Nokea
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.
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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.
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 35-year-old father of three tells the nurse that he wants information on a vasectomy. What would the nurse tell him about ejaculate after a vasectomy?
- A. There will be no ejaculate after a vasectomy, though the patients potential for orgasm is unaffected.
- B. There is no noticeable decrease in the amount of ejaculate even though it contains no sperm.
- C. There is a marked decrease in the amount of ejaculate after vasectomy, though this does not affect sexual satisfaction.
- D. There is no change in the quantity of ejaculate after vasectomy, but the viscosity is somewhat increased.
Correct Answer: B
Rationale: Vasectomy does not significantly reduce ejaculate volume (only a 3% decrease) as seminal fluid is produced by the prostate and seminal vesicles, unaffected by the procedure. Viscosity remains unchanged, and orgasm potential is preserved.
A 22-year-old male is being discharged home after surgery for testicular cancer. The patient is scheduled to begin chemotherapy in 2 weeks. The patient tells the nurse that he doesnt think he can take weeks or months of chemotherapy, stating that he has researched the adverse effects online. What is the most appropriate nursing action for this patient at this time?
- A. Provide empathy and encouragement in an effort to foster a positive outlook.
- B. Tell the patient it is his decision whether to accept or reject chemotherapy.
- C. Report the patients statement to members of his support system.
- D. Refer the patient to social work.
Correct Answer: A
Rationale: Empathy and encouragement help address the patient's fears and promote a positive attitude toward chemotherapy, which is critical for adherence. Informing support systems breaches confidentiality, and social work referral or emphasizing patient choice are less immediate.