NCLEX-RN Made Easy Questions Flashcards Preview

Med Surg 5 > NCLEX-RN Made Easy Questions > Flashcards

Flashcards in NCLEX-RN Made Easy Questions Deck (21):
1

What is the most important assessment for the nurse to make when administering tamsulosin to a client with BPH?
1. Voiding pattern
2.Size of the prostate
3.creatinine clearance
4.serum testosterone

1. The alpha-adrenergic blocker tamsulosin relaxes the smooth muscle of the bladder neck and prostate, so the urinary voiding symptoms of BPH are reduced in many clients. These drugs do not affect the size of the prostate, renal function, or the production or metabolism of testosterone.

2

A client is diagnosed with priapism. What condition is the client at risk for developing?
1.Disseminated intravascular coagulation (DIC)
2.Hydronephrosis
3.Penile gangrene
4.testicular atrophy

3. Priapism is a condition in which the penis persistently erect and painful. It's a urological emergency because gangrene, secondary to ischemia. can result if venous drainage of the corpora cavernosa does not occur. Priapism does not cause DIC, hydronephrosis, or testicular atrophy.

3

Which assessment finding is expected in a client receiving bicalutamide and leuprolide for advanced prostate cancer?
1. Abdominal distention
2.Acromegaly
3.Colicky pain
4. Hot flashes

4. Bicalutamide, a non steroidal antiandrogen, adn leuprolide, a gonadotropin-releasing hormone agonist, decrease the production of testosterone. This helps decrease the production of cancer cells involved in prostate cancer. Because androgens are responsible for the development of male genitalia and secondary male sex characteristics, low androgen levels can cause genital atrophy, breast enlargement, and hot flashes. Abdominal distention, acromegaly, and colicky pain aren't cause by bicalutamide and leuprolide therapy.

4

A client is being treated for chronic prostatitis. Which comment indicated to the nurse that further teaching is necessary?
1. I miss not being able to have sex
2. I enjoy soaking in a hot tub of water
3. Cutting down on coffee hasn't been as hard as I expected
4. I'm used to getting up and moving, not just sitting for long periods

1. Ejactulation can aid in the treatment of chronic prostatitis by decreasing the retention of prostatic fluid. Coffee should be eliminated from the diet because ti can increase prostate secretions. Warm sits baths and not sitting for long periods at a time promote comfort.

5

A male client reports perineal pain without any observable cause. What condition does the nurse suspect?
1. Endometriosis
2. Internal hemorrhoids
3. Prostatitis
4. Renal calculus

3. Prostatitis can use prostate pain, which is felt as perineal discomfort. Endometriosis can cause pain low in the abdomen, deep in the pelvis, or in the rectal or sacrococcygeal area, depending on the location of the ectopic tissue. Hemorrhoids cause rectal pain and pressure. Renal calculi typically produce flank pain.

6

Hydrocodone with acetaminophen has been prescribed for a client with metastatic prostate cancer. What information is essential for the nurse to include in the teaching plan?
1. You may develop blurred vision
2.constipation may develop with constant use
3.you may feel more relaxed and calm
4.nausea may occur

2. Consipation commonly develops with constant use of hydrocodone. The nurse should teach the client about constipation, and tell the client ways to decrease this risk, such as increasing fiber and liquids in the diet. Nausea may occur on occasion, however, it is not a sever problem and could be related to constipation. Blurred vision and diarrhea are not associated with the use of hydrocodone with acetaminophen. Feeling relaxed and calm is a common side effect does not need medical attention. As the body adjusts to the medicine during treatment these side effects may go away.

7

What should the nurse teach an uncircumcised client to prevent phimosis?
1.Proper cleaning of the prepuce
2.importance of regular ejaculation
3. Technique of testicular self-examination
4.Proper hand washing before touching the genitals

1. Proper cleaning of the preputial area to remove secretions is critical to the prevention of non congenital phimosis. Regular ejaculation can decrease the symptoms of chronic prostates, but it has no effect of the development of phimosis. Testicular self-examination is important in the early detection and treatment of testicular cancer but is unrelated to phimosis. Hand washing si important in preventing the spread of infection.

