1. To determine the severity of the symptoms for a 68-year-old patient with benign prostatic
hyperplasia (BPH) the nurse will ask the patient about
a.
... [Show More] blood in the urine
b. lower back or hip pain
c. erectile dysfunction (ED)
d. force of the urinary stream
i. The American Urological Association (AUA) Symptom Index for a patient with BPH
asks questions about the force and frequency of urination, nocturia, etc. Blood in
the urine, ED, and back or hip pain are not typical symptoms of BPH.
2. A 58-year-old patient who has been recently diagnosed with benign prostatic hyperplasia (BPH)
tells the nurse that he does not want to have a transurethral resection of the prostate (TURP)
because it might affect his ability to maintain an erection during intercourse. Which action should
the nurse take?
a. Provide teaching about medications for erectile dysfunction (ED).
b. Discuss that TURP does not commonly affect erectile function.
i. 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.
c. Offer reassurance that sperm production is not affected by TURP.
d. Discuss alternative methods of sexual expression besides intercourse.
3. The health care provider prescribes finasteride (Proscar) for a 67-year-old patient who has benign
prostatic hyperplasia (BPH). When teaching the patient about the drug, the nurse informs him that
a. he should change position from lying to standing slowly to avoid dizziness.
b. his interest in sexual activity may decrease while he is taking the medication.
i. A decrease in libido is a side effect of finasteride because of the androgen
suppression that occurs with the drug. Although orthostatic hypotension may occur
if the patient is also taking a medication for erectile dysfunction (ED), it should not
occur with finasteride alone. Improvement in symptoms of obstruction takes about
6 months. The medication does not cause hypertension.
c. improvement in the obstructive symptoms should occur within about 2 weeks.
d. he will need to monitor his blood pressure frequently to assess for hypertension.
4. The nurse will anticipate that a 61-year-old patient who has an enlarged prostate detected by
digital rectal examination (DRE) and an elevated prostate specific antigen (PSA) level will need
teaching about
a. cystourethroscopy
b. uroflowmetry studies
c. magnetic resonance imaging (MRI)
d. transrectal ultrasonography (TRUS)
i. In a patient with an abnormal DRE and elevated PSA, transrectal ultrasound is used
to visualize the prostate for biopsy. Uroflowmetry studies help determine the
extent of urine blockage and treatment, but there is no indication that this is a
problem for this patient. Cystoscopy may be used before prostatectomy but will
not be done until after the TRUS and biopsy. MRI is used to determine whether
prostatic cancer has metastasized but would not be ordered at this stage of the
diagnostic process.
5. Which information about continuous bladder irrigation will the nurse teach to a patient who is
being admitted for a transurethral resection of the prostate (TURP)?
a. Bladder irrigation decreases the risk of postoperative bleeding.
b. Hydration and urine output are maintained by bladder irrigation.
c. Antibiotics are infused continuously through the bladder irrigation.
d. Bladder irrigation prevents obstruction of the catheter after surgery [Show Less]