Nokea
The nurse is conducting a focused health history for a patient with possible testicular cancer. Which of the following topics should the nurse include in the assessment?
- A. Sexually transmitted infections (STIS)
- B. Testicular trauma
- C. Testicular torsion
- D. Undescended testicles
Correct Answer: D
Rationale: Cryptorchidism is a risk factor for testicular cancer if it is not corrected before puberty. STIs, testicular torsion, and testicular trauma are risk factors for other testicular conditions but not for testicular cancer.
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The nurse is assessing a couple at the infertility clinic because they have not been able to conceive. When performing a focused examination to determine possible causes for infertility, which of the following risk factors should the nurse assess in the male patient?
- A. Hydrocele
- B. Varioceele
- C. Epididymitis
- D. Paraphimosis
Correct Answer: B
Rationale: Persistent varicoceles are commonly associated with infertility. Hydrocele, epididymitis, and paraphimosis are not risk factors for infertility.
The nurse is caring for a patient recently diagnosed with benign prostatic hyperplasia (BPH) who tells the nurse that he does not want to have a transurethtral resection of the prostate (TURP) because he is afraid it might affect his ability to have intercourse. Which of the following actions should the nurse take?
- A. Offer reassurance that sperm production is not affected by TURP.
- B. Discuss alternative methods of sexual expression besides intercourse.
- C. Provide education about the use of medications for erectile dysfunction (ED).
- D. Teach that erectile dysfunction (ED) is unlikely following a TURP.
Correct Answer: D
Rationale: ED is not a concern with TURP, although retrograde ejaculation is likely and the nurse should discuss this with the patient. Erectile function is not usually affected by a TURP, so the patient will not need information about penile implants or reassurance that other forms of sexual expression may be used. Because the patient has not asked about fertility, reassurance about sperm production does not address his concerns.
The nurse is caring for a patient who has benign prostatic hyperplasia (BPH) with mild obstruction and tells the nurse, 'My symptoms have gotten a lot worse this week.' Which of the following responses by the nurse is best?
- A. I will talk to the health care provider about ordering a prostate specific antigen (PSA) test.
- B. Have you been taking any over-the-counter (OTC) medications recently?
- C. Have you talked to the doctor about surgical procedures such as transurethral resection of the prostate (TURP)?
- D. The prostate gland changes slightly in size from day to day, and this may be making your symptoms worse
Correct Answer: B
Rationale: Because the patient's increase in symptoms has occurred abruptly, the nurse should ask about OTC medications (such as decongestants and anticholinergics) that might cause contraction of the smooth muscle in the prostate and worsen obstruction. The prostate gland does not vary in size from day to day. A TURP may be needed, but more assessment about possible reasons for the sudden symptom change is a more appropriate first response by the nurse. PSA testing is done to differentiate BPH from prostatic cancer.
The nurse is teaching a patient who is scheduled for a transurethral resection of the prostate (TURP) about continuous bladder irrigation. Which of the following information should the nurse include?
- A. Bladder irrigation decreases the risk of postoperative bleeding.
- B. Hydration and urine output are maintained by bladder irrigation.
- C. Bladder irrigation prevents obstruction of the catheter after surgery.
- D. Antibiotics are infused on a continuous basis with bladder irrigation.
Correct Answer: C
Rationale: The purpose of bladder irrigation is to remove clots from the bladder and to prevent obstruction of the catheter by clots. The irrigation does not decrease bleeding or improve hydration. Antibiotics are given by the IV route, not through the bladder irrigation.
Which of the following information should the nurse include when teaching a patient to perform testicular self-examination?
- A. Testicular self-examination should be done in a warm area.
- B. The only structure normally felt in the scrotal sac is the testis.
- C. Testicular self-examination should be done at least every week.
- D. Call the health care provider if one testis is larger than the other.
Correct Answer: A
Rationale: The testes will hang lower in the scrotum when the temperature is warm (e.g., during a shower), and it will be easier to palpate. The epididymis is also normally palpable in the scrotum. One testis is normally larger. The patient should perform testicular self-examination monthly.