Chapter 57: Nursing Management: Male Reproductive Conditions:
Lewis’s Medical-Surgical Nursing, 5th Edition
1. The nurse is providing education for a patient who has been diagnosed with orchitis.
Which of the following information should the nurse include in the teaching plan?
A. Pain management
B. Emergency surgical repair
C. Aspiration of fluid from the scrotal sac
D. Application of warm packs to the scrotum
Answer: A
Explanation: Orchitis is often very painful, so effective pain management is a primary
concern. Surgical repair, aspiration, and warm packs are not standard treatments for orchitis.
2. The nurse is assessing a patient 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
Answer: D
Explanation: The American Urological Association (AUA) Symptom Index assesses the
severity of BPH by focusing on urinary symptoms like the force and frequency of urination.
Blood in the urine, ED, and back or hip pain are not typical symptoms used to evaluate BPH
severity.
3. The nurse is conducting a focused health history for a patient with possible testicular
cancer. Which of the following topics should the nurse include in the assessment?
A. Sexually transmitted infections (STIs)
B. Testicular trauma
C. Testicular torsion
D. Undescended testicles
Answer: D
Explanation: Cryptorchidism (undescended testicles) is a significant risk factor for testicular
cancer if not corrected before puberty. STIs, trauma, and torsion are risk factors for other
testicular conditions but not strongly linked to testicular cancer.
4. The nurse is caring for a patient with prostate cancer and is prescribed abiraterone.
Which of the following adverse effects should the nurse teach the patient about this
,medication? (Select all that apply.)
A. Fluid retention
B. Loss of libido
C. Breast pain
D. Hot flashes
E. Erectile dysfunction
Answer: A, D
Explanation: Abiraterone commonly causes joint swelling, fluid retention, hot flashes, and
diarrhea. Loss of libido, breast pain, and erectile dysfunction are associated with other anti-
androgen therapies like androgen receptor blockers (e.g., bicalutamide), not typically with
abiraterone.
5. The nurse is caring for a patient who had a transurethral resection of the prostate
(TURP) and has a continuous bladder irrigation with symptoms of painful bladder
spasms. The nurse observes a decrease in urine output and clots in the urine. Which of
the following actions should the nurse take first?
A. Increase the flow rate of the bladder irrigation.
B. Administer the prescribed IV morphine sulphate.
C. Give the patient the prescribed belladonna and opium suppository.
D. Manually instill and then withdraw 50 mL of saline into the catheter.
Answer: D
Explanation: The symptoms suggest catheter obstruction by a blood clot. The first action is
to attempt to clear the obstruction via manual irrigation to relieve the spasms and restore
flow. Increasing irrigation flow can worsen spasms, and pain medications or antispasmodics
will not resolve the physical blockage.
6. The nurse is preparing a teaching plan for a patient 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)
Answer: D
Explanation: Transrectal ultrasonography (TRUS) is used to visualize the prostate for biopsy
when a DRE is abnormal and PSA is elevated. Uroflowmetry assesses urinary blockage,
cystoscopy may be used pre-prostatectomy, and MRI is for staging cancer, not initial
diagnosis.
,7. The nurse is caring for a patient who had a perineal radical prostatectomy for
prostatic cancer. In the immediate postoperative period, which of the following
etiologies best relates to the nursing diagnosis of risk for infection?
A. Urinary stasis
B. Urinary incontinence
C. Fecal contamination of the surgical wound
D. Placement of a suprapubic catheter into the bladder
Answer: C
Explanation: The perineal incision is close to the anus, creating a high risk for fecal
contamination and subsequent infection. A urethral catheter is used, preventing stasis and
incontinence, and a suprapubic catheter is not typically placed.
8. The nurse is assessing a 22-year-old male patient at the health clinic with symptoms
of erectile dysfunction. When assessing for possible etiological factors, which of the
following questions should the nurse ask first?
A. "Are you using any recreational drugs or drinking more than 3 drinks of alcohol per day?"
B. "Have you been experiencing an unusual amount of anxiety or stress?"
C. "Do you have any history of an erection that lasted for 6 hours or more?"
D. "Do you have any persistent cardiovascular or peripheral vascular disease?"
Answer: A
Explanation: In younger men, substance use (recreational drugs, alcohol) is a common cause
of erectile dysfunction and should be assessed first. Stress, priapism, and cardiovascular
disease are less common primary causes in this age group.
