MSN Exam for Benign Prostatic Hypertrophy or Hyperplasia

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Q.1) After undergoing a transurethral resection of the prostate to treat benign prostatic hypertrophy, a patient is retuned to the room with continuous bladder irrigation in place. One day later, the patient reports bladder pain. What should the nurse do first?

  1. Increase the I.V. flow rate
  2. Notify the doctor immediately
  3. Assess the irrigation catheter for patency and drainage
  4. Administer meperidine (Demerol) as prescribed

Q.2) Alpha blockers in the treatment of BPH are associated with all of the following except:

  1. Improvment in symptoms in 2-3 weeks
  2. Side effects of dizziness and fatigue
  3. Once daily dosing
  4. 25% decrease in prostate size
  5. Minimal changes in blood pressure

Q.3) Of the options below, is NOT a symptom of BPH?

  1. Urinary incontinence
  2. Difficulty urinating
  3. Intestinal pain
  4. Sexual dysfunction

Q.4) An eighty five year old man was admitted for surgery for benign prostatic hypertrophy. Preoperatively he was alert, oriented, cooperative, and knowledgeable about his surgery. Several hours after surgery, the evening nurse found him acutely confused, agitated, and trying to climb over the protective side rails on his bed. The most appropriate nursing intervention that will calm an agitated client is

  1. limit visits by staff.
  2. encourage family phone calls.
  3. position in a bright, busy area.
  4. speak soothingly and provide quiet music.

Q.5) What is the relationship between prostate cancer and the condition of an enlarged prostate, also known as BPH?

  1. BPH and prostate cancer are unrelated
  2. BPH causes prostate cancer
  3. BPH is a symptom of prostate cancer

Q.6) How common is BPH?

  1. 10% of men in their 60s
  2. 30% of men in their 60s
  3. 50% of men in their 60s
  4. 90% of men in their 60s

Q.7) Romeo Diaz, age 78, is admitted to the hospital with the diagnosis of benign prostatic hyperplasia (BPH). He is scheduled for a transurethral resection of the prostate (TURP). It would be inappropriate to include which of the following points in the preoperative teaching?

  1. TURP is the most common operation for BPH.
  2. Explain the purpose and function of a two-way irrigation system.
  3. Expect bloody urine, which will clear as healing takes place.
  4. He will be pain free.

Q.8) The obstructive and irritative symptom complex caused by benign prostatic hypertrophy is termed

  1. prostatism.
  2. prostatitis.
  3. prostaglandin.
  4. prostatectomy.

Q.9) Transurethral resection of the prostate (TURP) is associated with all of the following except:

  1. Outpatient procedure in most cases
  2. Transfusion rate of 2-4%
  3. Retrograde ejaculation in 50% of men
  4. Most effective long term treatment
  5. Erectile dysfunction in 2%

Q.10) A client is admitted to the hospital with benign prostatic hyperplasia, the nurse most relevant assessment would be:

  1. Flank pain radiating in the groin
  2. Distention of the lower abdomen
  3. Perineal edema
  4. Urethral discharge

Q.11) What question would be most important to ask a male client who is in for a digital rectal examination?

  1. “Have you noticed a change in the force of the urinary system?”
  2. “Have you noticed a change in tolerance of certain foods in your diet?”
  3. “Do you notice polyuria in the AM?”
  4. “Do you notice any burning with urination or any odor to the urine?”

Q.12) The nurse is administering a psychotropic drug to an elderly client who has history of benign prostatic hypertrophy. It is most important for the nurse to teach this client to:

  1. Add fiber to his diet.
  2. Exercise on a regular basis.
  3. Report incomplete bladder emptying
  4. Take the prescribed dose at bedtime.

Q.13) Which of the following is true of laser therapy?

  1. Laser light exhibits all photons i phase (coherence)
  2. The photons travel at right angles (collimation)
  3. The photons have varying wavelenghts (polychromicity)
  4. May be legally performed in 48 of the 50 US states
  5. Cause eye damage in most surgeons after prolonged use
Answers and Rationales
  1. C. Assess the irrigation catheter for patency and drainage . Although postoperative pain is expected, the nurse should ensure that other factors, such as an obstructed irrigation catheter, aren’t the cause of the pain. After assessing catheter patency, the nurse should administer an analgesic such as meperidine as prescribed. Increasing the I.V. flow rate may worse the pain. Notifying the doctor isn’t necessary unless the pain is severe or unrelieved by the prescribed medication.
  2. D. 25% decrease in prostate size 
  3. C. Intestinal pain. Recent studies suggest that there is a correlation between lower urinary tract symptoms and sexual dysfunction in aging patients. In fact, the severity of urinary symptoms and the degree of sexual dysfunction are strongly correlated, indepently of age. In particular, community-based studies have found that a significant number of patients with symptomatic BPH have sexual dysfunction.
  4. D. speak soothingly and provide quiet music. The client needs frequent visits by the staff to orient him and to assess his safety. Phone calls from his family will not help a client who is trying to climb over the side rails and may even add to his danger. Putting the client in a bright, busy area would probably add to his confusion. The environment is an important factor in the prevention of injuries. Talking softly and providing quiet music have a calming effect on the agitated client.
  5. A. BPH and prostate cancer are unrelated 
  6. C. 50% of men in their 60s . Although the prostate continues to grow during most of a man’s life, the enlargement doesn’t usually cause problems until late in life. BPH rarely causes symptoms before the age of 40, but more than half of men in their 60s, and as many as 90% in their 70s and 80s, have some symptoms of BPH
  7. D. He will be pain free. Surgical interventions involve an experience of pain for the client which can come in varying degrees. Telling the pain that he will be pain free is giving him false reassurance.
  8. A. prostatism. Symptoms of prostatism include increased frequency of urination, nocturia, urgency, dribbling, and a sensation that the bladder has not completely emptied. Prostatitis is an inflammation of the prostate gland.Prostaglandins are physiologically active substances present in tissues with vasodilator properties. Prostatectomy refers to the surgical removal of the prostate gland.
  9. A. Outpatient procedure in most cases
  10. B. Distention of the lower abdomen . This indicates that the bladder is distended with urine, therefore palpable.
  11. A. “Have you noticed a change in the force of the urinary system?” This change would be most indicative of a potential complication with (BPH) benign prostate hypertrophy.
  12. C. Report incomplete bladder emptying . Urinary retention is a common anticholinergic side effect of psychotic medications, and the client with benign prostatic hypertrophy would have increased risk for this problem. Adding fiber to one’s diet and exercising regularly are measures to counteract another anticholinergic effect, constipation. Depending on the specific medication and how it is prescribed, taking the medication at night may or may not be important. However, it would have nothing to do with urinary retention in this client.
  13. A. Laser light exhibits all photons i phase (coherence) 

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