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- AQE Private College, Pretoria, Gauteng
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abirb.com/testChapter 54: Male Reproductive Problems
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Harding: Lewis’s Medical-Surgical Nursing, 11th Edition
MULTIPLE CHOICE abirb.com/test
1. What will the nurse will ask the patient about to determine the severity of benign prostatic
hyperplasia (BPH) symptoms?
a. Blood in the urine abirb.com/test
b. Lower back or hip pain
c. Force of urinary stream
d. Erectile dysfunction (ED)
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ANS: C
The American Urological Association Symptom Index for a patient with BPH asks questions
such as the force and frequency of urination and nocturia. Blood in the urine, ED, and back or
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hip pain are not typical symptoms of BPH.
DIF: Cognitive Level: Apply (application)
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TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
2. A patient who was recently diagnosed with benign prostatic hyperplasia (BPH) tells the nurse
that he does not want to have a transurethral resection of the prostate (TURP) because it might
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affect his ability to have sexual intercourse. Which action should the nurse take?
a. Discuss alternative methods of sexual expression.
b. Teach about medication for erectile dysfunction (ED).
c. Clarify that TURP does not commonly affect erection.
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d. Offer reassurance that fertility is not affected by TURP.
ANS: C
ED is not a concern with TURP, although retrograde ejaculation is likely, and the nurse
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should discuss this with the patient. Erectile function is not usually affected by a TURP, so the
patient will not need information about penile implants or reassurance that other forms of
sexual expression may be used. Because the patient has not asked about fertility, reassurance
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about fertility does not address his concerns.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
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3. The health care provider prescribes finasteride (Proscar) for a patient who has benign prostatic
hyperplasia (BPH). What information should the nurse provide when teaching the patient
about the drug? abirb.com/test
a. He should change position from lying to standing slowly to avoid dizziness.
b. His interest in sexual activity may decrease while he is taking the medication.
c. Improvement in the obstructive symptoms should occur within about 2 weeks.
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d. He will need to monitor his blood pressure frequently to assess for hypertension.
ANS: B
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, abirb.com/test
A decrease in libido is a side effect of finasteride because of the androgen suppression that
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occurs with the drug. Although orthostatic hypotension may occur if the patient is also taking
a medication for erectile dysfunction, it should not occur with finasteride alone. Improvement
in symptoms of obstruction takes about 6 months. The medication does not cause
hypertension. abirb.com/test
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
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4. What test will the nurse plan to explain to a 61-yr-old patient who has an enlarged prostate
detected by digital rectal examination (DRE) and an elevated prostate-specific antigen (PSA)
level?
a. Cystourethroscopy abirb.com/test
b. Uroflowmetry studies
c. Magnetic resonance imaging (MRI)
d. Transrectal ultrasonography (TRUS)
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ANS: D
In a patient 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
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blockage and treatment, but there is no indication that this is a problem for this patient.
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
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ordered at this stage of the diagnostic process.
DIF: Cognitive Level: Apply (application) TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity
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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. abirb.com/test
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.
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ANS: D
The purpose of bladder irrigation is to remove clots from the bladder and prevent obstruction
of the catheter by clots. The irrigation does not decrease bleeding or improve hydration.
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Antibiotics are given by the IV route, not through the bladder irrigation.
DIF: Cognitive Level: Understand (comprehension)
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TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
6. What information will the nurse plan to teach the patient scheduled for photovaporization of
the prostate (PVP)?
a. abirb.com/test
Care of an indwelling urinary catheter.
b. Urine will appear bloody for several days.
c. Symptom improvement takes 2 to 3 weeks.
d. Complications associated with urethral stenting.
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ANS: A
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The patient will have an indwelling catheter for 24 to 48 hours and will need teaching about
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catheter care. There is minimal bleeding with this procedure. Symptom improvement is
almost immediate after PVP. Stent placement is not part of the procedure.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Planning
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MSC: NCLEX: Physiological Integrity
7. A 53-yr-old patient is scheduled for an annual physical examination. What diagnostic test will
the nurse will plan to explain to the patient?
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a. Urinalysis collection
b. Uroflowmetry studies
c. Prostate-specific antigen (PSA)
d. abirb.com/test
Transrectal ultrasound scanning (TRUS)
ANS: C
An annual digital rectal exam (DRE) and PSA are usually recommended starting at age 50
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years for men who have an average risk for prostate cancer. Urinalysis and uroflowmetry
studies are done if patients have symptoms of urinary tract infection or changes in the urinary
stream. TRUS may be ordered if the DRE or PSA results are abnormal.
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DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity
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8. What potential cause of infection will the nurse consider in the plan of care for a patient
immediately after a perineal radical prostatectomy?
a. Urinary incontinence
b. Prolonged urinary stasis
c. Fecal wound contamination
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d. Suprapubic catheter placement
ANS: C
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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 patient has a retention catheter in place for 1 to 2 weeks. A urethral catheter
is used after the surgery. abirb.com/test
DIF: Cognitive Level: Apply (application) TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity
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9. What will the nurse plan to teach the patient who is incontinent of urine following a radical
retropubic prostatectomy?
a. Restrict oral fluid intake.
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b. Do pelvic muscle exercises.
c. Perform intermittent self-catheterization.
d. Use belladonna and opium suppositories.
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ANS: B
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
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bladder spasms after surgery. Intermittent self-catheterization may be taught before surgery if
the patient has urinary retention, but it will not be useful in reducing incontinence after
surgery. The patient should have a daily oral intake of 2 to 3 L.
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, abirb.com/test
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DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity
10. A 70-yr-old patient who has had a transurethral resection of the prostate (TURP) for benign
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prostatic hyperplasia (BPH) is being discharged from the hospital today. Which patient
statement indicates a need for the nurse to provide additional instruction?
a. “I should call the doctor if I have incontinence at home.”
b. “I will avoid driving until I get approval from my doctor.”
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c. “I should schedule yearly appointments for prostate examinations.”
d. “I will increase fiber and fluids in my diet to prevent constipation.”
ANS: A abirb.com/test
Because incontinence is common for several weeks after a TURP, the patient does not need to
call the health care provider if this occurs. The other patient statements indicate that the
patient has a good understanding of post-TURP instructions.
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DIF: Cognitive Level: Apply (application) TOP: Nursing Process: Evaluation
MSC: NCLEX: Physiological Integrity
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11. What side effect of leuprolide (Lupron) should the nurse plan to discuss with a patient who
has cancer of the prostate?
a. Flushing
b. Dizziness abirb.com/test
c. Infection
d. Incontinence
ANS: A abirb.com/test
Hot flashes may occur with decreased testosterone production. Dizziness may occur with the
-blockers used for benign prostatic hyperplasia. Urinary incontinence may occur after
prostate surgery, but it is not an expected side effect of medication. Risk for infection is
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increased in patients receiving chemotherapy.
DIF: Cognitive Level: Understand (comprehension)
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TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
12. Which information will the nurse teach a patient who has chronic prostatitis?
a. Ibuprofen (Motrin) should provide good pain control.
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b. Prescribed antibiotics should be taken for 7 to 10 days.
c. Intercourse or masturbation will help relieve symptoms.
d. Cold packs used every 4 hours will decrease inflammation.
ANS: C abirb.com/test
Ejaculation helps drain the prostate and relieve pain. Warm baths are recommended to reduce
pain. Nonsteroidal antiinflammatory drugs (NSAIDs) are frequently prescribed but usually do
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not offer adequate pain relief. Antibiotics for chronic prostatitis are taken for 4 to 12 weeks.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
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13. What should the nurse assess for when performing a focused examination to determine
possible causes of infertility?
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