A client is diagnosed with stage II cancer of the prostate. The nurse interprets this as indicating which of the following?
- A. Cancer is small with no symptoms.
- B. Tumor is confined to the prostate gland.
- C. Tumor has spread beyond the prostate.
- D. Tumor has expanded to the bladder.
Correct Answer: B
Rationale: Stage II cancer of the prostate involves a tumor that is larger than stage I but is still confined to the prostate gland, if left untreated, it is more likely to spread beyond the prostate and cause symptoms. Stage I cancer of the prostate involves a small, slow-growing cancer that may never cause symptoms or other health problems. Stage III involves a tumor that has spread beyond the prostate but has not reached the bladder, rectum, lymph nodes, or other organs. Stage IV involves a tumor that has spread to the bladder, rectum, lymph nodes, or distant organs such as the bones.
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Which of the following should nurses teach all men, especially those who have had cryptorchidism?
- A. Need for blood tests to measure serum acid phosphatase
- B. Importance of regular monitoring of prostate-specific antigen (PSA) levels
- C. Need to undergo a baseline and follow up lymph node biopsies
- D. How to perform a testicular self-examination
Correct Answer: D
Rationale: The nurses should teach all men, especially those who have had cryptorchidism, to perform testicular self-examination to detect any abnormal mass in the scrotum. The nurse instructs the clients to examine the testicles monthly, preferably when warm, such as in the shower. Having regular PSA levels, lymph node biopsies, and blood tests for measuring serum acid phosphatase are for the clients who are treated for prostate cancer.
A client is scheduled for a pump-type implanted penile prosthesis. Which client statement to the nurse would indicate the need for additional teaching?
- A. The reservoir is filled with saline solution.
- B. The penis will appear longer than usual.
- C. Surgery is required for placing the implant.
- D. The implant is pumped when sexual activity is desired.
Correct Answer: B
Rationale: When a pump-type implant is used, the erect penis tends to be shorter than usual because the saline filled cylinders do not fill the glans portion of the penis. This procedure is performed via surgical approach. The implant is pumped causing filling and erection when sexual activity is desired.
Which nursing assessment finding is most significant in determining the plan of care in a client with erectile dysfunction?
- A. Age
- B. Medication use
- C. Sexual history
- D. Undescended testicle
Correct Answer: B
Rationale: Certain medications such as antihypertensive drugs, antidepressants, narcotics, etc. can cause sexual dysfunction in men. Impotence is not a normal part of aging. Undescended testicle is not indicative of ED. Sexual history is not indicative of ED.
The nurse is providing discharge teaching to a client following a vasectomy. Which is the most important instruction to provide?
- A. Wear a scrotal support until swelling is resolved.
- B. Use a Tylenol as needed for discomfort.
- C. Use another form of birth control until further notice.
- D. Take a day or two to rest and recuperate from the procedure.
Correct Answer: C
Rationale: It may take up to 10 ejaculations to clear sperm and prevent impregnation. The client should be instructed to use another form of reliable birth control until a sperm count proves sterility has occurred. Use of Tylenol, scrotal support, and rest are all helpful during the initial recovery period.
A client comes to the outpatient clinic for information on a vasectomy. Which instruction should be included by the nurse?
- A. Vasectomies should be considered a permanent means of birth control.
- B. Following surgery, sexual intercourse should be avoided for 3 months.
- C. Postoperative discomfort can be relieved with use of warm bath.
- D. Vasectomy can result in permanent impotence.
Correct Answer: A
Rationale: Although attempts to reverse a vasectomy have proven successful, a vasectomy should be considered a permanent means of birth control. Scar formation and/or sperm leakage can interfere with restoration of reproductive effectiveness. Sexual intercourse can be resumed when it is comfortable to do so, usually in about 1 week. Postoperative discomfort should be controlled with application of cold to reduce swelling or use of mild analgesics. On occasion, clients have complained of impotence, but vasectomies have no effect on erection or ejaculation.
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