

Question 11

The nurse will inform a patient with cancer of the prostate that side effects of leuprolide (Lupron) may include

a. flushing.
b. dizziness.
c. infection.
d. incontinence.

Answer 11

a. flushing.

Question 12

Which information will the nurse teach a patient who has chronic prostatitis?

a. Ibuprofen (Motrin) should provide good pain control.
b. Prescribed antibiotics should be taken for 7 to 10 days.
c. Intercourse or masturbation will help re-lieve symptoms.
d. Cold packs used every 4 hours will de-crease inflammation.

Answer 12

c. Intercourse or masturbation will help re-lieve symptoms.

Question 13

The nurse performing a focused examination to determine possible causes of infertility will assess for

a. hydrocele.
b. varicocele.
c. epididymitis.
d. paraphimosis.

Answer 13

b. varicocele.

Question 14

Which information will the nurse plan to include when teaching a community health group about testicular self-examination?

a. Testicular self-examination should be done in a warm room.
b. The only structure normally felt in the scrotal sac is the testis.
c. Testicular self-examination should be done at least every week.
d. Call the health care provider if one testis is larger than the other.

Answer 14

a. Testicular self-examination should be done in a warm room.

Question 15

A 27-year-old man who has testicular cancer is being admitted for a unilateral orchiectomy. The patient does not talk to his wife and speaks to the nurse only to answer the admission questions. Which action is best for the nurse to take?

a. Teach the patient and the wife that impo-tence is unlikely after unilateral orchiec-tomy.
b. Ask the patient if he has any questions or concerns about the diagnosis and treat-ment.
c. Document the patient’s lack of communi-cation on the chart and continue preopera-tive care.
d. Inform the patient’s wife that concerns about sexual function are common with this diagnosis.

Answer 15

b. Ask the patient if he has any questions or concerns about the diagnosis and treat-ment.

Question 16

A 52-year-old man tells the nurse that he decided to seek treatment for erectile dysfunction (ED) because his wife “is losing patience with the situation.” The most appropriate nursing diagnosis for the patient is

a. situational low self-esteem related to ef-fects of ED.
b. ineffective role performance related to effects of ED.
c. anxiety related to inability to have sexual intercourse.
d. ineffective sexuality patterns related to infrequent intercourse.

Answer 16

b. ineffective role performance related to effects of ED.

Question 17

A patient with urinary obstruction from benign prostatic hyperplasia (BPH) tells the nurse, “My symptoms are much worse this week.” Which response by the nurse is most appropriate?

a. “Have you been taking any over-the-counter (OTC) medications recently?”
b. “I will talk to the doctor about ordering a prostate specific antigen (PSA) test.”
c. “Have you talked to the doctor about sur-gery such as transurethral resection of the prostate (TURP)?”
d. “The prostate gland changes in size from day to day, and this may be making your symptoms worse.”

Answer 17

a. “Have you been taking any over-the-counter (OTC) medications recently?”

Question 18

The nurse taking a focused health history for a patient with possible testicular cancer will ask the patient about a history of

a. testicular torsion.
b. testicular trauma.
c. undescended testicles.
d. sexually transmitted infection (STI).

Answer 18

c. undescended testicles.

Question 19

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 pre-scribed therapy should the nurse implement first?

a. Infuse normal saline at 50 mL/hr.
b. Insert a urinary retention catheter.
c. Draw blood for a complete blood count.
d. Schedule a pelvic computed tomography (CT) scan.

Answer 19

b. Insert a urinary retention catheter.

Question 20

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?

a. A 38-year-old who is being treated for acute prostatitis
b. A 48-year-old whose father died of metas-tatic prostate cancer
c. A 52-year-old who goes on long bicycle rides every weekend
d. A 75-year-old who uses saw palmetto to treat benign prostatic hyperplasia (BPH)

Answer 20

b. A 48-year-old whose father died of metas-tatic prostate cancer

Question 21

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?

a. Increase the flow rate of the bladder irri-gation.
b. Administer the prescribed IV morphine sulfate.
c. Give the patient the prescribed belladonna and opium suppository.
d. Manually instill and then withdraw 50 mL of saline into the catheter.

Answer 21

d. Manually instill and then withdraw 50 mL of saline into the catheter.

