Nokea
A client is interested in learning about the risk factors for prostate cancer. Which factors does the nurse include in the teaching?
- A. Family history of prostate cancer
- B. Smoking
- C. Obesity
- D. Advanced age
- E. Eating too much red meat
- F. Race
Correct Answer: A,D,E,F
Rationale: Advanced family history of prostate cancer, age, a diet high in animal fat, and race are all risk factors for prostate cancer. Smoking and obesity are not known risk factors.
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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.
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 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.
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.
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.