Nokea
A clinic nurse is providing preprocedure education for a man who will undergo a vasectomy. Which of the following measures will enhance healing and comfort? Select all that apply.
- A. Abstaining from sexual intercourse for at least 14 days postprocedure
- B. Wearing a scrotal support garment
- C. Using sitz baths
- D. Applying a heating pad intermittently
- E. Staying on bed rest for 48 to 72 hours postprocedure
Correct Answer: B,C
Rationale: Scrotal support reduces swelling and discomfort, and sitz baths promote healing post-vasectomy. Ice, not heat, is recommended, sexual activity can resume in about 7 days, and prolonged bed rest is unnecessary.
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A man tells the nurse that his father died of prostate cancer and he is concerned about his own risk of developing the disease, having heard that prostate cancer has a genetic link. What aspect of the pathophysiology of prostate cancer would underlie the nurses response?
- A. A number of studies have identified an association of BRCA-2 mutation with an increased risk of prostate cancer.
- B. HNPCC is a mutation of two genes that causes prostate cancer in men and it is autosomal dominant.
- C. Studies have shown that the presence of the TP53 gene strongly influences the incidence of prostate cancer.
- D. Recent research has demonstrated that prostate cancer is the result of lifestyle factors and that genetics are unrelated.
Correct Answer: A
Rationale: BRCA-2 mutations are associated with an increased risk of prostate cancer, particularly in men with a family history. HNPCC relates to colon cancer, TP53 is linked to breast cancer, and genetics, not just lifestyle, contribute to prostate cancer risk.
A patient presents to the emergency department with paraphimosis. The physician is able to compress the glans and manually reduce the edema. Once the inflammation and edema subside, what is usually indicated?
- A. Needle aspiration of the corpus cavernosum
- B. Circumcision
- C. Abstinence from sexual activity for 6 weeks
- D. Administration of vardenafil
Correct Answer: B
Rationale: Paraphimosis, where the foreskin is trapped behind the glans, often recurs, making circumcision the usual treatment after edema subsides to prevent future episodes. Aspiration is for priapism, abstinence is unnecessary, and vardenafil is irrelevant.
A patient has presented at the clinic with symptoms of benign prostatic hyperplasia. What diagnostic findings would suggest that this patient has chronic urinary retention?
- A. Hypertension
- B. Peripheral edema
- C. Tachycardia and other dysrhythmias
- D. Increased blood urea nitrogen (BUN)
Correct Answer: D
Rationale: Chronic urinary retention from benign prostatic hyperplasia can lead to azotemia, evidenced by increased BUN due to impaired renal clearance. Hypertension, edema, or tachycardia are not directly associated with this condition.
A nurse is performing an admission assessment on a 40-year-old man who has been admitted for outpatient surgery on his right knee. While taking the patients family history, he states, My father died of prostate cancer at age 48. The nurse should instruct him on which of the following health promotion activities?
- A. The patient will need PSA levels drawn starting at age 55.
- B. The patient should have testing for presence of the CDH1 and STK11 genes.
- C. The patient should have PSA levels drawn regularly.
- D. The patient should limit alcohol use due to the risk of malignancy.
Correct Answer: C
Rationale: A family history of prostate cancer at age 48 warrants regular PSA screening starting earlier than age 55, typically around age 40-45, to monitor for early signs. CDH1/STK11 genes are not linked to prostate cancer, and alcohol limitation is less specific.
A patient who is postoperative day 12 and recovering at home following a laparoscopic prostatectomy has reported that he is experiencing occasional dribbling of urine. How should the nurse best respond to this patients concern?
- A. Inform the patient that urinary control is likely to return gradually.
- B. Arrange for the patient to be assessed by his urologist.
- C. Facilitate the insertion of an indwelling urinary catheter by the home care nurse.
- D. Teach the patient to perform intermittent self-catheterization.
Correct Answer: A
Rationale: Urinary incontinence post-prostatectomy is common and typically resolves gradually within months to a year. Reassuring the patient about this normal recovery process is appropriate. Urologist referral, catheterization, or self-catheterization are not indicated at this stage.