A client is diagnosed with metastatic prostate cancer. The client asks the nurse the purpose of his treatment with the luteinizing hormones releasing hormone (LH-RH) agonist leproptide (Lupron) and the bisphosphonate pamidinate (Aoxide). Which statement by the nurse is most appropriate?
- A. The treatment reduces testosterone and prevents bone fractures.
- B. The medications prevent erectile dysfunction and increase libido.
- C. There is less gynecomastia and osteoporosis with this drug regimen.
- D. These medications both inhibit tumor progression by blocking androgens.
Correct Answer: A
Rationale: Lupron, an LH-RH agonist, stimulates the pituitary gland to release luteinizing hormone (LH) to the point that the gland is depleted of LH and testosterone production is lessened. This may decrease the prostate cancer since it is hormone dependent. Lupron can cause osteoporosis, which results in the need of Aoxide to prevent this. Erectile dysfunction, decreased libido, and gynecomastia are side effects of the LH-RH medications. Antiandrogen drugs inhibit tumor progression by blocking androgens at the site of the prostate.
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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 55-year-old male client is admitted to the emergency department with symptoms of a myocardial infarction. Which question by the nurse is the most appropriate before administering nitroglycerin?
- A. On a scale from 0 to 10, what is the rating of your chest pain?
- B. Are you allergic to any food or medications?
- C. Have you taken any drugs like Viagra recently?
- D. Are you light headed or dizzy right now?
Correct Answer: C
Rationale: Phosphodiesterase-5 inhibitors such as sildenafil (Viagra) relax smooth muscles to increase blood flow to the penis for treatment of erectile dysfunction. In combination with nitroglycerin, there can be extreme hypotension with reduction of blood flow to vital organs. The other questions are appropriate but not the highest priority before administering nitroglycerin.
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.
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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