MEDICAL SURGICAL NURSING 10TH EDITION LEWIS TEST BANK
Chapter 54: Male Reproductive and Genital Problems
Lewis: Medical-Surgical Nursing, 10th Edition
MULTIPLE CHOICE
1. To determine the severity of the symptoms for a patient with benign prostatic hyperplasia
(BPH), the nurse will ask the patient about
a. blood in the urine.
c. force of urinary stream.
b. lower back or hip pain.
d. erectile dysfunction (ED).
ANS: C
The American Urological Association Symptom Index for a patient with BPH asks questions
about the force and frequency of urination, nocturia, and so on. Blood in the urine, ED, and
back or hip pain are not typical symptoms of BPH.
DIF: Cognitive Level: Apply (application)
REF:
1268
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity
2. A 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 have sexual intercourse. Which action should the nurse take?
a. Discuss alternative methods of sexual expression.
b. Teach about medication for erectile dysfunction (ED).
c. Clarify that TURP does not commonly affect erection.
d. Offer reassurance that fertility is not affected by TURP.
ANS: C
NURSINGTB.COM
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.
DIF: Cognitive Level: Apply (application)
REF:
1272
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity
3. The health care provider prescribes finasteride (Proscar) for a 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.
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.
ANS: B
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, it should not occur with finasteride alone. Improvement
in symptoms of obstruction takes about 6 months. The medication does not cause
hypertension.
NURSINGTB.COM
MEDICAL SURGICAL NURSING 10TH EDITION LEWIS TEST BANK
DIF: Cognitive Level: Apply (application)
REF:
1271
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity
4. The nurse will anticipate that a 61-yr-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).
ANS: D
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.
DIF: Cognitive Level: Apply (application)
REF:
1270
TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity
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.
NURSINGTB.COM
d. Bladder irrigation prevents obstruction of the catheter after surgery.
ANS: D
The purpose of bladder irrigation is to remove clots from the bladder and prevent obstruction
of the catheter by clots. The irrigation does not decrease bleeding or improve hydration.
Antibiotics are given by the IV route, not through the bladder irrigation.
DIF: Cognitive Level: Understand (comprehension)
REF: 1274
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity
6. The nurse will plan to teach the patient scheduled for photovaporization of the prostate (PVP)
a. that urine will appear bloody for several days.
b. how to care for an indwelling urinary catheter.
c. that symptom improvement takes 2 to 3 weeks.
d. about complications associated with urethral stenting.
ANS: B
The patient will have an indwelling catheter for 24 to 48 hours and will need teaching about
catheter care. There is minimal bleeding with this procedure. Symptom improvement is
almost immediate after PVP. Stent placement is not included in the procedure.
DIF: Cognitive Level: Apply (application)
REF:
1272
TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity
NURSINGTB.COM
MEDICAL SURGICAL NURSING 10TH EDITION LEWIS TEST BANK
7. A 53-yr-old patient is scheduled for an annual physical examination. The nurse will plan to
teach the patient about the purpose of
a. urinalysis collection.
b. uroflowmetry studies.
c. prostate specific antigen (PSA) testing.
d. transrectal ultrasound scanning (TRUS).
ANS: C
An annual digital rectal exam (DRE) and PSA are usually recommended starting at age 50
years 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 results are abnormal.
DIF: Cognitive Level: Apply (application)
REF:
1273
TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity
8. The plan of care for a patient immediately after a perineal radical prostatectomy will include
decreasing the risk for infection related to
a. urinary incontinence.
c. fecal wound contamination.
b. prolonged urinary stasis.
d. suprapubic catheter placement.
ANS: C
The perineal approach increases the risk for infection because the incision is located close to
the anus, and contamination with feces is possible. Urinary stasis and incontinence do not
occur because the patient has a retention catheter in place for 1 to 2 weeks. A urethral catheter
is used after the surgery.
NURSINGTB.COM
DIF: Cognitive Level: Apply (application)
REF:
1278
TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity
9. The nurse will plan to teach the patient who is incontinent of urine following a radical
retropubic prostatectomy to
a. restrict oral fluid intake.
b. do pelvic muscle exercises.
c. perform intermittent self-catheterization.
d. use belladonna and opium suppositories.
