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Nursing Considerations and Patient Education

- Assess for lower urinary tract symptoms (LUTS) such as frequency, urgency, hesitancy, incontinence, incomplete emptying, dribbling, nocturia, diminished stream, straining, hematuria

- Use the International Prostate Symptom Score to determine the severity of manifestations and their effect on the patient's quality of life

- Perform digital rectal exam to palpate for enlarged smooth prostate

- Obtain urinalysis and culture, CBC, BUN and creatinine, prostate-specific antigen (PSA), culture, and sensitivity of prostatic fluid as indicated

- Administer medications such as 5alpha reductase inhibitors (finasteride) or alpha-blocking agents (tamsulosin) as prescribed

- Monitor for adverse effects of medications such as impotence, decreased libido, breast enlargement, orthostatic hypotension, dizziness, headache

- Educate patient about medication adherence, potential teratogenic effects of finasteride, and the need for regular followup

- Provide information about surgical options such as transurethral resection of the prostate (TURP), transurethral incision of the prostate (TUIP), laser prostatectomy, or prostatectomy if medications are ineffective or contraindicated

- Prepare patient for surgery and postoperative care such as continuous bladder irrigation, catheter care, pain management, prevention of infection and bleeding

- Encourage patient to avoid drinking large amounts of fluid at one time, urinate as soon as urge is felt, avoid bladder stimulants (alcohol, caffeine), avoid medications that decrease bladder tone (anticholinergics, decongestants, antihistamines)

- Advise patient that frequent ejaculation releases retained prostatic fluids and may decrease the size of the prostate

- Promote physical activity and healthy diet to reduce risk factors such as smoking, obesity, diabetes, heart disease

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Questions on Nursing Considerations and Patient Education

Correct Answer is C

Explanation

Rectal pain and discomfort are not typical symptoms of BPH.

Correct Answer is B

Explanation

A sedentary lifestyle may contribute to overall health issues but is not a specific risk factor for BPH.

Correct Answer is A

Explanation

An enlarged bladder compressing the urethra is not a common symptom of BPH. Instead, it is the enlarged prostate that causes the obstruction.

Correct Answer is A

Explanation

Improved urine flow is an intended outcome of relieving urinary retention with the catheter, not a complication.

Correct Answer is C

Explanation

Limiting fluid intake at night may cause dehydration and is not recommended. Instead, the client should focus on reducing evening fluid intake to minimize nighttime urine production.Questions

Correct Answer is D

Explanation

This is the correct answer. Difficulty starting a urine stream and a weak urine flow are obstructive voiding symptoms commonly seen in clients with BPH due to the enlargement of the prostate gland, which obstructs the urethra.

Correct Answer is D

Explanation

This is the correct answer. Difficulty emptying the bladder is a hallmark symptom of bladder outlet obstruction caused by an enlarged prostate in BPH.

Correct Answer is B

Explanation

Increased urine output is not a typical complication of BPH. BPH primarily affects the outflow of urine, resulting in obstructive voiding symptoms.

Correct Answer is C

Explanation

Urinary urgency is the sudden and strong desire to urinate and is not specifically related to postvoid dribbling.

Correct Answer is A

Explanation

Nocturia is the need to wake up at night to urinate.

Correct Answer is D

Explanation

This is the correct answer. Residual urine in the bladder after voiding provides a breeding ground for bacteria, increasing the risk of UTIs. In BPH, the enlarged prostate obstructs the urethra, leading to incomplete bladder emptying and the presence of residual urine, which contributes to recurrent UTIs.

Correct Answer is B

Explanation

Alpha-blockers do not enhance urine production by the kidneys. They primarily focus on relaxing the smooth muscles to improve urinary flow.Questions

Correct Answer is A

Explanation

A urinalysis is a general test used to assess the urine's appearance, specific gravity, and the presence of blood, proteins, and other substances. While it can provide information about kidney function and potential urinary tract infections, it is not specific to BPH.

Correct Answer is D

Explanation

This is the correct answer. During a transrectal ultrasound (TRUS), a lubricated probe is inserted into the rectum to obtain images of the prostate gland. Some clients may experience mild discomfort or pressure during the procedure, but it is generally well-tolerated.

Correct Answer is B

Explanation

The evaluation of urinary flow rate is typically done through urodynamic studies and flowmetry tests, not the PSA test.

Correct Answer is D

Explanation

This is the correct answer. Hematuria (blood in the urinE. can be associated with BPH due to irritation or trauma to the urinary tract caused by the enlarged prostate. Hematuria may be gross (visiblE. or microscopic and should be further evaluated to determine its cause.

Correct Answer is B

Explanation

Reduced bladder capacity is not a contributing factor to recurrent UTIs in BPH.

