1. Following a radical retropubic prostatectomy for prostate cancer, the patient is
incontinent of urine. An appropriate nursing intervention for this patient is to teach the
patient
a. pelvic floor muscle training.
b. the use of belladonna and opium suppositories.
c. how to perform intermitte...
BPH NCLEX QUESTIONS
1. Following a radical retropubic prostatectomy for prostate cancer, the patient is
incontinent of urine. An appropriate nursing intervention for this patient is to teach the
patient
a. pelvic floor muscle training.
b. the use of belladonna and opium suppositories.
c. how to perform intermittent self-catheterization.
d. to restrict oral fluid intake. - ✔️✔️Answer: A
Rationale: 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.
Cognitive Level: Application Text Reference: p. 1428
Nursing Process: Planning NCLEX: Physiological Integrity
2. A patient scheduled for a transurethral resection of the prostate (TURP) for BPH tells
the nurse that he has delayed having surgery because he is afraid it will affect his
sexual function. When responding to his concern, the nurse explains that
a. with this type of surgery, erectile problems are rare, but retrograde ejaculation may
occur.
b. information about penile implants used for ED is available if he is interested.
c. there are many methods of sexual expression that can be alternatives to sexual
intercourse.
d. sterility will not be a problem after surgery because sperm production will not be
affected. - ✔️✔️Answer: A
Rationale: Erectile problems are rare, but retrograde ejaculation may occur after TURP.
Erectile function is not usually affected by a TURP, so the patient will not need
information about penile implants or reassurance that other forms of sexual expression
may be used. Because the patient has not asked about fertility, reassurance about
sperm production does not address his concerns.
Cognitive Level: Application Text Reference: p. 1418
Nursing Process: Implementation NCLEX: Physiological Integrity
3. A 41-year-old man asks the nurse what he can do to decrease the risk of BPH. The
nurse explains that
a. riding a bicycle raises prostate specific antigen levels and may increase BPH risk.
b. prevention is not possible because prostatic enlargement occurs with normal aging.
c. decreasing butter and margarine and increasing fruits in the diet may help.
, d. taking a daily vitamin E supplement has reduced prostate size in some men. -
✔️✔️Answer: C
Rationale: A diet high in saturated fats, found in foods like butter, is associated with an
increased risk for BPH. Individuals who eat more fruits and vegetables may be at lower
risk. Riding a bicycle does increase prostate-specific antigen (PSA) levels, but this is not
associated with development of BPH. Dietary changes and increased exercise do
appear to help prevent BPH. Vitamin E supplements do not decrease prostate size.
Cognitive Level: Comprehension Text Reference: p. 1415
Nursing Process: Implementation NCLEX: Physiological Integrity
4. The health care provider prescribes finasteride (Proscar) for a 56-year-old male
patient who has a BPH symptom score of 12 on the AUA Symptom Index. When
teaching the patient about the drug, the nurse informs him that
a. his interest in sexual activity may decrease while he is taking the medication.
b. he should change position from lying to standing slowly to avoid dizziness.
c. improvement in the obstructive symptoms should occur within about 2 weeks.
d. he will need to monitor his blood pressure frequently to assess for hypertension. -
✔️✔️Answer: A
Rationale: A decrease in libido is a side effect of finasteride because of the androgen
suppression that occurs with the drug. Orthostatic hypotension is a side effect of the α-
blocking agents. Improvement in symptoms of obstruction takes 3 to 6 months. The
medication does not cause hypertension.
Cognitive Level: Application Text Reference: p. 1417
Nursing Process: Implementation NCLEX: Physiological Integrity
5. A patient with irritative and obstructive bladder symptoms has an enlarged prostate
on digital rectal examination (DRE) and an elevated PSA level. The nurse will anticipate
that the patient will need teaching about
a. uroflometry studies.
b. cystourethroscopy.
c. transrectal ultrasonography (TRUS).
d. magnetic resonance imaging (MRI). - ✔️✔️Answer: C
Rationale: In a patient with an abnormal DRE and elevated PSA, transrectal ultrasound
is used to help differentiate BPH from prostatic cancer. Uroflowmetry studies will help
determine the extent of urine blockage and treatment, but a differential diagnosis will be
obtained first. Cystourethroscopy may be used after TRUS if the diagnosis is still
uncertain. MRI is used to determine whether prostatic cancer has metastasized but
would not be ordered at this stage of the diagnostic process.
Cognitive Level: Application Text Reference: p. 1416
Nursing Process: Planning NCLEX: Physiological Integrity
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