ANS: B
Pelvic floor muscle training (Kegel) exercises are recommended to strengthen the pelvic floor
muscles and improve urinary control. Belladonna and opium suppositories are used to reduce
bladder spasms after surgery. Intermittent self-catheterization may be taught before surgery if
the patient has urinary retention, but it will not be useful in reducing incontinence after
surgery. The patient should have a daily oral intake of 2 to 3 L.
DIF: Cognitive Level: Apply (application)
REF:
1278
TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity
10. A 70-yr-old patient who has had a transurethral resection of the prostate (TURP) for benign
prostatic hyperplasia (BPH) is being discharged from the hospital today. Which patient
statement indicates a need for the nurse to provide additional instruction?
a. “I should call the doctor if I have incontinence at home.”
b. “I will avoid driving until I get approval from my doctor.”
NURSINGTB.COM
MEDICAL SURGICAL NURSING 10TH EDITION LEWIS TEST BANK
c. “I should schedule yearly appointments for prostate examinations.”
d. “I will increase fiber and fluids in my diet to prevent constipation.”
ANS: A
Because incontinence is common for several weeks after a TURP, the patient does not need to
call the health care provider if this occurs. The other patient statements indicate that the
patient has a good understanding of post-TURP instructions.
DIF: Cognitive Level: Apply (application)
REF:
1274
TOP: Nursing Process: Evaluation
MSC: NCLEX: Physiological Integrity
11. The nurse will inform a patient with cancer of the prostate that side effects of leuprolide
(Lupron) may include
a. flushing.
b. dizziness.
c. infection.
d. incontinence.
ANS: A
Hot flashes may occur with decreased testosterone production. Dizziness may occur with the
-blockers used for benign prostatic hyperplasia. Urinary incontinence may occur after
prostate surgery, but it is not an expected side effect of medication. Risk for infection is
increased in patients receiving chemotherapy.
DIF: Cognitive Level: Understand (comprehension)
REF: 1280
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity
12. Which information will the nurse teach a patient who has chronic prostatitis?
a. Ibuprofen (Motrin) should provide good pain control.
b. Prescribed antibiotics should be
taken for 7 to 10 days.
NURSINGTB.COM
c. Intercourse or masturbation will help relieve symptoms.
d. Cold packs used every 4 hours will decrease inflammation.
ANS: C
Ejaculation helps drain the prostate and relieve pain. Warm baths are recommended to reduce
pain. Nonsteroidal antiinflammatory drugs (NSAIDs) are frequently prescribed but usually do
not offer adequate pain relief. Antibiotics for chronic prostatitis are taken for 4 to 12 weeks.
DIF: Cognitive Level: Apply (application)
REF:
1283
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity
13. The nurse performing a focused examination to determine possible causes of infertility will
assess for
a. hydrocele.
b. varicocele.
c. epididymitis.
d. paraphimosis.
ANS: B
Persistent varicoceles are commonly associated with infertility. Hydrocele, epididymitis, and
paraphimosis are not risk factors for infertility.
DIF: Cognitive Level: Understand (comprehension)
REF: 1285
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity
NURSINGTB.COM
MEDICAL SURGICAL NURSING 10TH EDITION LEWIS TEST BANK
14. Which information will the nurse plan to include when teaching a young adult who has a
family history of testicular cancer about testicular self-examination?
a. Testicular self-examination should be done at least weekly.
b. Testicular self-examination should be done in a warm room.
c. The only structure normally felt in the scrotal sac is the testis.
d. Call the health care provider if one testis is larger than the other.
ANS: B
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. Men at high risk should perform testicular
self-examination monthly.
DIF: Cognitive Level: Understand (comprehension)
REF: 1286
TOP: Nursing Process: Planning
MSC: NCLEX: Health Promotion and Maintenance
15. A 27-yr-old patient who has testicular cancer is being admitted for a unilateral orchiectomy.
The patient does not talk to his wife and speaks to the nurse only to answer the admission
questions. Which action is appropriate for the nurse to take?
a. Teach the patient and the wife that impotence is unlikely after unilateral
orchiectomy.
b. Ask the patient if he has any questions or concerns about the diagnosis and
treatment.
c. Inform the patient’s wife that concerns about sexual function are common with this
diagnosis.
d. Document the patient’s lack of communication on the health record and continue
preoperative care.
