Chapter 57: Nursing Management: Male Reproductive Problems
Lewis: Medical-Surgical Nursing in Canada, 4th Canadian Edition
MULTIPLE CHOICE
1. The nurse is assessing a client with benign prostatic hyperplasia (BPH). Which of the
following symptoms should the nurse assess to determine the severity of the BPH?
a. Blood in the urine
b. Lower back or hip pain
c. Erectile dysfunction (ED)
d. Strength of the urinary stream
ANS: D
The American Urological Association (AUA) Symptom Index (used in Canada) for a
client 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.
DIF: Cognitive Level: Application TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity
2. The nurse is caring for a client recently diagnosed with benign prostatic hyperplasia (BPH)
who tells the nurse that he does not want to have a transurethral resection of the prostate
(TURP) because he is afraid it might affect his ability to have intercourse. Which of the
following actions should the nurse take?
a. Offer reassurance that sperm production is not affected by TURP.
b. Discuss alternative methods of sexual expression besides intercourse.
c. Provide education about the use of medications for erectile dysfunction (ED).
d. Teach that erectile dysfunction (ED) is unlikely following a TURP.
ANS: D
ED is not a concern with TURP, although retrograde ejaculation is likely and the nurse
should discuss this with the client. Erectile function is not usually affected by a TURP, so
the client will not need information about penile implants or reassurance that other forms
of sexual expression may be used. Because the client has not asked about fertility,
reassurance about sperm production does not address his concerns.
DIF: Cognitive Level: Application TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity
3. The health care provider prescribes finasteride for a client who has benign prostatic
hyperplasia (BPH). Which of the following information should the nurse include when
teaching the client about the drug?
a. Change position from lying to standing slowly.
b. Sexual activity interest may decrease while he is taking the medication.
c. Improvement in the obstructive symptoms should occur within about 2 weeks.
d. Required to monitor blood pressure frequently to assess for hypertension.
ANS: B
, A decrease in libido is an adverse effect of finasteride because of the androgen suppression
that occurs with the drug. Although orthostatic hypotension may occur if the client also is
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.
DIF: Cognitive Level: Application TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity
4. The nurse is preparing a teaching plan for a client who has an enlarged prostate detected
by digital rectal examination (DRE) and an elevated prostate specific antigen (PSA) level.
Which of the following procedures should the nurse include in the teaching plan?
a. Cystourethroscopy
b. Uroflowmetry studies
c. Magnetic resonance imaging (MRI)
d. Transrectal ultrasonography (TRUS)
ANS: D
In a client 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 client.
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: Application TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity
5. The nurse is teaching a client who is scheduled for a transurethral resection of the prostate
(TURP) about continuous bladder irrigation. Which of the following information should
the nurse include?
a. Bladder irrigation decreases the risk of postoperative bleeding.
b. Hydration and urine output are maintained by bladder irrigation.
c. Bladder irrigation prevents obstruction of the catheter after surgery.
d. Antibiotics are infused on a continuous basis with bladder irrigation.
ANS: C
The purpose of bladder irrigation is to remove clots from the bladder and to 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: Comprehension TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity
6. The nurse is preparing a teaching plan for a client with symptomatic benign prostatic
hyperplasia (BPH) who is scheduled for photovaporization of the prostate (PVP) at an
outpatient surgical centre. Which of the following information should the nurse include in
the teaching plan?
a. How to care for an in-dwelling urinary catheter?
b. The urine will appear bloody for several days.
c. Complications associated with urethral stenting
Lewis: Medical-Surgical Nursing in Canada, 4th Canadian Edition
MULTIPLE CHOICE
1. The nurse is assessing a client with benign prostatic hyperplasia (BPH). Which of the
following symptoms should the nurse assess to determine the severity of the BPH?
a. Blood in the urine
b. Lower back or hip pain
c. Erectile dysfunction (ED)
d. Strength of the urinary stream
ANS: D
The American Urological Association (AUA) Symptom Index (used in Canada) for a
client 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.
DIF: Cognitive Level: Application TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity
2. The nurse is caring for a client recently diagnosed with benign prostatic hyperplasia (BPH)
who tells the nurse that he does not want to have a transurethral resection of the prostate
(TURP) because he is afraid it might affect his ability to have intercourse. Which of the
following actions should the nurse take?
a. Offer reassurance that sperm production is not affected by TURP.
b. Discuss alternative methods of sexual expression besides intercourse.
c. Provide education about the use of medications for erectile dysfunction (ED).
d. Teach that erectile dysfunction (ED) is unlikely following a TURP.
ANS: D
ED is not a concern with TURP, although retrograde ejaculation is likely and the nurse
should discuss this with the client. Erectile function is not usually affected by a TURP, so
the client will not need information about penile implants or reassurance that other forms
of sexual expression may be used. Because the client has not asked about fertility,
reassurance about sperm production does not address his concerns.
DIF: Cognitive Level: Application TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity
3. The health care provider prescribes finasteride for a client who has benign prostatic
hyperplasia (BPH). Which of the following information should the nurse include when
teaching the client about the drug?
a. Change position from lying to standing slowly.
b. Sexual activity interest may decrease while he is taking the medication.
c. Improvement in the obstructive symptoms should occur within about 2 weeks.
d. Required to monitor blood pressure frequently to assess for hypertension.
ANS: B
, A decrease in libido is an adverse effect of finasteride because of the androgen suppression
that occurs with the drug. Although orthostatic hypotension may occur if the client also is
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.
DIF: Cognitive Level: Application TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity
4. The nurse is preparing a teaching plan for a client who has an enlarged prostate detected
by digital rectal examination (DRE) and an elevated prostate specific antigen (PSA) level.
Which of the following procedures should the nurse include in the teaching plan?
a. Cystourethroscopy
b. Uroflowmetry studies
c. Magnetic resonance imaging (MRI)
d. Transrectal ultrasonography (TRUS)
ANS: D
In a client 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 client.
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: Application TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity
5. The nurse is teaching a client who is scheduled for a transurethral resection of the prostate
(TURP) about continuous bladder irrigation. Which of the following information should
the nurse include?
a. Bladder irrigation decreases the risk of postoperative bleeding.
b. Hydration and urine output are maintained by bladder irrigation.
c. Bladder irrigation prevents obstruction of the catheter after surgery.
d. Antibiotics are infused on a continuous basis with bladder irrigation.
ANS: C
The purpose of bladder irrigation is to remove clots from the bladder and to 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: Comprehension TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity
6. The nurse is preparing a teaching plan for a client with symptomatic benign prostatic
hyperplasia (BPH) who is scheduled for photovaporization of the prostate (PVP) at an
outpatient surgical centre. Which of the following information should the nurse include in
the teaching plan?
a. How to care for an in-dwelling urinary catheter?
b. The urine will appear bloody for several days.
c. Complications associated with urethral stenting
