Nokea
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.
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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 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.
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.
The clinic nurse is reviewing patient laboratory results on the following four patients. Which of the following patients is priority to report to the health care provider?
- A. A 75-year-old who uses saw palmetto to treat benign prostatic hyperplasia (BPH) and has an elevated PSA test
- B. A 38-year-old who is being treated for acute prostatitis with an elevated PSA.
- C. A 48-year-old whose father died of metastatic prostate cancer and has a positive PCA3 test
- D. A 52-year-old who goes on long bicycle rides every weekend and has a positive PCA3 test
Correct Answer: C
Rationale: The family history (first degree relative) and elevation of PCA3 in the 48-year-old indicate that further evaluation of the patient for prostate cancer is most needed for this patient. The 52-year-old who goes on long bicycle rides every weekend and has a positive PCA3 test would be next priority. The elevations for the other patients are not unusual.
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.