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The nurse is caring for a patient following a radical retropubic prostatectomy for prostate cancer and is incontinent of urine. Which of the following information should the nurse include in the teaching plan?
- A. Restrict oral fluid intake.
- B. Pelvic floor muscle exercises
- C. Use belladonna and opium suppositories.
- D. Perform intermittent self-catheterization
Correct Answer: B
Rationale: Pelvic floor muscle training (Kegel) exercises are recommended to strengthen the pelvic floor muscles and improve urinary control. Belladonna and opium suppositories are used to reduce bladder spasms after surgery. Intermittent self-catheterization may be taught before surgery if the patient has urinary retention, but it will not be useful in reducing incontinence after surgery. The patient should have a daily oral intake of 2-3 L.
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The nurse is providing education for a patient who has been diagnosed with orchitis. Which of the following information should the nurse include in the teaching plan?
- A. Pain management
- B. Emergency surgical repair
- C. Aspiration of fluid from the scrotal sac
- D. Application of warm packs to the scrotum
Correct Answer: A
Rationale: Orchitis is very painful and effective pain management will be needed. The other therapies will not be used to treat orchitis.
The nurse working in a health clinic receives calls from all these patients. Which of the following patients should be seen by the health care provider first?
- A. A 64-year-old man who has perineal pain and a temperature of 38°C (100.4°F)
- B. A 60-year-old man who has a painful erection that has lasted over 5 hours
- C. A 62-year-old man who has light pink urine after having a transurethral resection of the prostate (TURP) 3 days ago
- D. A 23-year-old man who states had had difficulty maintaining an erection last night
Correct Answer: B
Rationale: Priapism can cause complications such as necrosis or hydronephrosis, and this patient should be treated immediately. The other patients do not require immediate action to prevent serious complications.
The nurse has completed discharge teaching for a patient who had a transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH). Which of the following patient statements indicate that additional instruction is required?
- A. I will avoid driving until I get approval from my doctor.
- B. I should call the doctor if I have any incontinence at home.
- C. I will increase fibre and fluids in my diet to prevent constipation.
- D. I should continue to schedule yearly appointments for prostate exams.
Correct Answer: B
Rationale: Since urinary incontinence is common for several weeks after a TURP the patient does not need to call the health care provider if this occurs. The other patient statements indicate that the patient has a good understanding of post-TURP instructions.
A 51-year-old male patient is scheduled for an annual physical exam at the outpatient clinic. Which of the following diagnostic tests should the nurse plan to teach to the patient?
- A. Urinalysis collection
- B. Uroflowmetry studies
- C. Digital rectal exam (DRE)
- D. Transrectal Ultrasound scanning (TRUS)
Correct Answer: C
Rationale: An annual digital rectal exam (DRE) is recommended starting at age 50 for men who have an average risk for prostate cancer. Urinalysis and uroflowmetry studies are done if patients have symptoms of urinary tract infection or changes in the urinary stream. TRUS may be ordered if the DRE or PSA is abnormal.
The health care provider prescribes finasteride for a patient who has benign prostatic hyperplasia (BPH). Which of the following information should the nurse include when teaching the patient about the drug?
- A. Change position from lying to standing slowly.
- B. Sexual activity interest may decrease while he is taking the medication.
- C. Improvement in the obstructive symptoms should occur within about 2 weeks.
- D. Required to monitor blood pressure frequently to assess for hypertension.
Correct Answer: B
Rationale: A decrease in libido is an adverse effect of finasteride because of the androgen suppression that occurs with the drug. Although orthostatic hypotension may occur if the patient also is taking a medication for erectile dysfunction (ED), it should not occur with finasteride alone. Improvement in symptoms of obstruction takes about 6 months. The medication does not cause hypertension.