9. The nurse is providing teaching for a patient with cancer of the prostate who has
been prescribed leuprolide. Which of the following adverse effects should the nurse
include in the teaching plan about this drug?
A. Dizziness
B. Hot flashes
C. Urinary incontinence
D. Increased infection risk
Answer: B
Explanation: Leuprolide, a gonadotropin-releasing hormone (GnRH) agonist, reduces
testosterone, commonly causing hot flashes. Dizziness is associated with alpha-blockers for
BPH, incontinence is a surgical complication, and infection risk is linked to chemotherapy.
10. The nurse is caring for a patient with benign prostatic hyperplasia (BPH) with mild
obstruction and tells the nurse, "My symptoms have gotten a lot worse this week."
Which of the following responses by the nurse is best?
A. "I will talk to the health care provider about ordering a prostate specific antigen (PSA)
, test."
B. "Have you been taking any over-the-counter (OTC) medications recently?"
C. "Have you talked to the doctor about surgical procedures such as transurethral resection of
the prostate (TURP)?"
D. "The prostate gland changes slightly in size from day to day, and this may be making your
symptoms worse."
Answer: B
Explanation: A sudden worsening of symptoms suggests a possible precipitating factor.
Many OTC medications (e.g., decongestants, antihistamines) can cause smooth muscle
contraction in the prostate and worsen obstruction. This assessment should precede
discussions of surgery or PSA testing. The prostate does not vary in size daily.
11. The nurse is caring for a patient 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.
Answer: D
Explanation: Erectile function is not typically affected by a TURP, though retrograde
ejaculation is a common outcome. The patient's concern is about intercourse, not fertility or
alternative sexual methods, so reassurance about the low risk of ED is the most appropriate
response.
12. The health care provider prescribes finasteride for a patient who has benign
prostatic hyperplasia (BPH). Which of the following information should the nurse
include when teaching the patient 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.
Answer: B
Explanation: Finasteride works by suppressing androgens, which can lead to a decrease in
libido as an adverse effect. Orthostatic hypotension is not associated with finasteride,
symptom improvement takes about 6 months, and it does not cause hypertension.
13. The nurse is admitting a patient with benign prostatic hyperplasia (BPH) who has
urinary retention and new onset elevations in blood urea nitrogen (BUN) and
Lewis’s Medical-Surgical Nursing, 5th Edition
1. The nurse is providing education for a patient who has been diagnosed with orchitis.
Which of the following information should the nurse include in the teaching plan?
A. Pain management
B. Emergency surgical repair
C. Aspiration of fluid from the scrotal sac
D. Application of warm packs to the scrotum
Answer: A
Explanation: Orchitis is often very painful, so effective pain management is a primary
concern. Surgical repair, aspiration, and warm packs are not standard treatments for orchitis.
2. The nurse is assessing a patient 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
Answer: D
Explanation: The American Urological Association (AUA) Symptom Index assesses the
severity of BPH by focusing on urinary symptoms like the force and frequency of urination.
Blood in the urine, ED, and back or hip pain are not typical symptoms used to evaluate BPH
severity.
3. The nurse is conducting a focused health history for a patient with possible testicular
cancer. Which of the following topics should the nurse include in the assessment?
A. Sexually transmitted infections (STIs)
B. Testicular trauma
C. Testicular torsion
D. Undescended testicles
Answer: D
Explanation: Cryptorchidism (undescended testicles) is a significant risk factor for testicular
cancer if not corrected before puberty. STIs, trauma, and torsion are risk factors for other
testicular conditions but not strongly linked to testicular cancer.
4. The nurse is caring for a patient with prostate cancer and is prescribed abiraterone.
Which of the following adverse effects should the nurse teach the patient about this
,medication? (Select all that apply.)
A. Fluid retention
B. Loss of libido
C. Breast pain
D. Hot flashes
E. Erectile dysfunction
Answer: A, D
Explanation: Abiraterone commonly causes joint swelling, fluid retention, hot flashes, and
diarrhea. Loss of libido, breast pain, and erectile dysfunction are associated with other anti-
androgen therapies like androgen receptor blockers (e.g., bicalutamide), not typically with
abiraterone.
5. The nurse is caring for a patient who had a transurethral resection of the prostate
(TURP) and has a continuous bladder irrigation with symptoms of painful bladder
spasms. The nurse observes a decrease in urine output and clots in the urine. Which of
the following actions should the nurse take first?