NURSINGTB.COM
ANS: B
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 teaching about complications after orchiectomy.
Documentation of the patient’s lack of interaction is not an adequate nursing action in this
situation.
DIF: Cognitive Level: Apply (application)
REF:
1280
TOP: Nursing Process: Implementation
MSC: NCLEX: Psychosocial Integrity
16. When performing discharge teaching for a patient after a vasectomy, the nurse instructs the
patient that he
a. should continue to use other methods of birth control for 6 weeks.
b. should not have sexual intercourse until his 6-week follow-up visit.
c. may have temporary erectile dysfunction (ED) because of swelling.
d. will notice a decrease in the appearance and volume of his ejaculate.
ANS: A
NURSINGTB.COM
MEDICAL SURGICAL NURSING 10TH EDITION LEWIS TEST BANK
Because it takes about 6 weeks to evacuate sperm that are distal to the vasectomy site, the
patient should use contraception for 6 weeks. ED that occurs after vasectomy is psychologic
in origin and not related to postoperative swelling. The patient does not need to abstain from
intercourse. The appearance and volume of the ejaculate are not changed because sperm are a
minor component of the ejaculate.
DIF: Cognitive Level: Understand (comprehension)
REF: 1286
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity
17. A patient tells the nurse that he decided to seek treatment for erectile dysfunction (ED)
because his wife “is losing patience with the situation.” The nurse’s follow-up questions
should focus on the man’s identified concern with
a. low self-esteem.
c. increased anxiety.
b. role performance.
d. infrequent intercourse.
ANS: B
The patient’s statement indicates that the relationship with his wife is his primary concern.
Although anxiety, low self-esteem, and ineffective sexuality patterns may also be concerns,
the patient information suggests that addressing the role performance problem will lead to the
best outcome for this patient.
DIF: Cognitive Level: Apply (application)
REF:
1288
TOP: Nursing Process: Intervention
MSC: NCLEX: Psychosocial Integrity
18. A patient with urinary obstruction from benign prostatic hyperplasia (BPH) tells the nurse,
“My symptoms are much worse this week.” Which response by the nurse is appropriate?
a. “Have you taken any over-the-counter (OTC) medications recently?”
b. “I will talk to the doctor aboutNURSINGTB.COM
a prostate specific antigen (PSA) test.”
c. “Have you talked to the doctor about surgery such as transurethral resection of the
prostate (TURP)?”
d. “The prostate gland changes in size from day to day, and this may be making your
symptoms worse.”
ANS: A
Because the patient’s increase in symptoms has occurred abruptly, the nurse should ask about
OTC medications that might cause contraction of the smooth muscle in the prostate and
worsen obstruction. The prostate gland does not vary in size from day to day. A TURP may be
needed, but more assessment about possible reasons for the sudden symptom change is a more
appropriate first response by the nurse. PSA testing is done to differentiate BPH from
prostatic cancer.
DIF: Cognitive Level: Apply (application)
REF:
1273
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity
19. The nurse taking a focused health history for a patient with possible testicular cancer will ask
the patient about a history of
a. testicular torsion.
b. testicular trauma.
c. undescended testicles.
d. sexually transmitted infection (STI).
ANS: C
NURSINGTB.COM
MEDICAL SURGICAL NURSING 10TH EDITION LEWIS TEST BANK
Cryptorchidism is a risk factor for testicular cancer if it is not corrected before puberty. STI,
testicular torsion, and testicular trauma are risk factors for other testicular conditions but not
for testicular cancer.
DIF: Cognitive Level: Understand (comprehension)
REF: 1284
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity
20. The nurse will plan to teach a 67-yr-old patient who has been diagnosed with orchitis about
a. pain management.
b. emergency surgery.
c. application of heat to the scrotum.
d. aspiration of fluid from the scrotal sac.
ANS: A
Orchitis is very painful, and effective pain management will be needed. Heat, aspiration, and
surgery are not used to treat orchitis.
