Nokea
The nurse is admitting a patient scheduled for a unilateral orchiectomy for testicular cancer. The nurse notes that the patient does not talk to his partner and speaks to the nurse only to answer the admission questions. Which of the following actions is best for the nurse to take?
- A. Ask the patient if he has any questions or concerns about the diagnosis and treatment.
- B. Document the patient's lack of communication on the chart and continue preoperative care.
- C. Assure the patient's partner that concerns about sexual function are common with this diagnosis.
- D. Teach the patient and the partner that impotence is rarely a problem after unilateral orchiectomy.
Correct Answer: A
Rationale: The initial action by the nurse should be assessment for any anxiety or questions about the surgery or postoperative care. The nurse should address the patient, not the spouse, when discussing the diagnosis and any possible concerns. Without further assessment of patient concerns, the nurse should not offer education about complications after orchiectomy. Documentation of the patient's lack of interaction is not an adequate nursing action in this situation.
You may also like to solve these questions
The nurse is admitting a patient with benign prostatic hyperplasia (BPH) who has urinary retention and new onset elevations in blood urea nitrogen (BUN) and creatinine. Which of the following prescribed therapies should the nurse implement first?
- A. Schedule an abdominal computed tomography (CT) scan
- B. Insert a urinary retention catheter.
- C. Draw blood for a complete blood count.
- D. Infuse normal saline at 50 mL/hour.
Correct Answer: B
Rationale: The patient data indicate that the patient may have acute renal failure caused by the BPH. The initial therapy will be to insert a catheter. The other actions also are appropriate, but they can be implemented after the acute urinary retention is resolved.
The nurse is caring for a patient with erectile dyfunction (ED) following treatment for benign prostatic hyperplasia (BPH). He shares with the nurse that he is seeking treatment as his wife 'is losing patience with the situation.' Which of the following nursing diagnoses is best for the patient?
- A. Ineffective role performance related to alteration in body image
- B. Anxiety related to threat to current status (inability to have sexual intercourse)
- C. Situational low self-esteem related to alteration in body image
- D. Ineffective sexuality pattern related to skill deficit about alternatives related to sexuality
Correct Answer: A
Rationale: The patient's statement indicates that the relationship with his wife is his primary concern. Although anxiety, low self-esteem, and ineffective sexuality patterns also may be concerns, the patient information suggests that addressing the role performance problem will lead to the best outcome for this patient.
The nurse is preparing a teaching plan for a patient who has an enlarged prostate detected by digital rectal examination (DRE) and an elevated prostate specific antigen (PSA) level. Which of the following procedures should the nurse include in the teaching plan?
- A. Cystourethroscopy
- B. Uroflowmetry studies
- C. Magnetic resonance imaging (MRI)
- D. Transrectal ultrasonography (TRUS)
Correct Answer: D
Rationale: In a patient with an abnormal DRE and elevated PSA, transrectal ultrasound is used to visualize the prostate for biopsy. Uroflowmetry studies help determine the extent of urine blockage and treatment, but there is no indication that this is a problem for this patient. Cystoscopy may be used before prostatectomy, but will not be done until after the TRUS and biopsy. MRI is used to determine whether prostatic cancer has metastasized but would not be ordered at this stage of the diagnostic process.
The nurse is conducting discharge teaching with a patient who has undergone a vasectomy in the health care provider's office. Which of the following information should the nurse include in the discharge instructions?
- A. May have temporary erectile dyfunction (ED) because of postoperative swelling.
- B. Should continue to use other methods of birth control for 6 weeks.
- C. Should not have sexual intercourse until his 6-week follow-up visit.
- D. Will notice a decrease in the appearance and volume of his ejaculate.
Correct Answer: B
Rationale: Because it takes about 6 weeks to evacuate sperm that are distal to the vasectomy site, the patient should use contraception for 6 weeks. ED that occurs after vasectomy is psychological in origin and not related to postoperative swelling. The patient does not need to abstain from intercourse. The appearance and volume of the ejaculate are not changed because sperm are a minor component of the ejaculate.
The nurse is providing teaching for a patient with cancer of the prostate who has been prescribed leuprolide. Which of the following adverse effects should the nurse include in the teaching plan about this drug?
- A. Dizziness
- B. Hot flashes
- C. Urinary incontinence
- D. Increased infection risk.
Correct Answer: B
Rationale: Hot flashes may occur with decreased testosterone production. Dizziness may occur with the alpha-blockers used for benign prostatic hyperplasia (BPH). Urinary incontinence may occur after prostate surgery, but it is not an expected medication adverse effect. Risk for infection is increased in patients receiving chemotherapy.