8

What is the most accurate information a nurse can teach a newly-diagnosed client with testicular cancer?
1. Testicular cancer isn't responsive to chemotherapy, but it is highly curative with surgery.
2.Radiation therapy is never used, so the unaffected testicle remains healthy.
3. Testicular self-examination is important because there is an increased risk for a second tumor
4.Taking testosterone after orchiectomy prevents changes in appearance and sexual function

3. A history of testicular malignancy puts the client at increased risk for a scored tumor. Testicular self-examination allows for early detection and treatment. Chemotherapy is added for clients who have evidence of metastasis after irradiation. Radiation therapy is used on the retroperitoneal lymph nodes. Testosterone usually is not needed because the unaffected testis usually produces sufficient hormone.

9

A client underwent an orchiectomy for testicular cancer and now has a persistent elevation in alpha-fetoprotein levels. Which statement by the nurse is most accurate?
1. you are still fertile
2. this is related to the surgical procedure
3. you need further testing to determine the cause of this elevation
4. When testosterone decrease, alpha fetoprotein increases

3. Alpha-fetoprotein is tumor marker elevated in nonseminomatous malignancies of the testicle. After the tumor is removed, the level should decrease. A persistent elevation after orchiectomy may indicate that a tumor may still be present outside the testicle that was removed. The nurse should tell the client that further testing is necessary. The level of alpha-fetoprotein is not related to fertility or testosterone level. A recurrence of the cancer is indicated by a post surgical decrease in alpha-fetoprotein live follow by an election as a new tumor starts to grow.

10

Which discharge instruction should the nurse give to a client after a prostatectomy?
1. Avoid straining at stool
2. Report close in the urine right away
3.Soak in a warm tub daily for comfort
4. Return to your usual activities in three weeks

1. Straining at stool after prostatectomy can cause bleeding. Small blood clots or pieces of tissue are commonly passed in the urine for up to two weeks postoperatively. Tub baths are prohibited because they cause dilation of pelvic blood vessels. Other activities are resumed based on the guidance of the health care provider. Sexual intercourse and driving are usually prohibited for about three weeks. Exercising and retiring to work are usually prohibited for about six weeks.

11

Which symptom should the nurse instruct a client to report following a biopsy of the prostate?
1. Pain on the following day
2.Discolored semen
3.difficulty urinating
4. temperature greater than 99F (37.2 C)

3. Difficulty urinating suggests urethral obstruction. Mild pain is expected for one to three days after the biopsy. Semen may be discolored for up to a month after the biopsy. Temperature higher than 101 F (38.3 C) should be reported because it suggests infection

12

Two days after a transrectal biopsy of the prostate, the client calls the clinic to report the t his stole is streaked with blood. Which response by the nurse is appropriate?
1. Tell the client to take a laxative
2. tell the client to come in for examination
3. Reassure the client that this is an expected occurrence
4.Ask the client to collect a still specimens for testing

3. After a trasrectal prostatic biopsy blood in the stool is expected for a number of days. Because blood in the stool is expected, testing the stool or examining the client isn't necessary. Stool softeners are prescribed if the client reports constipation. Straining at stool can precipitate bleeding, but laxatives generally are not necessary.

13

Which client does the nurse evaluate as having the highest risk of developing a postoperative wound infection?
1. A post surgical client following a radical prostatectomy
2.the client who had a perineal prostatectomy
3.A post surgical client following a suprapubic prostatectomy
4. The client who had a transurethral resection of the prostate

2. The incision in a perineal prostatectomy is close to the rectum, which normally contains gram-negative organisms that can cause infection if introduced into other areas of the body. Therefore, a perineal incision can become contaminated more easily than those of the other procedures.

