Chapter 59: Male Reproductive Problems|Harding: Lewis’s Medical-Surgical Nursing, 12th Edition

MULTIPLE CHOICE 1. What will the nurse ask the patient about to determine the severity of benign prostatic hyperplasia (BPH) symptoms? a. Blood in the urine b. Lower back or hip pain c. Force of urinary stream d. Erectile dysfunction (ED) 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 hip pain are not typical symptoms of BPH. DIF: Cognitive Level: Apply (Application) 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 affect his ability to have sexual intercourse. Which action would the nurse take? a. Discuss alternative methods of sexual expression. b. Teach about medication for erectile dysfunction (ED). c. Explain that TURP may cause retrograde ejaculation. 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 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 about fertility does not address his concerns. DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity 3. The health care provider prescribes finasteride (Proscar) for a patient who has benign prostatic hyperplasia (BPH). Which information would the nurse provide about the drug? 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. d. He will need to monitor his blood pressure frequently to assess for hypertension. ANS: B A decrease in libido is a side effect of finasteride because of the androgen suppression that 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. DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity 4. Which 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 b. Uroflowmetry studies c. Magnetic resonance imaging (MRI) d. Transrectal ultrasonography (TRUS)