Question 1

A nurse teaches a client who underwent insertion of a prostatic stent 5 weeks ago to be sure to tell all care providers about this procedure. When the client asks about the reason for this instruction, the nurse would reply that
A) increased frequency of assessment for prostatic cancer is needed.
B) ongoing antibiotic therapy will be needed for 1 year.
C) the client should not be catheterized through the stent for at least 3 months.
D) the client should not undergo magnetic resonance imaging.

Accepted Answer

To prevent complications, clients should be cautioned not to be catheterized through the stent for 3 months after stent placement. None of the other options is related.

Question 2

A nurse counsels a client who smokes cigarettes and uses alcohol daily that he should be aware that these substances have been known to cause
A) decreased erectile ability.
B) decreased sperm count.
C) gynecomastia.
D) increased ejaculatory ability.

Accepted Answer

Recreational drugs, alcohol, and smoking cause erectile dysfunction. They are not related to the other three problems.

Question 3

The statement by the client scheduled for TURP that would indicate the need for further preoperative teaching is
A) "I will have a catheter after surgery."
B) "I will need to drink a lot after surgery."
C) "My incision will probably be painful."
D) "My urine will be red after surgery."

Accepted Answer

TURP is performed by inserting a resectoscope through the urethra. No incision is made.

Question 4

The nurse preparing health teaching information about the etiology of prostate cancer would omit factors related to
A) diet.
B) heredity.
C) race.
D) vasectomies.

Accepted Answer

There are proven factors related to race, heredity, and diet. Factors that may be related to vasectomies and BPH are not conclusive.

Question 5

Because a client is receiving antispasmodics for bladder spasms, the nurse should be sure that the client
A) increases fluid intake.
B) is assessed frequently for bleeding.
C) receives stool softeners.
D) remains on bed rest.

Accepted Answer

Because antispasmodic drugs can cause constipation and straining at stool can precipitate bleeding from the operative site, stool softeners such as docusate sodium (Colace) are often given.

Question 6

After a transurethral resection, the nurse notes that the client's urinary catheter is blocked and his bladder is overdistended. The initial nursing action should be to
A) change the catheter.
B) irrigate the catheter.
C) milk the catheter tubing.
D) notify the physician.

Accepted Answer

If obstruction is suspected, manual (hand) irrigation may be necessary. After prostatectomy for BPH, at least 60 ml of irrigant must be used, with some force, to dislodge and evacuate blood clots and other debris.

Question 7

For a client with mild benign prostatic hypertrophy (BPH) who will be treated conservatively, the nurse would advise the client to
A) avoid alcoholic beverages.
B) limit fluid intake.
C) limit sexual intercourse.
D) void every couple of hours.

Accepted Answer

The nurse should advise the client to (a) void whenever the urge is felt (do not put it off), (b) avoid taking large quantities of fluid over a short period, and (3) avoid alcohol, because its diuretic effect, with the volume of fluid, increases bladder distention.

Question 8

For a client with radioactive iodine seeds implanted for local control of a prostate tumor, the nurse would address radiation precautions by
A) isolating the client while the implants are intact.
B) limiting time spent with the client.
C) not allowing children to sit on his lap.
D) treating all urine as radioactive.

Accepted Answer

The long half-life of these seeds allows delivery of an effective radiation dose for 1 year. The client should avoid intercourse for the first 1-2 months after implantation and intercourse for procreation is not allowed unless specifically cleared by the urologist or radiation oncologist. The nurse should also teach the client not to allow children-or anyone else-to sit on his lap for a prolonged period of time during the first 1-2 months after implantation. Otherwise, no specific radiation precautions are needed.

Question 9

After the urinary catheter is removed on the fourth day following a transurethral resection, the client is upset because he is dribbling urine. The most appropriate nursing intervention in this situation is to
A) help keep the client dry, explaining that it may take some time to clear up.
B) obtain urine for culture, because he may have a urinary tract infection.
C) remind him to void every hour to prevent dribbling.
D) tell him the problem will clear up in a few days.

Accepted Answer

Temporary urinary frequency, urgency, leakage, and dysuria are normal until complete healing occurs. The nurse should remind the client and his significant others that these problems are temporary but may take time to resolve.

