Chapter 64Male Reproduction Dysfunction: Nursing Management My Nursing Test Banks

Chapter 64Male Reproduction Dysfunction: Nursing Management

MULTIPLE CHOICE

1.The nurse is instructing a client diagnosed with acute prostatitis. Which of the following instructions would be the least beneficial to the client?

1.

Avoid alcohol and caffeine.

2.

Sex should be avoided during the acute phase.

3.

Sit for as long as you can.

4.

Sitz baths may provide comfort.

ANS: 3

The patient should be encouraged to use sitz baths for comfort but not to sit in them for long periods of time. Caffeine, alcohol, and sex should be avoided during the acute phase.

PTS: 1 DIF: Apply REF: Prostatitis: Patient and Family Teaching

2.The nurse is documenting the health history of a client diagnosed with benign prostatic hyperplasia (BPH). In which of the following areas would the nurse take a careful history?

1.

Bowel patterns

2.

Eating patterns

3.

Sleeping patterns

4.

Urinary patterns

ANS: 4

A careful history on urinary patterns should be taken by the nurse. The ease with which the stream of urine is started, the strength of the stream, and the perceived amount of urine eliminated with each voiding, along with the patients sense about whether the bladder is completely emptied and the presence of nocturia or dribbling, should be noted. The clients bowel, eating, and sleeping patterns are also important; however, they are not as important as the urinary patterns.

PTS:1DIF:Apply

REF: Benign Prostatic Hyperplasia: Assessment with Clinical Manifestations

3.A client, diagnosed with benign prostatic hyperplasia (BPH), should be instructed to do which of the following?

1.

Do nothing since this disorder does not require any follow-up.

2.

Decrease water intake to avoid dribbling.

3.

Void every 2 to 3 hours.

4.

Wear scrotal support.

ANS: 3

Clients with BPH should void every 2 to 3 hours to flush the urinary tract. Water should not be decreased because this will irritate the urinary mucosa. Scrotal support is not necessary, and BPH does require follow-up visits.

PTS:1DIF:Apply

REF:Benign Prostatic Hyperplasia: Patient and Family Teaching

4.A client, recovering from a transurethral resection of the prostate (TURP) with a continuous bladder irrigation system to a three-way indwelling urinary catheter, tells the nurse he has to void. What nursing intervention should the nurse perform?

1.

Call the physician.

2.

Increase the flow of the irrigant.

3.

Irrigate the catheter.

4.

Tell the client to void.

ANS: 3

After a TURP, clots that can occlude the catheter and create a sensation to void in the client are common. The nurse should irrigate the catheter to allow the urine to flow. The nurse does not need to phone the physician, increase the flow of the irrigant, or tell the client to void.

PTS: 1 DIF: Apply REF: Benign Prostatic Hyperplasia: Surgery

5.A client who is 12 hours postoperative after a transurethral resection of the prostate (TURP) is concerned about the blood clots in the catheter and urinary collection bag. How should the nurse respond?

1.

I need to call your physician.

2.

I will need to stop the bladder irrigation.

3.

Blood clots are common during this time frame and will start to decrease in a day.

4.

You need to stop moving and irritating the catheter.

ANS: 3

Blood clots are common during the first 36 hours following a TURP. The irrigant should not be stopped because it is flushing the clots out of the urinary system. A large amount of bright red blood would be an indication of hemorrhage. The nurse does not need to call the physician.

PTS: 1 DIF: Apply REF: Benign Prostatic Hyperplasia: Surgery

6.A client is being screened for prostate cancer. What tests would be completed at this time?

1.

Digital rectal examination and transrectal ultrasonography

2.

Biopsy of the prostate and magnetic resonance imagery

3.

Complete blood cell count and prostate-specific antigen

4.

Prostate-specific antigen (PSA) and digital rectal examination

ANS: 4

Early screening for prostate cancer includes a digital rectal examination and a PSA test. Other tests may be ordered later if either the PSA or digital rectal examination are abnormal.

PTS:1DIF:Analyze

REFrostate Cancer: Assessment with Clinical Manifestations

7.The nurse is instructing a client about testicular self-examination (TSE). Which of the following would not be included in these instructions?

1.

The testis should feel smooth and egg-shaped.

2.

Perform TSE after a bath or shower.

3.

TSE should be performed monthly by every male older than age 40.

4.

Any lumps and changes in the testicles should be reported.

ANS: 3

The highest risk group for testicular cancer is young men 15 to 35 years of age. TSE should be taught and performed monthly from the teenage years. The other choices are appropriate for the nurse to instruct the client.

PTS: 1 DIF: Apply REF: Testicular Cancer: Planning and Implementation

8.A male client is diagnosed with orchitis. The nurse should assess the client for which of the following?

1.

Recent infection with mumps

2.

Recent diagnosis of prostatitis

3.

History of type 2 diabetes mellitus

4.

Diagnosis of renal insufficiency

ANS: 1

Mumps is the most common viral cause of orchitis, with the orchitis occurring 4 to 7 days after the onset of mumps. Orchitis is not associated with prostatitis, type 2 diabetes mellitus, or renal insufficiency.

PTS: 1 DIF: Apply REF: Orchitis

9.A client is diagnosed with a spermatocele. The nurse should instruct the client on which of the following?

1.

The use of heat to reduce the size of the inflamed area

2.

The potential need for surgery to correct the disorder

3.

The use of ice packs to reduce the size of the inflamed area

4.

The importance of using antibiotics to treat the disorder

ANS: 2

Spermatoceles may become significantly uncomfortable and require treatment. Surgical correction may be done if infertility is associated with the spermatocele. Surgical removal of the spermatocele is performed under local anesthesia. Heat, ice, and antibiotics are not the first line treatments for the disorder.

