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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.
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The nurse is administering finasteride (Proscar) and doxazosin (Cardura) to a 67-year-old client with benign prostatic hyperplasia. What precautions are related to the side effects of these medications?
- A. Assessing for blood pressure changes when lying, sitting, and arising from the bed
- B. Immediately reporting any change in the alanine aminotransferase laboratory test
- C. Teaching the client about the possibility of increased libido with these medications
- D. Taking the clients pulse rate for a minute in anticipation of bradycardia
- E. Asking the client to report any weakness, light-headedness, or dizziness
Correct Answer: A,B,E
Rationale: Both the 5-alpha-reductase inhibitor (5-ARI) and the alpha-selective blocking agents can cause orthostatic hypotension. The 5-ARI agent (Proscar) can cause a decreased libido rather than an increased sexual drive. The alpha-blocking drug (Cardura) can cause tachycardia rather than bradycardia.
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.
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.
The nurse is administering sulfamethoxazole-trimethoprim (Bactrim) to a client diagnosed with bacterial prostatitis. Which finding causes the nurse to question this medication for this client?
- A. Urinary tract infection
- B. Allergy to sulfa medications
- C. Hematuria
- D. Elevated serum white blood cells
Correct Answer: B
Rationale: Before administering sulfamethoxazole-trimethoprim, the nurse must assess if the client is allergic to sulfa drugs. Urinary tract infection, hematuria, and elevated serum white blood cells are common problems associated with bacterial prostatitis that require long-term antibiotic therapy.
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.