Question 10

A client is admitted to the hospital for a transurethral resection of the prostate (TURP). To learn more about the client's concerns regarding this surgery and his sexual functioning, the nurse might say
A) "Did you talk to anyone about how this surgery will affect your sex life?"
B) "It is not unusual for a man to worry about how this surgery will affect his sex life. What are some of your concerns?"
C) "This surgery may affect your sex life. Would you like to talk about this?"
D) "You may have heard about some side effects of surgery. Are you worried about how this surgery will affect your sex life?"

Accepted Answer

Giving men permission to express their feelings and health-related concerns draws them and their significant others into the process of health care. This option is better than the others. Option a is a yes/no question and is rather abrupt; it also sounds like there will definitely be some effect on sexuality. In reality, erectile dysfunction occurs in only 5-10% of clients and only when nerves are damaged during the operation. Options c and d are also yes/no questions. Yes/no questions are considered a barrier to therapeutic communication because the client can simply answer "yes" or "no" without elaborating.

Question 11

Nursing management of a client with acute bacterial prostatitis would include
A) catheterizing as needed.
B) encouraging ambulation.
C) limiting fluid intake.
D) providing fiber and fluid intake.

Accepted Answer

Rest, increased fluids, and analgesics are important in all clients with prostatitis. Because constipation can be a painful problem with prostatitis, the nurse should encourage the client to manage this with a high-fiber diet and increased fluids along with regular exercise.

Question 12

On the first day after prostatectomy, a client complains of pain that is caused by bladder spasm. The priority action by the nurse is to
A) administer antispasmodic drugs as ordered.
B) administer pain medication as ordered.
C) assess urethral catheter for patency.
D) encourage the client to use relaxation techniques.

Accepted Answer

Bladder spasms frequently occur after prostate procedures. The nurse should be sure that the drainage system is not obstructed, because obstruction and bladder irritation can cause bladder spasms. Once the nurse is assured that the catheter system is patent, then he/she can administer an antispasmodic medication.

Question 13

A client developed retrograde ejaculation after prostate surgery. In responding to the client's questions regarding this complication, the nurse would be aware that
A) the client will not be able to experience orgasm.
B) the problem can be repaired surgically.
C) this condition is a risk of surgery.
D) this condition is usually temporary.

Accepted Answer

Complications of prostate surgery include sexual dysfunction, such as erectile dysfunction, retrograde ejaculation, and infertility.

Question 14

In counseling a couple who want to conceive, the appropriate recommendation that the nurse would make to the man is
A) avoid using recreational drugs and alcohol.
B) have intercourse every 24 hours during ovulation.
C) take hot, soaking baths several times a week.
D) wear jockey shorts instead of boxer type.

Accepted Answer

Clients who want to conceive can try to prevent infertility by reducing exposure to gonadotoxins (marijuana, other recreational drugs, and possibly tobacco) and keeping the scrotum cool (avoiding excessive heat, hot baths, and tight clothing). Couples are advised to have intercourse only once every 36 hours during the woman's periovulatory period because it takes 24 hours for a normal sperm count to be generated after ejaculation.

Question 15

A client tells the nurse that on discharge following the client's transurethral resection, his wife is going to drive him to his daughter's house 3 hours away to recuperate. The nurse's most appropriate response would be
A) "During the drive, be sure to stop every hour to void."
B) "I'm glad you have someone to help you after your operation."
C) "Try to limit fluid intake before the drive to avoid problems."
D) "You need to avoid prolonged sitting for 2 weeks; can you plan something else?"

Accepted Answer

Prolonged sitting increases intra-abdominal pressure and may precipitate bleeding. After the client leaves the health care facility, driving an automobile or taking prolonged automobile rides should be avoided until at least 2 weeks after surgery, when the risk of bleeding decreases. In fact, the man should not sit at all except for meals during this time.

Question 16

A 45-year-old client says to the nurse, "I'm really worried about occasional impotence." The most appropriate response by the nurse would be
A) "Do you feel you should see a sex therapist?"
B) "Impotence is usually caused by psychogenic causes."
C) "This is not unusual after age 40."
D) "You should see your doctor to determine if the cause is physical."

Accepted Answer

There are multiple medical problems and medications that can cause erectile dysfunction (ED), so the client should be encouraged to seek medical attention to rule out or treat serious physiologic causes, such as hypertension and diabetes. A sex therapist would not be a first-line referral before a medical evaluation. Many older men continue to enjoy satisfactory erections and sex lives. Although psychogenic causes can lead to ED, again the client should seek medical attention. The nurse, while he/she may need to explain to the client that psychogenic causes may be a problem, should not do so in a way that makes the man feel like it is "all in his head."