Question 22

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 etio-logic factors?

a. “Do you experience an unusual amount of stress?”
b. “Do you use any recreational drugs or drink alcohol?”
c. “Do you have chronic cardiovascular or peripheral vascular disease?”
d. “Do you have a history of an erection that lasted for 6 hours or more?”

Answer 22

b. “Do you use any recreational drugs or drink alcohol?”

Question 23

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?

a. Assure the patient that ED is common with aging.
b. Ask the patient about any prescription drugs he is taking.
c. Tell the patient that Viagra does not al-ways work for ED.
d. Discuss the common adverse effects of erectogenic drugs.

Answer 23

b. Ask the patient about any prescription drugs he is taking.

Question 24

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

a. A 48-year-old man who has perineal pain and a temperature of 100.4° F
b. A 58-year-old man who has a painful erection that has lasted over 6 hours
c. A 38-year-old man who states he had dif-ficulty maintaining an erection last night
d. A 68-year-old man who has pink urine after a transurethral resection of the pros-tate (TURP) 3 days ago

Answer 24

b. A 58-year-old man who has a painful erection that has lasted over 6 hours

Question 25

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)?

a. The patient has noticed a decrease in en-ergy level for a few years.
b. The patient’s symptoms have increased steadily over the last few years.
c. The patient has been using sildenafil (Viagra) several times every week.
d. The patient has had a gradual decrease in the force of his urinary stream.

Answer 25

d. The patient has had a gradual decrease in the force of his urinary stream.

Question 26

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

a. vaccinate the patient with sipuleucel-T ( Provenge).
b. provide the patient with information about cryotherapy.
c. teach the patient about placement of in-traurethral stents.
d. schedule the patient for annual prostate-specific antigen testing.

Answer 26

d. schedule the patient for annual prostate-specific antigen testing.

Question 27

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

a. Instruct patient to avoid sexual intercourse until treatment is complete.
b. Administer ibuprofen (Advil) 400 mg every 8 hours as needed for pain.
c. Catheterize the patient as needed if symp-toms of urinary retention develop.
d. Give trimethoprim/sulfamethoxazole (Bactrim) DS 1 tablet daily for 28 days.

Answer 27

c. Catheterize the patient as needed if symp-toms of urinary retention develop.

Question 28

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?

a. 22-year-old who has noticed a firm, non-tender lump on his scrotum
b. 35-year-old who is concerned that his scrotum “feels like a bag of worms”
c. 40-year-old who has pelvic pain while being treated for chronic prostatitis
d. 70-year-old who is reporting frequent uri-nary dribbling after a prostatectomy

Answer 28

a. 22-year-old who has noticed a firm, non-tender lump on his scrotum

Question 29

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. “Are you circumcised?”
b. “Have you had surgery for phimosis?”
c. “Do you use medications to improve mus-cle mass?”
d. “Is there a history of prostate cancer in your family?”

Answer 29

c. “Do you use medications to improve mus-cle mass?”

Question 30

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

a. 19-year-old who is complaining of severe scrotal pain
b. 60-year-old with a nontender ulceration of the glans penis
c. 22-year-old who has purulent urethral drainage and back pain
d. 64-year-old who has dysuria after brachy-therapy for prostate cancer

Answer 30

a. 19-year-old who is complaining of severe scrotal pain

Question 31

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. The UAP apply a cold pack to the scrotum for a patient with mumps orchitis.
b. The UAP help a patient who has had a prostatectomy to put on antiembolism hose.
c. The UAP leave the foreskin pulled back after cleaning the glans of a patient who has a retention catheter.
d. The UAP encourage a high oral fluid in-take for patient who had transurethral re-section of the prostate yesterday.

Answer 31

c. The UAP leave the foreskin pulled back after cleaning the glans of a patient who has a retention catheter

Question 32

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)?

a. Teach the patient how to perform Kegel exercises.
b. Report any complaints of pain or spasms to the nurse.
c. Monitor for increases in bleeding or pres-ence of clots.
d. Increase the flow rate of the irrigation if clots are noted.

Answer 32

b. Report any complaints of pain or spasms to the nurse.

Question 33

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?

a. Elevated temperature
b. Respiratory rate and lung sounds
c. Bladder spasms and decreased urine out-put
d. No prescription for antihypertensive drugs

Answer 33

c. Bladder spasms and decreased urine out-put