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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.
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A nurse is teaching a 53-year-old man about prostate cancer. What information should the nurse provide to best facilitate the early identification of prostate cancer?
- A. Have a digital rectal examination and prostate-specific antigen (PSA) test done yearly.
- B. Have a transrectal ultrasound every 5 years.
- C. Perform monthly testicular self-examinations, especially after age 60.
- D. Have a complete blood count (CBC), blood urea nitrogen (BUN) and creatinine assessment performed annually.
Correct Answer: A
Rationale: Annual digital rectal examination and PSA testing are recommended for men over 50 to detect prostate cancer early, as they identify prostate abnormalities and tumor markers. Transrectal ultrasound is used post-diagnosis, testicular exams do not detect prostate issues, and CBC/BUN/creatinine are not screening tools.
A patient has returned to the floor from the PACU after undergoing a suprapubic prostatectomy. The nurse notes significant urine leakage around the suprapubic tube. What is the nurses most appropriate action?
- A. Cleanse the skin surrounding the suprapubic tube.
- B. Inform the urologist of this finding.
- C. Remove the suprapubic tube and apply a wet-to-dry dressing.
- D. Administer antispasmodic drugs as ordered.
Correct Answer: B
Rationale: Significant leakage around a suprapubic tube may indicate obstruction or malposition, requiring urologist evaluation. Cleansing is supportive but not primary, removing the tube is unsafe, and antispasmodics do not address leakage.
The nurse is leading a workshop on sexual health for men. The nurse should teach participants that organic causes of erectile dysfunction include what? Select all that apply.
- A. Diabetes
- B. Testosterone deficiency
- C. Anxiety
- D. Depression
- E. Parkinsonism
Correct Answer: A,B,E
Rationale: Organic causes of erectile dysfunction include diabetes (vascular and neuropathic effects), testosterone deficiency (endocrine disruption), and Parkinsonism (neurologic impairment). Anxiety and depression are psychogenic causes.
A public health nurse is teaching a health class for the male students at the local high school. The nurse is teaching the boys to perform monthly testicular self-examinations. What point would be appropriate to emphasize?
- A. Testicular cancer is a highly curable type of cancer.
- B. Testicular cancer is very difficult to diagnose.
- C. Testicular cancer is the number one cause of cancer deaths in males.
- D. Testicular cancer is more common in older men.
Correct Answer: A
Rationale: Testicular cancer is highly curable, especially with early detection through monthly self-examinations, which facilitate timely treatment. It is not difficult to diagnose, not the leading cause of cancer deaths, and is more common in younger men.
A nurse is providing care for a patient who has recently been admitted to the postsurgical unit from PACU following a transurethral resection of the prostate. The nurse is aware of the nursing diagnosis of Risk for Imbalanced Fluid Volume. In order to assess for this risk, the nurse should prioritize what action?
- A. Closely monitoring the input and output of the bladder irrigation system
- B. Administering parenteral nutrition and fluids as ordered
- C. Monitoring the patients level of consciousness and skin turgor
- D. Scanning the patients bladder for retention every 2 hours
Correct Answer: A
Rationale: Continuous bladder irrigation post-TURP requires close monitoring of input and output to prevent fluid volume excess or deficit from occlusion or bleeding. Parenteral nutrition is unnecessary, skin turgor is unreliable, and bladder scanning is not needed with a catheter.