Nokea
A 22-year-old male is being discharged home after surgery for testicular cancer. The patient is scheduled to begin chemotherapy in 2 weeks. The patient tells the nurse that he doesnt think he can take weeks or months of chemotherapy, stating that he has researched the adverse effects online. What is the most appropriate nursing action for this patient at this time?
- A. Provide empathy and encouragement in an effort to foster a positive outlook.
- B. Tell the patient it is his decision whether to accept or reject chemotherapy.
- C. Report the patients statement to members of his support system.
- D. Refer the patient to social work.
Correct Answer: A
Rationale: Empathy and encouragement help address the patient's fears and promote a positive attitude toward chemotherapy, which is critical for adherence. Informing support systems breaches confidentiality, and social work referral or emphasizing patient choice are less immediate.
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An adolescent is identified as having a collection of fluid in the tunica vaginalis of his testes. The nurse knows that this adolescent will receive what medical diagnosis?
- A. Cryptorchidism
- B. Orchitis
- C. Hydrocele
- D. Prostatism
Correct Answer: C
Rationale: A hydrocele is characterized by fluid accumulation in the tunica vaginalis surrounding the testes, often presenting as a painless scrotal swelling. Cryptorchidism involves undescended testes, orchitis is testicular inflammation, and prostatism refers to symptoms from prostate obstruction, none of which match the described condition.
A patient has presented at the clinic with symptoms of benign prostatic hyperplasia. What diagnostic findings would suggest that this patient has chronic urinary retention?
- A. Hypertension
- B. Peripheral edema
- C. Tachycardia and other dysrhythmias
- D. Increased blood urea nitrogen (BUN)
Correct Answer: D
Rationale: Chronic urinary retention from benign prostatic hyperplasia can lead to azotemia, evidenced by increased BUN due to impaired renal clearance. Hypertension, edema, or tachycardia are not directly associated with this condition.
A nurse is providing an educational event to a local mens group about prostate cancer. The nurse should cite an increased risk of prostate cancer in what ethnic group?
- A. Native Americans
- B. Caucasian Americans
- C. African Americans
- D. Asian Americans
Correct Answer: C
Rationale: African American men have a higher incidence and mortality rate from prostate cancer compared to other ethnic groups, making them a high-risk population.
A man tells the nurse that his father died of prostate cancer and he is concerned about his own risk of developing the disease, having heard that prostate cancer has a genetic link. What aspect of the pathophysiology of prostate cancer would underlie the nurses response?
- A. A number of studies have identified an association of BRCA-2 mutation with an increased risk of prostate cancer.
- B. HNPCC is a mutation of two genes that causes prostate cancer in men and it is autosomal dominant.
- C. Studies have shown that the presence of the TP53 gene strongly influences the incidence of prostate cancer.
- D. Recent research has demonstrated that prostate cancer is the result of lifestyle factors and that genetics are unrelated.
Correct Answer: A
Rationale: BRCA-2 mutations are associated with an increased risk of prostate cancer, particularly in men with a family history. HNPCC relates to colon cancer, TP53 is linked to breast cancer, and genetics, not just lifestyle, contribute to prostate cancer risk.
A patient presents to the emergency department with paraphimosis. The physician is able to compress the glans and manually reduce the edema. Once the inflammation and edema subside, what is usually indicated?
- A. Needle aspiration of the corpus cavernosum
- B. Circumcision
- C. Abstinence from sexual activity for 6 weeks
- D. Administration of vardenafil
Correct Answer: B
Rationale: Paraphimosis, where the foreskin is trapped behind the glans, often recurs, making circumcision the usual treatment after edema subsides to prevent future episodes. Aspiration is for priapism, abstinence is unnecessary, and vardenafil is irrelevant.