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A patient has just been diagnosed with prostate cancer and is scheduled for brachytherapy next week. The patient and his wife are unsure of having the procedure because their daughter is 3 months pregnant. What is the most appropriate teaching the nurse should provide to this family?
- A. The patient should not be in contact with the baby after delivery.
- B. The patients treatment poses no risk to his daughter or her infant.
- C. The patients brachytherapy may be contraindicated for safety reasons.
- D. The patient should avoid close contact with his daughter for 2 months.
Correct Answer: D
Rationale: Brachytherapy involves radioactive seeds emitting low-level radiation, requiring the patient to avoid close contact with pregnant women and infants for about 2 months to minimize exposure risk. The treatment is not contraindicated, and complete isolation from the baby post-delivery is unnecessary.
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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 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 been prescribed sildenafil. What should the nurse teach the patient about this medication?
- A. Sexual stimulation is not needed to obtain an erection.
- B. The drug should be taken 1 hour prior to intercourse.
- C. Facial flushing or headache should be reported to the physician immediately.
- D. The drug has the potential to cause permanent visual changes.
Correct Answer: B
Rationale: Sildenafil requires sexual stimulation to be effective and should be taken about 1 hour before intercourse for optimal effect. Facial flushing and headache are common, non-serious side effects, and visual changes are rare and typically transient, not permanent.
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.
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.