Nokea
A client who comes to the clinic complaining of perineal pain, dysuria, and fever is diagnosed with prostatitis. The nurse understands that which of the following organisms would be the most likely cause?
- A. Staphylococcus
- B. Sreptococcus
- C. Escherichia coli
- D. Paramyxovirus
Correct Answer: C
Rationale: Prostatitis is an inflammation of the prostate gland and is most often caused by microorganisms that reach the prostate by way of the urethra. Escherichia coli and microbes that cause sexually transmitted infections often are responsible. Staphylococcus and Sreptococcus are not typically a cause of prostatitis. Paramyxovirus is the cause of mumps.
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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.
After examination, a client is found to have a prostatic nodule and is scheduled for prostatic-specific antigen (PSA) testing. When the nurse is reviewing the results, which of the following would indicate that the nodule is malignant?
- A. 4 ng/mL.
- B. 7 ng/mL.
- C. 4 ng/mL.
- D. 12 ng/mL.
Correct Answer: D
Rationale: After a prostatic nodule is detected, prostate-specific antigen testing may be done. A PSA greater than 4 ng/mL is the basis for performing more definitive diagnostic procedures, and a PSA greater than 10 ng/mL indicates a prostatic malignancy. A PSA greater than 80 ng/mL indicates advanced metastatic disease.
The nurse is obtaining a medication history from a client who is reporting erectile dysfunction. Which medication would the nurse identify as being least likely to contribute to the client's condition?
- A. Spironolactone
- B. Cimetidine
- C. Ibprofen
- D. Methyldopa
Correct Answer: C
Rationale: Certain medications, such as antihypertensive agents (e.g., methyldopa and spironolactone), antidepressants, narcotics, and cimetidine cause sexual dysfunction in men. Ibprofen is not associated with causing erectile dysfunction. Cimetidine is a histamine-receptor antagonist used for gastric ulcers.
Which pharmacologic agent poses the greatest risk for urinary retention in a client with benign prostatic hyperplasia (BPH)?
- A. Muscle relaxers
- B. Antihypertensives
- C. Nitrates
- D. Antihistamines
Correct Answer: D
Rationale: Antihistamines and over-the-counter cold medications should be avoided in clients with BPH due to the increase in urinary retention properties. Muscle relaxers are commonly prescribed for treatment of urinary retention. Nitrates and antihypertensive medications do not cause significant risk in the management of BPH.
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.