Prostate Cancer
4. A patient has an enlarged prostate detected by digital rectal examination (DRE) and
an elevated prostate specific antigen (PSA) level. The nurse will anticipate that the
patient will need teaching about
a. cystourethroscopy.
b. uroflowmetry studies.
c. magnetic resonance imaging (MRI).
d. transrectal ultrasonography (TRUS). correct answers 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.
5. When teaching a patient who is scheduled for a transurethral resection of the
prostate (TURP) about continuous bladder irrigation, which information will 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. correct answers
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.
6. A patient with symptomatic benign prostatic hyperplasia (BPH) is scheduled for
photovaporization of the prostate (PVP) at an outpatient surgical center. The nurse will
plan to teach the patient
a. how to care for an indwelling urinary catheter.
b. that the urine will appear bloody for several days.
c. about complications associated with urethral stenting.
d. that symptom improvement will occur in 2 to 3 weeks. correct answers ANS: A
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.
7. A 51-year-old man is scheduled for an annual physical exam at the outpatient clinic.
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). correct answers ANS: C
An annual digital rectal exam (DRE) and PSA are recommended starting at age 50 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 are abnormal.
8. A 64-year-old has a perineal radical prostatectomy for prostatic cancer. In the
immediate postoperative period, the nurse establishes the nursing diagnosis of risk for
infection related to
a. urinary stasis.
b. urinary incontinence.
c. possible fecal contamination of the surgical wound.
d. placement of a suprapubic catheter into the bladder. correct answers 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.
9. Following a radical retropubic prostatectomy for prostate cancer, the patient is
incontinent of urine. The nurse will plan to teach the patient
a. to restrict oral fluid intake.
b. pelvic floor muscle exercises.
c. the use of belladonna and opium suppositories.
d. how to perform intermittent self-catheterization. correct answers 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.
10. Following discharge teaching for a patient who has had a transurethral resection of
the prostate (TURP) for benign prostatic hyperplasia (BPH), the nurse determines that
additional instruction is needed when the patient says,
a. "I will avoid driving until I get approval from my doctor."
b. "I should call the doctor if I have any incontinence at home."
c. "I will increase fiber and fluids in my diet to prevent constipation."
d. "I should continue to schedule yearly appointments for prostate exams." correct
answers ANS: B
Since 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.
4. A patient has an enlarged prostate detected by digital rectal examination (DRE) and
an elevated prostate specific antigen (PSA) level. The nurse will anticipate that the
patient will need teaching about
a. cystourethroscopy.
b. uroflowmetry studies.
c. magnetic resonance imaging (MRI).
d. transrectal ultrasonography (TRUS). correct answers 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.
5. When teaching a patient who is scheduled for a transurethral resection of the
prostate (TURP) about continuous bladder irrigation, which information will 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. correct answers
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.
6. A patient with symptomatic benign prostatic hyperplasia (BPH) is scheduled for
photovaporization of the prostate (PVP) at an outpatient surgical center. The nurse will
plan to teach the patient
a. how to care for an indwelling urinary catheter.
b. that the urine will appear bloody for several days.
c. about complications associated with urethral stenting.
d. that symptom improvement will occur in 2 to 3 weeks. correct answers ANS: A
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.
7. A 51-year-old man is scheduled for an annual physical exam at the outpatient clinic.
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). correct answers ANS: C
An annual digital rectal exam (DRE) and PSA are recommended starting at age 50 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 are abnormal.
8. A 64-year-old has a perineal radical prostatectomy for prostatic cancer. In the
immediate postoperative period, the nurse establishes the nursing diagnosis of risk for
infection related to
a. urinary stasis.
b. urinary incontinence.
c. possible fecal contamination of the surgical wound.
d. placement of a suprapubic catheter into the bladder. correct answers 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.
9. Following a radical retropubic prostatectomy for prostate cancer, the patient is
incontinent of urine. The nurse will plan to teach the patient
a. to restrict oral fluid intake.
b. pelvic floor muscle exercises.
c. the use of belladonna and opium suppositories.
d. how to perform intermittent self-catheterization. correct answers 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.
10. Following discharge teaching for a patient who has had a transurethral resection of
the prostate (TURP) for benign prostatic hyperplasia (BPH), the nurse determines that
additional instruction is needed when the patient says,
a. "I will avoid driving until I get approval from my doctor."
b. "I should call the doctor if I have any incontinence at home."
c. "I will increase fiber and fluids in my diet to prevent constipation."
d. "I should continue to schedule yearly appointments for prostate exams." correct
answers ANS: B
Since 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.
