Nokea
After examination, a client is found to have a prostatic nodule and is scheduled for prostatic-specific antigen (PSA) testing. When the nurse is reviewing the results, which of the following would indicate that the nodule is malignant?
- A. 4 ng/mL.
- B. 7 ng/mL.
- C. 4 ng/mL.
- D. 12 ng/mL.
Correct Answer: D
Rationale: After a prostatic nodule is detected, prostate-specific antigen testing may be done. A PSA greater than 4 ng/mL is the basis for performing more definitive diagnostic procedures, and a PSA greater than 10 ng/mL indicates a prostatic malignancy. A PSA greater than 80 ng/mL indicates advanced metastatic disease.
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Which of the following should nurses teach all men, especially those who have had cryptorchidism?
- A. Need for blood tests to measure serum acid phosphatase
- B. Importance of regular monitoring of prostate-specific antigen (PSA) levels
- C. Need to undergo a baseline and follow up lymph node biopsies
- D. How to perform a testicular self-examination
Correct Answer: D
Rationale: The nurses should teach all men, especially those who have had cryptorchidism, to perform testicular self-examination to detect any abnormal mass in the scrotum. The nurse instructs the clients to examine the testicles monthly, preferably when warm, such as in the shower. Having regular PSA levels, lymph node biopsies, and blood tests for measuring serum acid phosphatase are for the clients who are treated for prostate cancer.
Which pharmacologic agent poses the greatest risk for urinary retention in a client with benign prostatic hyperplasia (BPH)?
- A. Muscle relaxers
- B. Antihypertensives
- C. Nitrates
- D. Antihistamines
Correct Answer: D
Rationale: Antihistamines and over-the-counter cold medications should be avoided in clients with BPH due to the increase in urinary retention properties. Muscle relaxers are commonly prescribed for treatment of urinary retention. Nitrates and antihypertensive medications do not cause significant risk in the management of BPH.
The surgeon has ordered belladonna and opium (B and O) suppositories for the management of a postoperative prostatectomy client who is receiving continuous bladder irrigation. Which symptom(s) would indicate to the nurse the need for administration of this drug? Select all that apply.
- A. Increased blood in the catheter tubing
- B. Slowed or stopped infusion rate
- C. Increased bladder pressure and pain
- D. Increased speed of infusion rate
- E. Signs of urinary retention
- F. Increased force of urinary stream
Correct Answer: B,C
Rationale: Belladonna and opium suppositories are ordered to reduce bladder spasms that cause increased bladder pressure and pain following a prostatectomy. As spasms occur, the infusion of saline will slow or stop. Increased blood in the catheter tubing is a sign of active bleeding. With an indwelling three-way catheter, urinary retention and increased force of urinary stream are not present.
Which of the following would a nurse include in a teaching plan for a client with benign prostatic hyperplasia who is not yet a candidate for surgery?
- A. Maintaining optimal bladder emptying
- B. Using appropriate coping to alley anxiety.
- C. Performing deep breathing exercises periodically
- D. Doing leg exercises at least daily.
Correct Answer: A
Rationale: For the client with benign prostatic hyperplasia who is not yet a candidate for surgery, the nurse would teach a client how to maintain optimal bladder emptying. The surgical client requires support and information to allay anxiety. The nurse teaches deep breathing and leg exercises for the client who is to have surgery.
The nurse is caring for a client with benign prostatic hyperplasia (BPH). Which assessment finding provides the best indication of urinary retention?
- A. Frequency
- B. Urgency
- C. Hesitancy
- D. Dribbling
Correct Answer: A
Rationale: As residual urine accumulates, the client has an urge to void more often. Urgency, hesitancy, and dribbling are all urinary symptoms associated with BPH but not specific to urinary retention.