14

A client had a transurethral prostatectomy for benign prostatic hypertrophy, and is currently being treated with continuous bladder irrigation. The client reports an increase in the severity of his bladder spasms. Which intervention is most important for the nurse to implement?
1. Administer an oral analgesic
2. Stop the irrigation and call the health care provider
3. Administer a belladonna and opium suppository as ordered by the health care provider
4. Check for the presence of clots, and make sure the catheter is draining properly

4. Blood clots and blocked outflow of the urine can increase spasms. The irrigation shouldn't be stopped as long as the catheter is draining because clots will form. A bella donna and opium suppository should be given to relieve spasms per order, but only after assessment of the drainage. Oral analgesics should be given if the spasms are unrelieved by the suppository.

15

A client has returned from surgery with continuous bladder irrigation. Which assessment finding indicates the bladder irrigation is successful?
1. The urine flow is red.
2. The irrigate flow is pink.
3. The bladder feels distended
4. The irrigate outflow is half of the intake.

2. The irrigate should be infused at a rate fast enough to maintain pink urine. Red urine indicated inadequate irrigation and possible clot formation. Bladder distention should not occur as long as the system is draining properly, and no clots are obstruction the outflow of urine. The outflow should be almost the same as the intake.

16

An 80 year old male reports urinary retention. Which favor may contribute to this client's problem?
1. BPH
2. Diabetes
3. Diet
4. Hypertension

1. BPH is common among older adult men and typically results in urinary retention, frequency, dribbling, and difficulty starting the urine stream. Diabetes , diet and hypertension usually do not affect urinary retention.

17

A client who underwent a cystoscopy is scheduled to be discharged to home within 24 hours. What is the most important information for the nurse to give the client?
1. Expect bloody urine for about a week
2. Drink eight to ten glasses of water every eight hours
3. Try to urinate frequently and measure your output
4. Check the color consistency, and amount of urine in the indwelling urinary catheter bag every four to eight hours.

3. The bladder needs to be emptied frequently and output should be measure to make sure the bladder is implying. Blood in the urine is not normal except for small amounts for the first 24 hours following the procedure. Large amounts of fluids help flush microorganisms out of the body, but eight to ten glasses every eight hours may not be reasonable. This client may not have an indwelling urinary catheter.

18

Which instruction would help the cline perform Kegel exercises?
1. Completely empty the bladder
2. Do the exercises 200 times per day
3. Sit of stand with your legs together
4. Drink small amounts of fluid frequently

2. Do the exercises 200 times per day

19

A client is diagnosed wit prostate cancer. Which test should the nurse anticipate to monitor the clients progress?
1.seru creatinine
2.complete blood count
3.prostate specifica antigen
4.serum potassium

3. The PSA test is used to monitor prostate cancer progression. Higher PSA levels indicate greater tumor burden. Serum creatinine levels may suggest blockage from an enlarged prostate. CBC is used to diagnose anemia and polycythemia. Serum potassium levels identify hypokalemia and hyperkalemia

20

After radical prostatectomy for prostate cancer, a client has an indwelling catheter removed. he then begins to have periods of incontinence. During the postoperative period, which intervention should be implemented first?
1. Kegal exercises
2. Fluid restriction
3. artificial sphincter use
4. Self-catheterization

1. Kegel exercises are noninvasive and are recommended as the initial intervention for incontinence. Fluid restriction is useful for a client with increase detrusor contraction related to acidic urine. Artificial sphincter use is not primary intervention for post prostatectomy incontinence. Self-catheterization may be used as a temporary measure but is not a primary intervention.

21

After a retropubic prostatectomy a client requires continuous bladder irrigation. The client has an IV of dextrose 5% in water infusing at 40 mL per hour and a triple lumen urinary catheter with normal Celine solution infusing at 200 mL per hour. The nurse empties the urinary catheter drainage bag three times during an eight hour period for a total of 2780 mL. How many milliliters does the nurse calculate as urine? Record your answer using a whole number

1,180