Nokea
A 55-year-old African-American client is having a visit with his health care provider. What test should the nurse discuss with the client as an option to screen for prostate cancer, even though screening is not routinely recommended?
- A. Complete blood count
- B. Culture and sensitivity
- C. Prostate-specific antigen
- D. Cystoscopy
Correct Answer: C
Rationale: The prostate-specific antigen test should be discussed as an option for prostate cancer screening. A complete blood count and culture and sensitivity laboratory test will be ordered if infection is suspected. A cystoscopy would be performed to assess the effect of a bladder neck obstruction.
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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 client is diagnosed with benign prostatic hyperplasia and seems sad and irritable. After assessing the clients behavior, which statement by the nurse would be the most appropriate?
- A. The urine incontinence should not prevent you from socializing.
- B. You seem depressed and should seek more pleasant thing to do.
- C. It is common for men at your age to have changes in mood.
- D. Nocturia could cause interruption of your sleep and cause changes in mood.
Correct Answer: D
Rationale: Frequent visits to the bathroom during the night could cause sleep interruptions and affect the clients mood and mental status. Incontinence could cause the client to feel embarrassment and cause him to limit his activities outside the home. The social isolation could lead to clinical depression and should be treated professionally. The nurse should not give advice before exploring the clients response to his change in behavior. The statement about age has no validity.
The nurse is teaching a client with benign prostatic hyperplasia (BPH). What statement indicates a lack of understanding by the client?
- A. There should be no problem with a glass of wine with dinner each night.
- B. I am so glad that I weaned myself off of coffee about a year ago.
- C. I need to inform my allergist that I cannot take my normal decongestant.
- D. My normal routine of drinking a quart of water during exercise needs to change.
Correct Answer: A
Rationale: This client did not associate wine with the avoidance of alcohol, and requires additional teaching. The nurse must teach a client with BPH to avoid alcohol, caffeine, and large quantities of fluid in a short amount of time to prevent overdistention of the bladder. Decongestants also need to be avoided to lower the chance for urinary retention.
The nurse is teaching an uncircumcised 65-year-old client about self-management of a urinary catheter in preparation for discharge to his home. What statement indicates a lack of understanding by the client?
- A. I only have to wash the outside of the catheter once a week.
- B. I should take extra time to clean the catheter site by pushing the foreskin back.
- C. The drainage bag needs to be changed at least once a week and as needed.
- D. I should pour a solution of vinegar and water through the tubing and bag.
Correct Answer: A
Rationale: The first few inches of the catheter must be washed daily starting at the penis and washing outward with soap and water. The other options are correct for self-management of a urinary catheter in the home setting.
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.