Men’s Health – Flashcards
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A male client asks the nurse what he can do to decrease the risk of prostate cancer. The nurse explains that: a. Treatment of any enlargement of the prostate gland will help prevent prostate cancer b. Nothing can decrease the risk because prostate cancer is primarily a disease of aging c. Substituting fresh fruits and vegetables for high-fat foods in the diet may lower the risk of prostate cancer d. Using a natural herb, saw palmetto, has been found to be an effective protection against prostate cancer
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C. Substituting fresh fruits and vegetables for high-fat foods in the diet may lower the risk of prostate cancer
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When teaching a client testicular self-examination, the nurse instructs the client to report a finding of: a. An irregular-feeling epididymis b. One testis larger than the other c. The spermatic cord within the testicle d. A firm, nontender nodule on the testis
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D. A firm, nontender nodule on the testis
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The nurse teaches the client having a vasectomy that following the procedure: a. The amount of ejaculate will be noticeably decreased b. He may have difficulty maintaining an erection for several months c. An alternative form of contraception must be used for 6 to 8 weeks d. The testes will gradually
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C. An alternative form of contraception must be used for 6 to 8 weeks
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A client seeking medical intervention for erectile dysfunction should be thoroughly evaluated primarily because: a. Treatment of erectile dysfunction is based upon the cause of the problem b. Psychologic counseling can reverse the problem in 80% to 90% of the cases c. New invasive and experimental techniques currently used have unknown risks d. Most treatments for erectile dysfunction are controllable in clients with systemic diseases
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A. Treatment of erectile dysfunction is based upon the cause of the problem
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A 72 -year-old male client asks the nurse whether it is normal for him to become impotent at his age. The best response by the nurse includes the information that: a. Most decreased sexual function in older adults is due to psychologic stress b. Physiologic changes of aging may require increased stimulation of an erection to occur c. Although the penis decreases in size in older men, there should be no change on sexual function d. Benign changes in the prostate gland that occur with aging can cause a decreased ability to attain an erection
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B. Physiologic changes of aging may require increased stimulation of an erection to occur
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A health care provider at an outpatient clinic is considering prescribing sildenafil (Viagra) for 61-year-old client. The nurse would make it a priority to discuss which item in the client's health history with the prescriber? a. Coronary artery disease (CAD) with nitroglycerine use b. Renal impairment with elevated creatinine level c. Blurred vision of unknown etiology d. Gout managed with allopurinol (Zyloprim)
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A. Coronary artery disease (CAD) with nitroglycerine use
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The client has prostate cancer and is scheduled to have a radical prostatectomy. Which of the following information should the nurse give to the client before surgery? a. He will be sterile after surgery b. He will definitely be impotent after surgery c. Orgasm will be impossible d. He will have an ileoconduit to drain urine
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A. He will be sterile after surgery
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The client has testicular cancer and is scheduled to a unilateral orchiectomy. He tells the nurse that his life is over because he will no longer be able to have children. Which of the following responses by the nurse would be appropriate? a. "You will still have one testicle which will produce sperm." b. "Perhaps you should save some of your sperm in a sperm bank." c. "Fertility will be considerably decreased by this surgery; would you like to discuss other options for parenthood?" d. "Unfortunately, you will be sterile after surgery. Would you like to discuss this with a psychologist?"
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A. "You will still have one testicle which will produce sperm."
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An abnormal finding noted during physical examination of the male reproductive system is: a. Descended testes b. Symmetric scrotum c. Slight clear urethral discharge d. The glans covered prepuce
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C. Slight clear urethral discharge
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Discharge instructions for a client with epididymitis include which of the following: a. Frequent sitz baths b. Avoiding lifting heavy objects for 4 to 6 weeks c. Liberal use of warm packs d. Low-salt diet
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B. Avoiding lifting heavy objects for 4 to 6 weeks
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Cryptorchidism
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undescended testis
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Epididymitis
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acute, painful inflammatory process of the epididymis. Due to infectious process, trauma, or urinary reflux down the ductus. (Normally unilateral). Treatment: antibiotic, bedrest, no intercourse during acute phase, elevate scrotum
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Hydrocele
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Non-tender, fluid-filled mass that results from interference with lymphatic drainage of the scrotum and swelling of the tunica vaginalis that surrounds the testis. No treatment unless swelling becomes large and uncomfortable
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Spermatocele
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Firm, sperm-containing cystic mass. Treatment is surgery
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Torsion
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Twisting of spermatic cord
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Varicocele
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Cluster of dilated veins near the testis
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Phimosis
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constricted foreskin unable to retract over glans
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Priapism
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painful erection lasting longer than 6 hours Cause: Medication, vascular or neurological factors
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Vasectomy
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Bilateral surgical ligation or resection of the ductus deferens performed for the purpose of sterilization
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Prostatitis
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Inflammatory and non-imflammatory conditions affecting the prostate gland
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A nurse is asking the past history of a male patient. Which of the following diseases should the nurse be worried will cause inflammation of the testis? A. Cardiovascular disease B. Skin disease C. Mumps and rubella D. Endocrine disorders
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C. Mumps and rubella
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True or False? When expecting the pubis, the nurse should not be concerned if there is little to no hair present and the male patient states "I do not shave or wax."
