Questions Fully Answered .
The nurse is caring for a client who will have a bilateral orchiectomy. The client asks what is involved with
this procedure. The nurse's most appropriate response would be? "The surgery:
1. Removes the entire prostate gland, prostatic capsule, and seminal vesicles."
2. Tends to cause urinary incontinence and impotence."
3. Freezes prostate tissue, killing cells."
4. Results in reduction of the major circulating androgen, testosterone. - Answer 4.
R: Bilateral orchiectomy (removal of testes) results in reduction of the major circulating androgen,
testosterone, as a palliative measure to reduce symptoms and progression of prostate cancer. A radical
prostatectomy (removal of entire prostate gland,
prostatic capsule, and seminal vesicles) may include pelvic lymphadenectomy. Complications include
urinary incontinence, impotence, and rectal injury with the radical prostatectomy. Cryosurgery freezes
prostate tissue, killing tumor cells without prostatectomy.
A client asks the nurse why the prostate- specific antigen (PSA) level is determined before the digital
rectal examination. The nurse's best response is which of the following?
1. "It is easier for the client."
2. "A prostate examination can possibly decrease the PSA."
3. "A prostate examination can possibly increase the PSA."
4. "If the PSA is normal, the client will not have to undergo the rectal examination." - Answer 3.
R: Manipulation of the prostate during the digital rectal examination may falsely increase the PSA levels.
The PSA determination and the digital rectal examination are no longer recommended as screening tools
for prostate cancer. Prostate cancer is the most common cancer in men and the second leading killer
from cancer among men in the United States. Incidence increases sharply with age, and the disease is
predominant in the 60- to 70- year-old age group.
, The nurse is performing a digital rectal examination. Which of the following findings is a key sign for
prostate cancer?
1. A hard prostate, localized or diffuse.
2. Abdominal pain.
3. A boggy, tender prostate.
4. A nonindurated prostate. - Answer 1.
R: On digital rectal examination, key signs of prostate cancer are a hard prostate, induration of the
prostate, and an irregular, hard nodule. Accompanying symptoms of prostate cancer can include
constipation, weight loss, and lymph- adenopathy. Abdominal
pain usually does not accompany prostate cancer. A boggy, tender prostate is found with infection (eg,
acute or chronic prostatitis)
A client is undergoing a total prostatectomy for prostate cancer. The client asks questions about his
sexual function. The best response by the nurse is which of the following? "Loss of the prostate gland
means that:
1. You will be impotent."
2. You will be infertile and there will be no ejaculation. You can still experience the sensations of
orgasm."
3. You will have no loss of sexual function and drive."
4. Your erectile capability will return immediately after surgery." - Answer 2. Loss of the prostate gland
interrupts the flow of semen, so there will be no ejaculation fluid. The sensations of orgasm remain
intact. The client needs to be advised that return of erectile capability is often disrupted after surgery,
but within 1 year 95% of men
have returned to normal erectile function with sexual intercourse.
A 65-year-old client has been told by the physician that his prostate cancer was graded at stage IIB. The
client inquires if this means he is going to die soon. The best
response by the nurse is which of the following?
1. "Prostate cancer at this stage is very slow growing."
2. "Prostate cancer at this stage is very fast growing."