NU 300 FINAL EXAM | COMPREHENSIVE MEDICAL-SURGICAL NURSING STUDY
GUIDE, PRACTICE QUESTIONS & ANSWERS 2026/2027
benign prostatic hyperplasia (BPH) - ANS ✔✔glandular units in prostate increase in number-
inflammation
BPH s/s - ANS ✔✔frequency, urgency, nocturia, incomplete emptying, urinary stasis, hematuria, urinary
overflow incontinence (acute urinary retention- emergency!), chronic urinary retention (UTI, bladder
calculi, hydroureter, hydronephrosis)
BPH RX - ANS ✔✔frequent sex, avoid drinking lots of fluids at once, avoid alc/caffeine/diuretics, avoid
drugs causing urinary retention, void as soon as urge felt, 5-alpha reductase inhibitors (reduce prostate
size, SE ED/decreased libido/ortho hypotension/gynecomastia/increased hair growth; PREG HANDLE
WITH GLOVES; finasteride, dutasteride), alpha 1 adrenergic blockers (relax bladder and prostate, SE
tachycardia/syncope/hypotension/dizzy/congestion/drowsy; TAKE AFTER EATING; tamsulosin,
doxazosin), TURP surgery, HoLEP laser surgery
BPH TURP post op teaching - ANS ✔✔urinary catheter for several days, do not void with catheter in (can
cause bladder spasms...pee will come out on its own!), pink clotty urine after catheter removal (normal!
notify if it does not go away after a few days/less than 150-200 ml every few hours), retrograde
ejaculation
the nurse is caring for a patient on continuous bladder irrigation following a TURP. what is priority care? -
ANS ✔✔administer 1 L/hr of bladder irrigation
acute prostatitis s/s - ANS ✔✔*fever, chills*, low back pain, discharge, boggy/tender prostate, elevated
WBC/PSA
chronic prostatitis s/s - ANS ✔✔hesitancy, urgency, dysuria, hematuria, perineal discomfort, backache,
enlarged/firm/tender prostate, elevated WBC/PSA
prostatitis complications - ANS ✔✔*epididymitis, cystitis*, prostatic abscess, UTI
prostatitis RX - ANS ✔✔sitz bath, NSAID, stool softener, alpha blocker (flomax), avoid urinary retention
causing food/drugs, increase fluid intake, antibiotics (bactrim), encourage activities that drain prostate
(ejaculation, massage)
prostate cancer risk factors - ANS ✔✔>65, black, fam HX, PIN lesions (precancerous), BRCA2, high animal
fat diet, low fiber intake, vasectomy, environmental toxin exposure
prostate cancer s/s - ANS ✔✔early- bladder obstruction (difficulty starting, frequent UTI, urinary
retention)
late (sign of metastasis)- hematuria, pelvic/lower back pain, swollen lymph nodes, weight loss
PSA recommended screening - ANS ✔✔low risk- 50
high risk (1st degree relative has it)- 45
, higher risk (2+ relative with it)- 40
transrectal ultrasound (TRUS) with biopsy teaching - ANS ✔✔small amt of bleeding normal, report
hematuria/fever/chills/difficulty urinating, drink lots of fluids, avoid strenuous activity
prostate cancer RX - ANS ✔✔watchful waiting, radial prostatectomy (curative), bilateral orchiectomy,
radiation, LH-RH agonists (Lupron, SE hot flashes/gynecomastia/decreased libido/osteoporosis), anti-
androgens (flutamide, same SE), chemo
ED/impotence types - ANS ✔✔organic- gradual deterioration of function (HTN/anti HTN drugs,
prostatectomy, neuro conditions)
functional- psychological causes (difficulty performing on demand, stress)
ED RX - ANS ✔✔PDE-5 inhibitors (viagra/levitra/cialis, avoid with patients on nitrates!, SE
dyspepsia/facial flushing/HA/priapism), vacuum constriction device, penile implant
priapism - ANS ✔✔uncontrolled long maintained erection without sexual desire, affects corpora
cavernosa
caused by neural/vascular/pharm (thrombosis, leukemia, SCA, DM, ED drugs, prolonged sexual activity)
priapism RX - ANS ✔✔MUST BE RESOLVED WITHIN 24-30 HR!!, prostatic massage, sedation, ice packs,
rest, needle aspiration, meperidine (demerol), catheterization
priapism complications - ANS ✔✔penile ischemia, gangrene, fibrosis, ED
phimosis - ANS ✔✔narrowing of the opening of the foreskin over the penis
caused by inflammation/infection from poor hygiene
RX- circumcision (soak dressing in warm bath to facilitate removal, sex within 1-2 weeks after pain is
over)
paraphimosis - ANS ✔✔condition in which a retracted foreskin cannot be pulled forward to cover the
penis, impeded blood flow- EMERGENCY!