PTS:1DIF:Apply

REF: Hydrocele, Hematocele, and Spermatocele: Surgery

10.A client is diagnosed with a varicocele. The nurse realizes that this client is likely to develop:

1.

hydrocele.

2.

prostate cancer.

3.

prostatitis.

4.

infertility.

ANS: 4

Infertility or subinfertility often occurs in conjunction with varicocele because the increased blood flow in the varicocele raises the scrotal temperature about 93.2F, which is the ideal temperature for spermatogenesis. The client is not likely to develop a hydrocele, prostate cancer, or prostatitis from a varicocele.

PTS: 1 DIF: Analyze REF: Varicocele: Pathophysiology

11.A newborn male child is diagnosed with cryptorchidism. The nurse should prepare to administer which of the following to this client?

1.

Intravenous fluids

2.

Antipyretic medication

3.

Human chorionic gonadotropin medication

4.

Antibiotics

ANS: 3

Human chorionic gonadotropin may be given intramuscularly to promote bilateral testicular descent. This medication is provided 2 to 3 times a week for up to 6 weeks. Intravenous fluids, antipyretics, or antibiotics are not indicated in the treatment of this disorder.

PTS: 1 DIF: Apply REF: Cryptorchidism: Planning and Implementation

12.A client is experiencing priapism. Which of the following should the nurse do first to help the client?

1.

Apply ice packs to the perineum.

2.

Prepare for emergency surgery.

3.

Prepare for an aspiration of blood from the penis.

4.

Apply heat to the perineum.

ANS: 1

The goal of treating priapism is to resolve the condition before permanent damage occurs that leaves the client unable to achieve an erection in the future. Ice packs to the perineum will resolve some cases of the disorder. This is what the nurse should do first. The client does not need emergency surgery. The client may need blood aspirated from the penis. Heat should not be applied to the perineum.

PTS: 1 DIF: Apply REF: Priapism: Planning and Implementation

MULTIPLE RESPONSE

1.A client is diagnosed with testicular torsion. Which of the following might be indicated for this client? (Select all that apply.)

1.

Manually untwist the testicle

2.

Orchiopexy

3.

Testicle removal

4.

Pain management

5.

Application of ice and a scrotal support

6.

Prescribe medication

ANS: 1, 2, 3, 4, 5

The goal of the treatment for testicular torsion is to untwist the spermatic cord and reestablish normal blood flow to the testicle. The testicle may be manually untwisted to promote blood flow. If this is unsuccessful, the client may need an orchiopexy or a surgical procedure to untwist the testicle. If surgical treatment occurs within 6 hours of the onset of pain, the testicle is salvaged. If treatment is delayed for 12 hours or more, the testicle will begin to necrose and will need to be removed. Pain medication is needed for this disorder. Ice and a scrotal support are used for this disorder. No medications alone will cure this disorder.

PTS: 1 DIF: Apply REF: Testicular Torsion: Planning and Implementation

2.A client is diagnosed with epididymitis. The nurse should instruct the client on which of the following as treatment for the disorder? (Select all that apply.)

1.

Broad spectrum antibiotics

2.

NSAIDs

3.

Bed rest

4.

Elevate the scrotum

5.

Apply cold packs

6.

Apply heat

ANS: 1, 2, 3, 4, 5

Treatment for epididymitis includes broad spectrum antibiotics, NSAIDs, bed rest, elevation of the scrotum, and application of cold packs. Heat is not recommended as treatment for this disorder.

PTS: 1 DIF: Apply REF: Epididymitis

3.Which of the following should the nurse instruct a client who is recovering from a vasectomy? (Select all that apply.)

1.

Use ice packs to control postoperative bleeding.

2.

Wear cotton jockey type briefs for scrotal support.

3.

Use warm sitz baths to aid in comfort.

4.

Recognize the signs and symptoms of postoperative infection.

5.

A vasectomy protects the client from sexually transmitted illnesses.

6.

Ejaculate will be reduced after the procedure.

ANS: 1, 2, 3, 4

The client recovering from a vasectomy should be instructed to use ice packs to control postoperative bleeding, wear cotton jockey type briefs for scrotal support, use warm sitz baths to aid in comfort,  and recognize the signs and symptoms of postoperative infection. A vasectomy does not protect the client from sexually transmitted illnesses. Ejaculate will not be reduced after the procedure.

PTS: 1 DIF: Apply REF: Vasectomy: Patient and Family Teaching

4.The nurse is assessing a client diagnosed with balanitis and posthitis. Which of the following will the nurse most likely assess in this client? (Select all that apply.)

1.

Penile discharge

2.

Hematuria

3.

Pain

4.

Erythema

5.

Flank pain

6.

Edema

ANS: 1, 3, 4, 6

The typical manifestations for balanitis and posthitis include penile discharge, pain, erythema, and edema. Hematuria and flank pain are not associated with this disorder.

PTS:1DIF:Apply

REF:Balanitis and Posthitis: Assessment with Clinical Manifestations

5.The nurse is assessing a client who is experiencing erectile dysfunction. For which of the following should the nurse assess the client? (Select all that apply.)

1.

Diagnosis of diabetes mellitus

2.

Thyroid disease

3.

Chronic renal failure

4.

Multiple sclerosis

5.

Parkinsons disease

6.

Gastroesophageal reflux disease

ANS: 1, 2, 3, 4, 5

Erectile dysfunction has been associated with diabetes mellitus, thyroid disease, chronic renal failure, multiple sclerosis, and Parkinsons disease. Erectile dysfunction has not been associated with gastroesophageal reflux disease.

PTS: 1 DIF: Apply REF: Erectile Dysfunction: Etiology

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