DIF: Cognitive Level: Apply (application)
REF:
1284
TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity
21. A patient who has benign prostatic hyperplasia (BPH) with urinary retention is admitted to the
hospital with elevated blood urea nitrogen (BUN) and creatinine. Which prescribed therapy
should the nurse implement first?
a. Infuse normal saline at 50 mL/hr.
b. Insert a urinary retention catheter.
c. Draw blood for a complete blood count.
d. Schedule pelvic magnetic resonance imaging
NURSINGTB.COM
ANS: B
The patient data indicate that the patient may have acute kidney injury caused by the BPH.
The initial therapy will be to insert a catheter. The other actions are also appropriate, but they
can be implemented after the acute urinary retention is resolved.
DIF: Cognitive Level: Analyze (analysis)
REF: 1269
OBJ: Special Questions: Prioritization
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity
22. The nurse in the clinic notes elevated prostate specific antigen (PSA) levels in the laboratory
results of these patients. Which patient’s PSA result is not expected to be elevated?
a. A 38-yr-old patient who is being treated for acute prostatitis
b. A 48-yr-old patient whose father died of metastatic prostate cancer
c. A 52-yr-old patient who goes on long bicycle rides every weekend
d. A 75-yr-old patient who uses saw palmetto to treat benign prostatic hyperplasia
(BPH)
ANS: B
The family history of prostate cancer and elevation of PSA indicate that further evaluation of
the patient for prostate cancer is needed. Elevations in PSA for the other patients are not
unusual.
DIF: Cognitive Level: Apply (application)
OBJ: Special Questions: Multiple Patients
REF:
NURSINGTB.COM
1281
MEDICAL SURGICAL NURSING 10TH EDITION LEWIS TEST BANK
TOP: Nursing Process: Assessment
MSC: NCLEX: Health Promotion and Maintenance
23. After a transurethral resection of the prostate (TURP), a 64-yr-old patient with continuous
bladder irrigation complains of painful bladder spasms. The nurse observes clots in the urine.
Which action should the nurse take first?
a. Increase the flow rate of the bladder irrigation.
b. Administer the prescribed IV morphine sulfate.
c. Give the patient the prescribed belladonna and opium suppository.
d. Manually instill and then withdraw 50 mL of saline into the catheter.
ANS: D
The assessment suggests that obstruction by a clot is causing the bladder spasms, and the
nurse’s first action should be to irrigate the catheter manually and to try to remove the clots.
IV morphine will not decrease the spasm, although pain may be reduced. Increasing the flow
rate of the irrigation will further distend the bladder and may increase spasms. The belladonna
and opium suppository will decrease bladder spasms but will not remove the obstructing
blood clot.
DIF: Cognitive Level: Analysis (analyze)
REF: 1272
OBJ: Special Questions: Prioritization
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity
24. A 22-yr-old patient tells the nurse at the health clinic that he has recently had some problems
with erectile dysfunction. Which question should the nurse ask to assess for possible etiologic
factors in this age group?
a. “Do you use recreational drugs or drink alcohol?”
b. “Do you experience an unusual amount of stress?”
NURSINGTB.COM
c. “Do you have cardiovascular or peripheral vascular disease?”
d. “Do you have a history of an erection that lasted for 6 hours or more?”
ANS: A
A common etiologic factor for erectile dysfunction (ED) in younger men is use of recreational
drugs or alcohol. Stress, priapism, and cardiovascular illness also contribute to ED, but they
are not common etiologic factors in younger men.
DIF: Cognitive Level: Apply (application)
REF:
1287
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity
25. A 58-yr-old patient with erectile dysfunction (ED) tells the nurse he is interested in using
sildenafil (Viagra). Which action should the nurse take first?
a. Assure the patient that ED is common with aging.
b. Ask the patient about any prescription drugs he is taking.
c. Tell the patient that Viagra does not always work for ED.
d. Discuss the common adverse effects of erectogenic drugs.
ANS: B
Because some medications can cause ED and patients using nitrates should not take sildenafil,
the nurse should first assess for prescription drug use. The nurse may want to teach the patient
about realistic expectations and adverse effects of sildenafil therapy, but this should not be the
first action. Although ED does increase with aging, it may be secondary to medication use or
cardiovascular disease.
