Nokea
A nurse practitioner is assessing a 55-year-old male patient who is complaining of perineal discomfort, burning, urgency, and frequency with urination. The patient states that he has pain with ejaculation. The nurse knows that the patient is exhibiting symptoms of what?
- A. Varicocele
- B. Epididymitis
- C. Prostatitis
- D. Hydrocele
Correct Answer: C
Rationale: Prostatitis presents with perineal discomfort, urinary symptoms (burning, urgency, frequency), and pain with ejaculation due to prostate inflammation. Varicocele involves dilated scrotal veins, epididymitis affects the epididymis with scrotal pain, and hydrocele causes fluid accumulation without urinary or ejaculatory symptoms.
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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 55-year-old man presents at the clinic complaining of erectile dysfunction. The patient has a history of diabetes. The physician orders tadalafil (Cialis) to be taken 1 hour before sexual intercourse. The nurse reviews the patients history prior to instructing the patient on the use of this medication. What disorder will contraindicate the use of tadalafil (Cialis)?
- A. Cataracts
- B. Retinopathy
- C. Hypotension
- D. Diabetic nephropathy
Correct Answer: C
Rationale: Tadalafil is contraindicated in patients with hypotension due to the risk of severe blood pressure drops, especially with nitrates. Cataracts, retinopathy, and nephropathy do not typically contraindicate its use, though retinopathy requires caution.
A patient is 24 hours postoperative following prostatectomy and the urologist has ordered continuous bladder irrigation. What color of output should the nurse expect to find in the drainage bag?
- A. Red wine colored
- B. Tea colored
- C. Amber
- D. Light pink
Correct Answer: D
Rationale: Post-prostatectomy urine output typically transitions from reddish-pink immediately after surgery to light pink within 24 hours as bleeding subsides, indicating normal healing. Red wine or tea colors suggest persistent bleeding, and amber indicates concentrated urine, not typical post-surgery.
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 has returned to the floor after undergoing a transurethral resection of the prostate (TURP). The patient has a continuous bladder irrigation system in place. The patient tells you he is experiencing bladder spasms and asks what you can do to relieve his discomfort. What is the most appropriate nursing action to relieve the discomfort of the patient?
- A. Apply a cold compress to the pubic area.
- B. Notify the urologist promptly.
- C. Irrigate the catheter with 30 to 50 mL of normal saline as ordered.
- D. Administer a smooth-muscle relaxant as ordered.
Correct Answer: D
Rationale: Smooth-muscle relaxants, often ordered PRN post-TURP, relieve bladder spasms by reducing irritability. Cold compresses, urologist notification, or catheter irrigation do not directly address spasms.