Nokea
The nurse is teaching a client with benign prostatic hyperplasia (BPH). What statement indicates a lack of understanding by the client?
- A. There should be no problem with a glass of wine with dinner each night.
- B. I am so glad that I weaned myself off of coffee about a year ago.
- C. I need to inform my allergist that I cannot take my normal decongestant.
- D. My normal routine of drinking a quart of water during exercise needs to change.
Correct Answer: A
Rationale: This client did not associate wine with the avoidance of alcohol, and requires additional teaching. The nurse must teach a client with BPH to avoid alcohol, caffeine, and large quantities of fluid in a short amount of time to prevent overdistention of the bladder. Decongestants also need to be avoided to lower the chance for urinary retention.
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A client is diagnosed with metastatic prostate cancer. The client asks the nurse the purpose of his treatment with the luteinizing hormones releasing hormone (LH-RH) agonist leproptide (Lupron) and the bisphosphonate pamidinate (Aoxide). Which statement by the nurse is most appropriate?
- A. The treatment reduces testosterone and prevents bone fractures.
- B. The medications prevent erectile dysfunction and increase libido.
- C. There is less gynecomastia and osteoporosis with this drug regimen.
- D. These medications both inhibit tumor progression by blocking androgens.
Correct Answer: A
Rationale: Lupron, an LH-RH agonist, stimulates the pituitary gland to release luteinizing hormone (LH) to the point that the gland is depleted of LH and testosterone production is lessened. This may decrease the prostate cancer since it is hormone dependent. Lupron can cause osteoporosis, which results in the need of Aoxide to prevent this. Erectile dysfunction, decreased libido, and gynecomastia are side effects of the LH-RH medications. Antiandrogen drugs inhibit tumor progression by blocking androgens at the site of the prostate.
A client is diagnosed with benign prostatic hyperplasia and seems sad and irritable. After assessing the clients behavior, which statement by the nurse would be the most appropriate?
- A. The urine incontinence should not prevent you from socializing.
- B. You seem depressed and should seek more pleasant thing to do.
- C. It is common for men at your age to have changes in mood.
- D. Nocturia could cause interruption of your sleep and cause changes in mood.
Correct Answer: D
Rationale: Frequent visits to the bathroom during the night could cause sleep interruptions and affect the clients mood and mental status. Incontinence could cause the client to feel embarrassment and cause him to limit his activities outside the home. The social isolation could lead to clinical depression and should be treated professionally. The nurse should not give advice before exploring the clients response to his change in behavior. The statement about age has no validity.
A 34-year-old client comes to the clinic with concerns about an enlarged left testicle and heaviness in his lower abdomen. Which diagnostic test would the nurse expect to be ordered to confirm testicular cancer?
- A. Alpha-fetoprotein (AFP)
- B. Prostate-specific antigen (PSA)
- C. Prostate acid phosphatase (PAP)
- D. C-reactive protein (CRP)
Correct Answer: A
Rationale: AFP is a glycoprotein that is elevated in testicular cancer. PSA and PAP testing is used in the screening of prostate cancer. CRP is diagnostic for inflammatory conditions.
Post transurethral resection of the prostate, a client has a three-way catheter with a continuous bladder irrigation. Over the last 12 hours, there has been 1400 ml of irrigation solution infused and 2000 ml measured in output from the drainage bag. What is the recording of the urinary output for the 12-hour period? (Record your answer using a whole number) ml.
Correct Answer: 600 ml
Rationale: 2000 ml from the drainage bag (including both the irrigation fluid and urine) minus the 1400 ml of irrigation fluid equals 600 ml of urine: 2000 ml - 1400 ml = 600 ml.
A 25-year-old client has recently been diagnosed with testicular cancer and is scheduled for radiation therapy. Which intervention by the nurse is best?
- A. Ask the client about his support system of friends and relatives.
- B. Encourage the client to verbalize his fears about sexual performance.
- C. Explore with the client the possibility of sperm collection.
- D. Provide privacy to allow time for reflection about the treatment.
Correct Answer: C
Rationale: Sperm collection is a viable option for a client diagnosed with testicular cancer and should be completed before radiation therapy, chemotherapy, or radical lymph node dissection. The other options would promote psychosocial support but are not the priority intervention.