NURSINGTB.COM
MEDICAL SURGICAL NURSING 10TH EDITION LEWIS TEST BANK
DIF: Cognitive Level: Analysis (analyze)
REF: 1288
OBJ: Special Questions: Prioritization
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity
26. The nurse in a health clinic receives requests for appointments from several patients. Which
patient should be seen by the health care provider first?
a. A 48-yr-old patient who has perineal pain and a temperature of 100.4° F
b. A 58-yr-old patient who has a painful erection that has lasted more than 6 hours
c. A 38-yr-old patient who reports that he had difficulty maintaining an erection
twice last week
d. A 68-yr-old patient who has pink urine after a transurethral resection of the
prostate (TURP) 3 days ago
ANS: B
Priapism can cause complications such as necrosis or hydronephrosis, and this patient should
be treated immediately. The other patients do not require immediate action to prevent serious
complications.
DIF: Cognitive Level: Analyze (analysis)
REF: 1283
OBJ: Special Questions: Multiple Patients | Special Questions: Prioritization
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity
27. Which assessment information collected by the nurse may present a contraindication to a
testosterone replacement therapy (TRT)?
a. The patient has noticed a decrease in energy level for a few years.
b. The patient’s symptoms have increased steadily over the past few years.
c. The patient has been using sildenafil (Viagra) several times every week.
d. The patient has had a gradual NURSINGTB.COM
decrease in the force of his urinary stream.
ANS: D
The decrease in urinary stream may indicate benign prostatic hyperplasia (BPH) or prostate
cancer, which are contraindications to the use of testosterone replacement therapy (TRT). The
other patient data indicate that TRT may be a helpful therapy for the patient.
DIF: Cognitive Level: Apply (application)
REF:
1269
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity
28. A patient who has been diagnosed with stage 2 prostate cancer chooses the option of active
surveillance. The nurse will plan to
a. vaccinate the patient with sipuleucel-T (Provenge).
b. provide the patient with information about cryotherapy.
c. teach the patient about placement of intraurethral stents.
d. schedule the patient for annual prostate-specific antigen testing.
ANS: D
Patients who opt for active surveillance need to have annual digital rectal examinations and
prostate-specific antigen testing. Vaccination with sipuleucel-T, cryotherapy, and stent
placement are options for patients who choose to have active treatment for prostate cancer.
DIF: Cognitive Level: Understand (comprehension)
REF: 1269
TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity
NURSINGTB.COM
MEDICAL SURGICAL NURSING 10TH EDITION LEWIS TEST BANK
29. The health care provider prescribes the following interventions for a patient with acute
prostatitis caused by Escherichia coli. Which intervention should the nurse question?
a. Give trimethoprim/sulfamethoxazole 1 tablet daily for 28 days.
b. Administer ibuprofen 400 mg every 8 hours as needed for pain.
c. Instruct patient to avoid sexual intercourse until treatment is complete.
d. Catheterize the patient as needed if symptoms of urinary retention develop.
ANS: D
Although acute urinary retention may occur, insertion of a catheter through an inflamed
urethra is contraindicated, and the nurse will anticipate that the health care provider will need
to insert a suprapubic catheter. The other actions are appropriate.
DIF: Cognitive Level: Apply (application)
REF:
1282
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity
30. Several patients call the urology clinic requesting appointments with the health care provider
as soon as possible. Which patient will the nurse schedule to be seen first?
a. A 22-yr-old patient who has noticed a firm, nontender lump on his scrotum
b. A 35-yr-old patient who is concerned that his scrotum “feels like a bag of worms”
c. A 40-yr-old patient who has pelvic pain while being treated for chronic prostatitis
d. A 70-yr-old patient who is reporting frequent urinary dribbling after a
prostatectomy
ANS: A
The patient’s age and symptoms suggest possible testicular cancer. Some forms of testicular
cancer can be very aggressive, so the patient should be evaluated by the health care provider
as soon as possible. Varicoceles do require treatment but not emergently. Ongoing pelvic pain
NURSINGTB.COM
is common with chronic prostatitis.
Urinary dribbling is a common problem after
prostatectomy.