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False. No hair = circulatory issues
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Risk for testicular cancer
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If scrotum, and testes are not descended, there is a higher risk for the male to get testicular cancer
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What is DRE and when should this test be done?
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Digital Rectal Exam -Required for all men with symptoms of prostate trouble and for all men 50 years of age and older
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The nurse is taking a health history from a man who is concerned about sexual functioning and maintaining an erection. Which of the patient's medications could be the cause of erectile dysfunction? A. Warfarin (Coumadin) B. Propranolol (Inderal) C. Zafirlukast (Accolate) D. Lansoprazole (Prevacid)
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Answer: B. Propranolol (Inderal) Rationale: Patients taking antihypertensive medications such as amlodipine, lisinopril, propranolol, and clonidine should be closely assessed for erectile dysfunction. The other medications listed do not cause erectile dysfunction.
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Prostate Cancer
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-1 in every 6 men will develop it in their lifetime -Most common cancer among men, excluding skin cancer -Second leading cause of cancer death in men
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Androgen-dependent adenocarcinoma
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Slow growing cancer Can be on any part of the prostate and can spread to bone, lymph system
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Way Prostate Cancer spreads
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#1 Direct extension Involves seminal vesicles, urethral mucosa, bladder wall, and external sphincter
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Way Prostate Cancer spreads
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#2 Through lymph system To the regional lymph nodes
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Way Prostate Cancer spreads
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#3 Through bloodstream To pelvic bones, head of femur, lower lumbar spine, liver, and lungs
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Risk factors for acquiring Prostate Cancer
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Above 50 years of age, having a first-degree relative with prostate cancer increases risk, obesity Diets such as high red meat intake, high-fat dairy products, and low intake of vegetables and fruits
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Screening tools for Prostate Cancer
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Blood test: PSA (prostate-specific antigen) Increase from 0-4 mcg/L [normal level] does not 100% mean cancer exists DRE: abnormal finding such as hardness, nodular, asymmetrical
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What is the diagnostic test that is necessary to confirm the diagnosis of Prostate Cancer? A. PSA levels B. A high Prostatic Acid Phosphatase level C. DRE with abnormal findings D. Biopsy of prostate tissue
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D. Biopsy of Prostate Tissue
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Why would a male take Finasteride (Proscar)?
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To help treat BPH and reduce the chance of getting cancer (by 25%)
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What tool is used to classify the extent of any cancer?
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TNM (Tumor, node, and metastasis). Grades on a scale of 1-5. 1= lowest grade, most like the original cells. 5= highest grade, unlike original cells
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Hypospadias
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Urethral meatus is on ventral surface of penis. Requires surgery
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The nurse is caring for a 62-year-old man after a transurethral resection of the prostate (TURP). Which instructions should the nurse include in the teaching plan? A. Avoid straining during defecation. B. Restrict fluids to prevent incontinence. C. Sexual functioning will not be affected. D. Prostate exams are not needed after surgery.
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A. Avoid straining during defecation.
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The nurse coordinates postoperative care for a 70-year-old man with osteoarthritis after prostate surgery. Which task is appropriate for the nurse to delegate to a licensed practical/vocational nurse (LPN/LVN)? A. Teach the patient how to perform Kegel exercises. B. Provide instructions to the patient on catheter care. C. Administer oxybutynin (Ditropan) for bladder spasms. D. Manually irrigate the urinary catheter to determine patency.
