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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.
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A patient has experienced occasional urinary incontinence in the weeks since his prostatectomy. In order to promote continence, the nurse should encourage which of the following?
- A. Pelvic floor exercises
- B. Intermittent urinary catheterization
- C. Reduced physical activity
- D. Active range of motion exercises
Correct Answer: A
Rationale: Pelvic floor exercises strengthen muscles supporting the bladder, aiding continence post-prostatectomy. Catheterization is unnecessary and risky, and physical activity levels do not directly impact continence.
A 29-year-old patient has just been told that he has testicular cancer and needs to have surgery. During a presurgical appointment, the patient admits to feeling devastated that he requires surgery, stating that it will leave him emasculated and a shell of a man. The nurse should identify what nursing diagnosis when planning the patients subsequent care?
- A. Disturbed Body Image Related to Effects of Surgery
- B. Spiritual Distress Related to Effects of Cancer Surgery
- C. Social Isolation Related to Effects of Surgery
- D. Risk for Loneliness Related to Change in Self-Concept
Correct Answer: A
Rationale: The patient's statements reflect concerns about his body image and masculinity post-surgery, supporting a diagnosis of Disturbed Body Image. There is no evidence of spiritual distress, social isolation, or loneliness.
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.
A patient who is scheduled for an open prostatectomy is concerned about the potential effects of the surgery on his sexual function. What aspect of prostate surgery should inform the nurses response?
- A. Erectile dysfunction is common after prostatectomy as a result of hormonal changes.
- B. All prostatectomies carry a risk of nerve damage and consequent erectile dysfunction.
- C. Erectile dysfunction after prostatectomy is expected, but normally resolves within several months.
- D. Modern surgical techniques have eliminated the risk of erectile dysfunction following prostatectomy.
Correct Answer: B
Rationale: Prostatectomies risk damaging pudendal nerves, leading to permanent erectile dysfunction in some cases. Hormonal changes are not the cause, resolution is not guaranteed, and modern techniques reduce but do not eliminate the risk.
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.