DIF: Cognitive Level: Analyze (analysis)
REF: 1285
OBJ: Special Questions: Multiple Patients | Special Questions: Prioritization
TOP: Nursing Process: Planning
MSC: NCLEX: Safe and Effective Care Environment
31. The nurse is obtaining the pertinent health history for a man who is being evaluated for
infertility. Which question focuses on a possible cause of infertility?
a. “Are you circumcised?”
b. “Have you had surgery for phimosis?”
c. “Do you use medications to improve muscle mass?”
d. “Is there a history of prostate cancer in your family?”
ANS: C
Testosterone or testosterone-like medications may adversely affect sperm count. The other
information will be obtained in the health history but does not affect the patient’s fertility.
DIF: Cognitive Level: Apply (application)
REF:
1289
TOP: Nursing Process: Assessment
MSC: NCLEX: Health Promotion and Maintenance
32. The following male patients recently arrived in the emergency department. Which one should
the nurse assess first?
a. A 19-yr-old patient who is complaining of severe scrotal pain
b. A 60-yr-old patient with a nontender ulceration of the glans penis
NURSINGTB.COM
MEDICAL SURGICAL NURSING 10TH EDITION LEWIS TEST BANK
c. A 64-yr-old patient who has dysuria after brachytherapy for prostate cancer
d. A 22-yr-old patient who has purulent urethral drainage and severe back pain
ANS: A
The patient’s age and symptoms suggest possible testicular torsion, which will require rapid
treatment to prevent testicular necrosis. The other patients also require assessment by the
nurse, but their history and symptoms indicate nonemergent problems (acute prostatitis,
cancer of the penis, and radiation-associated urinary tract irritation).
DIF: Cognitive Level: Analyze (analysis)
REF: 1285
OBJ: Special Questions: Prioritization | Special Questions: Multiple Patients
TOP: Nursing Process: Planning
MSC: NCLEX: Safe and Effective Care Environment
33. Which action by the unlicensed assistive personnel (UAP) who are assisting with the care of
male patients with reproductive problems indicates that the nurse should provide more
teaching?
a. The UAP apply a cold pack to the scrotum for a patient with mumps orchitis.
b. The UAP help a patient who has had a prostatectomy to put on antiembolism hose.
c. The UAP leave the foreskin pulled back after cleaning the glans of a patient who
has a retention catheter.
d. The UAP encourage a high oral fluid intake for patient who had transurethral
resection of the prostate yesterday.
ANS: C
Paraphimosis can be caused by failing to replace the foreskin back over the glans after
cleaning. The other actions by UAP are appropriate.
NURSINGTB.COM
DIF: Cognitive Level: Apply (application)
REF:
1274
OBJ: Special Questions: Delegation
TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity
34. When caring for a patient with continuous bladder irrigation after having transurethral
resection of the prostate, which action could the nurse delegate to unlicensed assistive
personnel (UAP)?
a. Teach the patient how to perform Kegel exercises.
b. Report any complaints of pain or spasms to the nurse.
c. Monitor for increases in bleeding or presence of clots.
d. Increase the flow rate of the irrigation if clots are noted.
ANS: B
UAP education and role includes reporting patient concerns to supervising nurses. Patient
teaching, assessments for complications, and actions such as bladder irrigation require more
education and should be done by licensed nursing staff.
DIF: Cognitive Level: Apply (application)
REF:
1274
OBJ: Special Questions: Delegation
TOP: Nursing Process: Planning
MSC: NCLEX: Safe and Effective Care Environment
35. After reviewing the electronic medical record shown in the accompanying figure for a patient
who had transurethral resection of the prostate the previous day, which information requires
the most rapid action by the nurse?
NURSINGTB.COM
MEDICAL SURGICAL NURSING 10TH EDITION LEWIS TEST BANK
a.
b.
c.
d.
Elevated temperature and pulse
Bladder spasms and urine output
Respiratory rate and lung crackles
No prescription for antihypertensive drugs
ANS: B
Bladder spasms and lack of urine output indicate that the nurse needs to assess the continuous
bladder irrigation for kinks and may need to manually irrigate the patient’s catheter. The other
information will also require actions, such as having the patient take deep breaths and cough
and discussing the need for antihypertensive medication prescriptions with the health care
provider, but the nurse’s first action should be to address the problem with the urinary
drainage system.
DIF: Cognitive Level: Apply (application)
REF:
1274
OBJ: Special Questions: Prioritization
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity
NURSINGTB.COM
NURSINGTB.COM