Nokea
The nurse is teaching a client about the management of benign prostatic hyperplasia (BPH). Which instruction(s) should be included in the teaching? Select all that apply.
- A. Moderate use of alcohol is useful for bladder relaxation.
- B. Do not delay the urge to void.
- C. Low-dose Benadryl will promote restful sleep.
- D. Prolonged exposure to heat increases bladder spasms.
- E. Painless hematuria is a common symptom of BPH.
- F. Schedule digital rectal exams.
Correct Answer: B,F
Rationale: The client should be instructed to void promptly when the urge to empty the bladder is signaled by the stretch receptors in the bladder. Voiding promptly will decrease the risk for urinary retention. Digital rectal exams should be monitored to detect further enlargement of the gland and/or presence of prostatic nodules. Alcohol and antihistamines (e.g., Benadryl) should be avoided in the management of BPH. Exposure to heat and painless hematuria are not significant in the management of BPH. Alcohol and antihistamines interact with many BPH drugs.
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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.
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.
The nurse is caring for a client with erectile dysfunction. Because the client has coronary artery disease (CAD), the nurse anticipates the provider will prescribe which medication for ED?
- A. Sidenafil (Viagra)
- B. Tadlafil (Cialis)
- C. Apomorphine (Uprima)
- D. Vardenafil (Levitra)
Correct Answer: C
Rationale: Apomorphine (Uprima), a dopamine agonist, is a possible alternative to phosphodiesterase (PDE5) inhibitors, such as sidenafil (Viagra), tadlafil (Cialis), and vardenafil (Levitra) for the treatment of ED. Uprima is safer for men with CAD and does not cause mass vasodilation of the blood vessels such as the PDE5 inhibitors.
A client comes to the outpatient clinic for information on a vasectomy. Which instruction should be included by the nurse?
- A. Vasectomies should be considered a permanent means of birth control.
- B. Following surgery, sexual intercourse should be avoided for 3 months.
- C. Postoperative discomfort can be relieved with use of warm bath.
- D. Vasectomy can result in permanent impotence.
Correct Answer: A
Rationale: Although attempts to reverse a vasectomy have proven successful, a vasectomy should be considered a permanent means of birth control. Scar formation and/or sperm leakage can interfere with restoration of reproductive effectiveness. Sexual intercourse can be resumed when it is comfortable to do so, usually in about 1 week. Postoperative discomfort should be controlled with application of cold to reduce swelling or use of mild analgesics. On occasion, clients have complained of impotence, but vasectomies have no effect on erection or ejaculation.
Following morning hygiene of an older adult client, the nurse is unable to replace the retracted foreskin of the penis. Which is the most likely outcome?
- A. Erection of the penis
- B. Unclean gls
- C. Painful swelling
- D. Nuseea and vomiting
Correct Answer: C
Rationale: Paraphimosis results in strangulation of the glans penis from inability to replace the retracted foreskin. The strangulation results in painful swelling of the glans. Erection of the penis in the presence of phimosis can cause pain but is not a result of retracted foreskin. Nausea and vomiting are not indicated with retraction of foreskin.