can be caused by HCW not pulling foreskin back after catheterization
hydrocele - ANS ✔✔fluid filled cyst in scrotum around testicle
spermatocele - ANS ✔✔sperm filled cyst on epididymis
varicocele - ANS ✔✔veins above/behind testes are dilated (can be removed surgically- varicoelectomy)
testicular torsion - ANS ✔✔EMERGENCY! twisting of spermatic cord and blood vessels, compromises
vascular supply; surgical RX required within 12 hr to provide maximum survival of testes
azoospermia - ANS ✔✔absence of living sperm in semen
oligospermia - ANS ✔✔low sperm count
GUIDE, PRACTICE QUESTIONS & ANSWERS 2026/2027
benign prostatic hyperplasia (BPH) - ANS ✔✔glandular units in prostate increase in number-
inflammation
BPH s/s - ANS ✔✔frequency, urgency, nocturia, incomplete emptying, urinary stasis, hematuria, urinary
overflow incontinence (acute urinary retention- emergency!), chronic urinary retention (UTI, bladder
calculi, hydroureter, hydronephrosis)
BPH RX - ANS ✔✔frequent sex, avoid drinking lots of fluids at once, avoid alc/caffeine/diuretics, avoid
drugs causing urinary retention, void as soon as urge felt, 5-alpha reductase inhibitors (reduce prostate
size, SE ED/decreased libido/ortho hypotension/gynecomastia/increased hair growth; PREG HANDLE
WITH GLOVES; finasteride, dutasteride), alpha 1 adrenergic blockers (relax bladder and prostate, SE
tachycardia/syncope/hypotension/dizzy/congestion/drowsy; TAKE AFTER EATING; tamsulosin,
doxazosin), TURP surgery, HoLEP laser surgery
BPH TURP post op teaching - ANS ✔✔urinary catheter for several days, do not void with catheter in (can
cause bladder spasms...pee will come out on its own!), pink clotty urine after catheter removal (normal!
notify if it does not go away after a few days/less than 150-200 ml every few hours), retrograde
ejaculation
the nurse is caring for a patient on continuous bladder irrigation following a TURP. what is priority care? -
ANS ✔✔administer 1 L/hr of bladder irrigation
acute prostatitis s/s - ANS ✔✔*fever, chills*, low back pain, discharge, boggy/tender prostate, elevated
WBC/PSA
chronic prostatitis s/s - ANS ✔✔hesitancy, urgency, dysuria, hematuria, perineal discomfort, backache,
enlarged/firm/tender prostate, elevated WBC/PSA
prostatitis complications - ANS ✔✔*epididymitis, cystitis*, prostatic abscess, UTI
prostatitis RX - ANS ✔✔sitz bath, NSAID, stool softener, alpha blocker (flomax), avoid urinary retention
causing food/drugs, increase fluid intake, antibiotics (bactrim), encourage activities that drain prostate
(ejaculation, massage)
prostate cancer risk factors - ANS ✔✔>65, black, fam HX, PIN lesions (precancerous), BRCA2, high animal
fat diet, low fiber intake, vasectomy, environmental toxin exposure
prostate cancer s/s - ANS ✔✔early- bladder obstruction (difficulty starting, frequent UTI, urinary
retention)
late (sign of metastasis)- hematuria, pelvic/lower back pain, swollen lymph nodes, weight loss
PSA recommended screening - ANS ✔✔low risk- 50
high risk (1st degree relative has it)- 45
, higher risk (2+ relative with it)- 40
transrectal ultrasound (TRUS) with biopsy teaching - ANS ✔✔small amt of bleeding normal, report
hematuria/fever/chills/difficulty urinating, drink lots of fluids, avoid strenuous activity
prostate cancer RX - ANS ✔✔watchful waiting, radial prostatectomy (curative), bilateral orchiectomy,
radiation, LH-RH agonists (Lupron, SE hot flashes/gynecomastia/decreased libido/osteoporosis), anti-
androgens (flutamide, same SE), chemo
ED/impotence types - ANS ✔✔organic- gradual deterioration of function (HTN/anti HTN drugs,
prostatectomy, neuro conditions)
functional- psychological causes (difficulty performing on demand, stress)
ED RX - ANS ✔✔PDE-5 inhibitors (viagra/levitra/cialis, avoid with patients on nitrates!, SE
dyspepsia/facial flushing/HA/priapism), vacuum constriction device, penile implant
priapism - ANS ✔✔uncontrolled long maintained erection without sexual desire, affects corpora
cavernosa
caused by neural/vascular/pharm (thrombosis, leukemia, SCA, DM, ED drugs, prolonged sexual activity)
priapism RX - ANS ✔✔MUST BE RESOLVED WITHIN 24-30 HR!!, prostatic massage, sedation, ice packs,
rest, needle aspiration, meperidine (demerol), catheterization
priapism complications - ANS ✔✔penile ischemia, gangrene, fibrosis, ED
phimosis - ANS ✔✔narrowing of the opening of the foreskin over the penis
caused by inflammation/infection from poor hygiene
RX- circumcision (soak dressing in warm bath to facilitate removal, sex within 1-2 weeks after pain is
over)
paraphimosis - ANS ✔✔condition in which a retracted foreskin cannot be pulled forward to cover the
penis, impeded blood flow- EMERGENCY!
can be caused by HCW not pulling foreskin back after catheterization
hydrocele - ANS ✔✔fluid filled cyst in scrotum around testicle
spermatocele - ANS ✔✔sperm filled cyst on epididymis
varicocele - ANS ✔✔veins above/behind testes are dilated (can be removed surgically- varicoelectomy)
testicular torsion - ANS ✔✔EMERGENCY! twisting of spermatic cord and blood vessels, compromises
vascular supply; surgical RX required within 12 hr to provide maximum survival of testes
azoospermia - ANS ✔✔absence of living sperm in semen
oligospermia - ANS ✔✔low sperm count
