Nokea
A 25-year-old client has recently been diagnosed with testicular cancer and is scheduled for radiation therapy. Which intervention by the nurse is best?
- A. Ask the client about his support system of friends and relatives.
- B. Encourage the client to verbalize his fears about sexual performance.
- C. Explore with the client the possibility of sperm collection.
- D. Provide privacy to allow time for reflection about the treatment.
Correct Answer: C
Rationale: Sperm collection is a viable option for a client diagnosed with testicular cancer and should be completed before radiation therapy, chemotherapy, or radical lymph node dissection. The other options would promote psychosocial support but are not the priority intervention.
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The nurse is conducting a history on a male client to determine the severity of symptoms associated with prostate enlargement. Which finding is cause for prompt action by the nurse?
- A. Cloudy urine
- B. Urinary hestancy
- C. Post-void dribbling
- D. Weak urinary stream
Correct Answer: A
Rationale: Cloudy urine could indicate infection due to possible urine retention and should be a priority action. Common symptoms of benign prostatic hyperplasia are urinary hestancy, post-void dribbling, and a weak urinary stream due to the enlarged prostate causing bladder outlet obstruction.
A 34-year-old client comes to the clinic with concerns about an enlarged left testicle and heaviness in his lower abdomen. Which diagnostic test would the nurse expect to be ordered to confirm testicular cancer?
- A. Alpha-fetoprotein (AFP)
- B. Prostate-specific antigen (PSA)
- C. Prostate acid phosphatase (PAP)
- D. C-reactive protein (CRP)
Correct Answer: A
Rationale: AFP is a glycoprotein that is elevated in testicular cancer. PSA and PAP testing is used in the screening of prostate cancer. CRP is diagnostic for inflammatory conditions.
A client came to the clinic with erectile dysfunction. What are some possible causes of this condition that the nurse could discuss with the client during history taking?
- A. Recent prostatectomy
- B. Long-term hypertension
- C. Diabetes mellitus
- D. Hour-long exercise sessions
- E. Consumption of beer each night
Correct Answer: A,B,C,E
Rationale: Organic erectile dysfunction can be caused by surgical procedures, hypertension and its treatment, diabetes mellitus, and alcohol consumption. There is no evidence that exercise is related to this problem.
Post transurethral resection of the prostate, a client has a three-way catheter with a continuous bladder irrigation. Over the last 12 hours, there has been 1400 ml of irrigation solution infused and 2000 ml measured in output from the drainage bag. What is the recording of the urinary output for the 12-hour period? (Record your answer using a whole number) ml.
Correct Answer: 600 ml
Rationale: 2000 ml from the drainage bag (including both the irrigation fluid and urine) minus the 1400 ml of irrigation fluid equals 600 ml of urine: 2000 ml - 1400 ml = 600 ml.
A 70-year-old client returned from a transurethral resection of the prostate 8 hours ago with a continuous bladder irrigation. The nurse reviews his laboratory results as follows: [Sodium data]. Which action should the nurse take?
- A. Consider starting a blood transfusion.
- B. Slow down the bladder irrigation if the urine is pink.
- C. Report the findings to the surgeon immediately.
- D. Take the vital signs every 15 minutes.
Correct Answer: B
Rationale: The serum sodium is decreased due to large-volume bladder irrigation (normal is 136 to 145 mEq/L). By slowing the irrigation, there will be less fluid overload and sodium dilution. The hemoglobin and hematocrit values are a low normal, with a slight decrease in the red blood cell count. Therefore, a blood transfusion or frequent vital signs should not be necessary. Immediate report to the surgeon is not necessary.