Nokea
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.
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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.
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 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 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 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.