A. Increase the flow rate of the bladder irrigation.
B. Administer the prescribed IV morphine sulphate.
C. Give the patient the prescribed belladonna and opium suppository.
D. Manually instill and then withdraw 50 mL of saline into the catheter.
Answer: D
Explanation: The symptoms suggest catheter obstruction by a blood clot. The first action is
to attempt to clear the obstruction via manual irrigation to relieve the spasms and restore
flow. Increasing irrigation flow can worsen spasms, and pain medications or antispasmodics
will not resolve the physical blockage.
6. The nurse is preparing a teaching plan for a patient 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)
Answer: D
Explanation: Transrectal ultrasonography (TRUS) is used to visualize the prostate for biopsy
when a DRE is abnormal and PSA is elevated. Uroflowmetry assesses urinary blockage,
cystoscopy may be used pre-prostatectomy, and MRI is for staging cancer, not initial
diagnosis.
,7. The nurse is caring for a patient who had a perineal radical prostatectomy for
prostatic cancer. In the immediate postoperative period, which of the following
etiologies best relates to the nursing diagnosis of risk for infection?
A. Urinary stasis
B. Urinary incontinence
C. Fecal contamination of the surgical wound
D. Placement of a suprapubic catheter into the bladder
Answer: C
Explanation: The perineal incision is close to the anus, creating a high risk for fecal
contamination and subsequent infection. A urethral catheter is used, preventing stasis and
incontinence, and a suprapubic catheter is not typically placed.
8. The nurse is assessing a 22-year-old male patient at the health clinic with symptoms
of erectile dysfunction. When assessing for possible etiological factors, which of the
following questions should the nurse ask first?
A. "Are you using any recreational drugs or drinking more than 3 drinks of alcohol per day?"
B. "Have you been experiencing an unusual amount of anxiety or stress?"
C. "Do you have any history of an erection that lasted for 6 hours or more?"
D. "Do you have any persistent cardiovascular or peripheral vascular disease?"
Answer: A
Explanation: In younger men, substance use (recreational drugs, alcohol) is a common cause
of erectile dysfunction and should be assessed first. Stress, priapism, and cardiovascular
disease are less common primary causes in this age group.
9. The nurse is providing teaching for a patient with cancer of the prostate who has
been prescribed leuprolide. Which of the following adverse effects should the nurse
include in the teaching plan about this drug?
A. Dizziness
B. Hot flashes
C. Urinary incontinence
D. Increased infection risk
Answer: B
Explanation: Leuprolide, a gonadotropin-releasing hormone (GnRH) agonist, reduces
testosterone, commonly causing hot flashes. Dizziness is associated with alpha-blockers for
BPH, incontinence is a surgical complication, and infection risk is linked to chemotherapy.
10. The nurse is caring for a patient with benign prostatic hyperplasia (BPH) with mild
obstruction and tells the nurse, "My symptoms have gotten a lot worse this week."
Which of the following responses by the nurse is best?
A. "I will talk to the health care provider about ordering a prostate specific antigen (PSA)
, test."
B. "Have you been taking any over-the-counter (OTC) medications recently?"
C. "Have you talked to the doctor about surgical procedures such as transurethral resection of
the prostate (TURP)?"
D. "The prostate gland changes slightly in size from day to day, and this may be making your
symptoms worse."
Answer: B
Explanation: A sudden worsening of symptoms suggests a possible precipitating factor.
Many OTC medications (e.g., decongestants, antihistamines) can cause smooth muscle
contraction in the prostate and worsen obstruction. This assessment should precede
discussions of surgery or PSA testing. The prostate does not vary in size daily.
11. The nurse is caring for a patient 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.
Answer: D
Explanation: Erectile function is not typically affected by a TURP, though retrograde
ejaculation is a common outcome. The patient's concern is about intercourse, not fertility or
alternative sexual methods, so reassurance about the low risk of ED is the most appropriate
response.
12. The health care provider prescribes finasteride for a patient who has benign
prostatic hyperplasia (BPH). Which of the following information should the nurse
include when teaching the patient 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.
Answer: B
Explanation: Finasteride works by suppressing androgens, which can lead to a decrease in
libido as an adverse effect. Orthostatic hypotension is not associated with finasteride,
symptom improvement takes about 6 months, and it does not cause hypertension.
13. The nurse is admitting a patient with benign prostatic hyperplasia (BPH) who has
urinary retention and new onset elevations in blood urea nitrogen (BUN) and