Question 17

After a transurethral resection, the nurse notices that the client's urine in the Foley catheter bag is bright red, has numerous clots, and is viscous. The priority nursing action at this time is to
A) add fluid to the balloon end of the catheter.
B) call the physician immediately.
C) force fluids for the next 8 hours.
D) irrigate the catheter with sterile saline.

Accepted Answer

Arterial bleeding is bright red, has numerous clots, and is viscous. Blood pressure may fall, and emergency surgical intervention may become necessary.

Question 18

To provide protection against development of BPH, the nurse would encourage men in a community health education class to increase their intake of
A) citrus juices.
B) dairy products.
C) red meat.
D) yellow vegetables.

Accepted Answer

Dietary factors have been examined, and it has been concluded that yellow vegetables appear to provide some protection against BPH.

Question 19

Because a client's mother took diethylstilbestrol (DES) during pregnancy, a nurse should advise a client to maintain screening practices for which associated health risk?
A) Decreased sperm count
B) High risk of erectile dysfunction
C) Increased chance of bladder cancer
D) Increased risk of testicular cancer

Accepted Answer

The male offspring of women who used estrogen during the first trimester of pregnancy (called "DES sons"), or who were exposed to estrogen-progestin combinations frequently used in diagnostic tests to confirm pregnancy, are at greater risk of developing testicular cancer.

Question 20

Considering the potential long-term side effects of a radical prostectomy, the nurse would make the nursing diagnosis of
A) Deficient Fluid Volume
B) Impaired Urinary Elimination
C) Risk for Sexual Dysfunction
D) Social Isolation

Accepted Answer

Although various surgical approaches can be used, permanent erectile dysfunction and incontinence are possible risks of surgery.

Quiz 38: Management of Men with Reproductive Disorders

A nurse teaches a client who underwent insertion of a prostatic stent 5 weeks ago to be sure to tell all care providers about this procedure. When the client asks about the reason for this instruction, the nurse would reply that

A nurse counsels a client who smokes cigarettes and uses alcohol daily that he should be aware that these substances have been known to cause

The statement by the client scheduled for TURP that would indicate the need for further preoperative teaching is

The nurse preparing health teaching information about the etiology of prostate cancer would omit factors related to

Because a client is receiving antispasmodics for bladder spasms, the nurse should be sure that the client

After a transurethral resection, the nurse notes that the client's urinary catheter is blocked and his bladder is overdistended. The initial nursing action should be to

For a client with mild benign prostatic hypertrophy (BPH) who will be treated conservatively, the nurse would advise the client to

For a client with radioactive iodine seeds implanted for local control of a prostate tumor, the nurse would address radiation precautions by

After the urinary catheter is removed on the fourth day following a transurethral resection, the client is upset because he is dribbling urine. The most appropriate nursing intervention in this situation is to

A client is admitted to the hospital for a transurethral resection of the prostate (TURP) . To learn more about the client's concerns regarding this surgery and his sexual functioning, the nurse might say

Nursing management of a client with acute bacterial prostatitis would include

On the first day after prostatectomy, a client complains of pain that is caused by bladder spasm. The priority action by the nurse is to

A client developed retrograde ejaculation after prostate surgery. In responding to the client's questions regarding this complication, the nurse would be aware that

In counseling a couple who want to conceive, the appropriate recommendation that the nurse would make to the man is

A client tells the nurse that on discharge following the client's transurethral resection, his wife is going to drive him to his daughter's house 3 hours away to recuperate. The nurse's most appropriate response would be

A 45-year-old client says to the nurse, "I'm really worried about occasional impotence." The most appropriate response by the nurse would be

After a transurethral resection, the nurse notices that the client's urine in the Foley catheter bag is bright red, has numerous clots, and is viscous. The priority nursing action at this time is to

To provide protection against development of BPH, the nurse would encourage men in a community health education class to increase their intake of

Because a client's mother took diethylstilbestrol (DES) during pregnancy, a nurse should advise a client to maintain screening practices for which associated health risk?

Considering the potential long-term side effects of a radical prostectomy, the nurse would make the nursing diagnosis of