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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.
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A nurse is planning the postoperative care of a patient who is scheduled for radical prostatectomy. What intraoperative position will place the patient at particular risk for the development of deep vein thrombosis postoperatively?
- A. Fowlers position
- B. Prone position
- C. Supine position
- D. Lithotomy position
Correct Answer: D
Rationale: The lithotomy position, used during prostatectomy, elevates the legs, potentially impairing venous return and increasing the risk of deep vein thrombosis. Compression stockings are critical for prevention. Fowlers, prone, and supine positions do not pose the same risk.
A physician explains to the patient that he has an inflammation of the Cowper glands. Where are the Cowper glands located?
- A. Within the epididymis
- B. Below the prostate, within the posterior aspect of the urethra
- C. On the inner epithelium lining the scrotum, lateral to the testes
- D. Medial to the vas deferens
Correct Answer: B
Rationale: Cowper glands (bulbourethral glands) are located below the prostate within the posterior urethra, secreting lubricating fluid during ejaculation. They are not in the epididymis, scrotal lining, or near the vas deferens.
A nurse is providing care for a patient who has recently been admitted to the postsurgical unit from PACU following a transurethral resection of the prostate. The nurse is aware of the nursing diagnosis of Risk for Imbalanced Fluid Volume. In order to assess for this risk, the nurse should prioritize what action?
- A. Closely monitoring the input and output of the bladder irrigation system
- B. Administering parenteral nutrition and fluids as ordered
- C. Monitoring the patients level of consciousness and skin turgor
- D. Scanning the patients bladder for retention every 2 hours
Correct Answer: A
Rationale: Continuous bladder irrigation post-TURP requires close monitoring of input and output to prevent fluid volume excess or deficit from occlusion or bleeding. Parenteral nutrition is unnecessary, skin turgor is unreliable, and bladder scanning is not needed with a catheter.
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.
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.