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D. Manually irrigate the urinary catheter to determine patency
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The nurse teaches a 30-year-old man with a family history of prostate cancer about dietary factors associated with prostate cancer. The nurse determines that teaching is successful if the patient selects which menu? A. Grilled steak, French fries, and vanilla shake B. Hamburger with cheese, pudding, and coffee C. Baked chicken, peas, apple slices, and skim milk D. Grilled cheese sandwich, onion rings, and hot tea
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C. Baked chicken, peas, apple slices, and skim milk
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The nurse is teaching clinic patients about risk factors for testicular cancer. Which individual is at highest risk for developing testicular cancer? A. A 30-year-old white male with a history of cryptorchidism Correct B. A 48-year-old African American male with erectile dysfunction C. A 19-year-old Asian male who had surgery for testicular torsion D. A 28-year-old Hispanic male with infertility caused by a varicocele
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A 30-year-old white male with a history of cryptorchidism
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A 45-year-old man reports having recent problems attaining an erection. Which medication will the nurse further explore as the possible etiology of this patient's sexual dysfunction? A. Furosemide (Lasix) B. Fluoxetine (Prozac) C. Clopidogrel (Plavix) D. Nitroglycerin (Nitrostat)
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B. Fluoxetine (Prozac)
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A 73-year-old male patient admitted for total knee replacement states during the health history interview that he has no problems with urinary elimination except that the "stream is less than it used to be." The nurse should give the patient anticipatory guidance that what condition may be developing? A. A tumor of the prostate B. Benign prostatic hyperplasia C. Bladder atony because of age D. Age-related altered innervation of the bladder
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B. Benign prostatic hyperplasia
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To accurately monitor progression of a symptom of decreased urinary stream, the nurse should encourage the patient to have which primary screening measure done on a regular basis? A. Uroflowmetry B. Transrectal ultrasound C. Digital rectal examination (DRE) D. Prostate-specific antigen (PSA) monitoring
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C. Digital rectal examination (DRE)
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A patient is one day postoperative following a transurethral resection of the prostate (TURP). Which event is not an expected normal finding in the care of this patient? A. The patient requires two tablets of Tylenol #3 during the night. B. The patient complains of fatigue and claims to have minimal appetite. C. The patient has continuous bladder irrigation (CBI) infusing, but output has decreased. D. The patient has expressed anxiety about his planned discharge home the following day.
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C. The patient has continuous bladder irrigation (CBI) infusing, but output has decreased.
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A 71-year-old patient with a diagnosis of benign prostatic hyperplasia (BPH) has been scheduled for a contact laser technique. What is the primary goal of this intervention? A. Resumption of normal urinary drainage B. Maintenance of normal sexual functioning C. Prevention of acute or chronic renal failure D. Prevention of fluid and electrolyte imbalances
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A. Resumption of normal urinary drainage
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Which task can the nurse delegate to an unlicensed assistive personnel (UAP) in the care of a patient who has recently undergone prostatectomy? A. Assessing the patient's incision B. Irrigating the patient's Foley catheter C. Assessing the patient's pain and selecting analgesia D. Performing cleansing of the meatus and perineal region
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D. Performing cleansing of the meatus and perineal region
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The patient has a low-grade carcinoma on the left lateral aspect of the prostate gland and has been on "watchful waiting" status for 5 years. Six months ago his last prostate-specific antigen (PSA) level was 5 ng/mL. Which manifestations now indicate that the prostate cancer may be growing and he needs a change in his care (select all that apply)? A. Casts in his urine B. Presence of α-fetoprotein C. Serum PSA level 10 ng/mL D. Onset of erectile dysfunction E. Nodularity of the prostate gland
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C. Serum PSA level 10 ng/mL E. Nodularity of the prostate gland Correct
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A 33-year-old patient noticed a painless lump in his scrotum on self-examination of his testicles and a feeling of heaviness. The nurse should first teach him about what diagnostic test? A. Ultrasound B. Cremasteric reflex C. Doppler ultrasound D. Transillumination with a flashlight
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A. Ultrasound
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A male patient complains of fever, dysuria, and cloudy urine. What additional information may indicate that these manifestations may be something other than a urinary tract infection (UTI)? A. E. coli bacteria in his urine B. A very tender prostate gland C. Complaints of chills and rectal pain D. Complaints of urgency and frequency
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B. A very tender prostate gland
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After a vasectomy, what teaching should be included in the discharge teaching? A. "You will want to use an alternative form of contraception for 6 weeks." B. "You may lose some secondary sexual characteristics after this surgery." C. "You may have erectile dysfunction for several months after this surgery." D. "You will be uncomfortable, but you may safely have sexual intercourse today."
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A. "You will want to use an alternative form of contraception for 6 weeks."
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The patient has had cardiovascular disease for some time and has now developed erectile dysfunction. He is frustrated because he cannot take erectogenic medications because he takes nitrates for his cardiac disease. What should the nurse do first to help this patient? A. Give the patient choices for penile implant surgery. B. Recommend counseling for the patient and his partner. C. Obtain a thorough sexual, health, and psychosocial history. D. Assess levels of testosterone, prolactin, LH, and thyroid hormones.
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C. Obtain a thorough sexual, health, and psychosocial history.