Correct Answer is C

Explanation

A urodynamic study is not used to evaluate the bladder's capacity directly, but it does assess bladder function during voiding.

Correct Answer is C

Explanation

Urge urinary incontinence is characterized by a sudden, strong urge to urinate, followed by involuntary urine loss. It is not related to the symptoms described in the question.Questions

Correct Answer is C

Explanation

Invasive surgery is usually reserved for severe cases of BPH that do not respond to conservative management or when complications occur.

Correct Answer is A

Explanation

Anticholinergics are used to treat overactive bladder symptoms, which are not specific to BPH-related LUTS.

TURP does not have a direct impact on fertility, as it does not affect the production or release of sperm.

Contracting the prostate gland is not a desired effect in BPH management.

Avoiding sitting for extended periods is not a specific activity restriction after a TURP.

Pelvic floor exercises are helpful for strengthening pelvic muscles but are not a primary intervention for relieving urinary retention.

Reducing the risk of urinary incontinence is not the primary goal of combination therapy with these medications.Questions

Urgency is the sudden and strong need to urinate, and it is not specifically associated with BPH.

Prostate cancer may cause symptoms similar to BPH, but sudden severe pain in the lower abdomen, groin, and testicles is not a typical presentation of prostate cancer.

Inadequate fluid intake may contribute to UTIs, but the primary reason for recurrent UTIs in BPH is the bacterial colonization of the prostate due to urinary retention.

Prostate cancer may have similar symptoms to BPH but would not present with acute urinary retention and a distended bladder.

This is the correct answer. Hematuria in clients with BPH may be due to the presence of bladder stones. Urinary retention and stasis can lead to the formation of stones in the bladder, which may cause bleeding and hematuria.

Urinary retention may cause decreased frequency of urination rather than nocturia and frequent nighttime urination.

Increased fluid intake may be beneficial for overall bladder health but will not directly relieve the obstruction causing acute urinary retention.Questions

This statement is incorrect. Over-the-counter cold medications containing decongestants can worsen BPH symptoms by constricting blood vessels, including those in the prostate, and can lead to urinary retention.

This is the correct answer. Catheterization is necessary to relieve urinary retention and drain the distended bladder.

Administering anticoagulant medications may not be necessary after a TURP unless specifically ordered by the healthcare provider. The nurse should follow the prescribed medication regimen and monitor for bleeding complications.

Waiting for new symptoms to arise before seeking a follow-up appointment may delay necessary interventions and could lead to worsening of symptoms.

This is the correct answer. Alpha-blocker medications used to treat BPH can cause a sudden drop in blood pressure, leading to dizziness. Clients should be educated about this potential side effect and advised to change positions slowly to minimize the risk of falls.

This is the correct answer. Clients should be instructed to report any signs of catheter blockage or leakage to their healthcare provider. Catheter blockage can lead to urinary retention, and leakage may indicate a problem with the catheter or the drainage system.

Eating a high-protein diet is not specifically indicated for managing urinary frequency and urgency in clients with BPH.Questions

This statement is not correct. BPH does not involve the absence of the prostate gland; it is an enlargement of the gland.

Urinalysis is a urine test that evaluates the urine's physical and chemical properties but does not directly assess the size and shape of the prostate gland.

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Nursing Considerations and Patient Education

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client with suspected BPH. Which symptom is most commonly associated with this condition? A Dysuria (painful urination) B Hematuria (blood in the urinE. C Urinary frequency D Rectal pain and discomfort Click to see answer

Correct Answer is C

Explanation

A nurse is educating a client about risk factors for developing BPH. Which risk factor should the nurse include in the teaching? A Young age B Family history of BPH C High intake of dairy products D Sedentary lifestyle Click to see answer

Correct Answer is B

Explanation

Correct Answer is A

Explanation

Correct Answer is A

Explanation

A client with BPH is experiencing urinary frequency and nocturia. The nurse should advise the client to limit fluid intake at which time of the day to reduce nighttime awakenings? A Morning B Afternoon C Evening D Night Click to see answer

Correct Answer is C

Explanation

A client with BPH complains of difficulty starting a urine stream and a weak urine flow. The nurse should recognize these symptoms as indicative of: A Acute urinary retention B Urinary incontinence C Stress urinary incontinence D Obstructive voiding symptoms Click to see answer

Correct Answer is D

Explanation

A nurse is assessing a client with suspected BPH. Which symptom is most indicative of bladder outlet obstruction? A Increased urinary frequency B Nocturia C Hematuria (blood in the urinE. D Difficulty emptying the bladder Click to see answer

Correct Answer is D

Explanation

A nurse is educating a client about the symptoms of BPH. Which symptom should the nurse include in the teaching as a potential complication of BPH? A Urinary urgency B Erectile dysfunction C Stress urinary incontinence D Increased urine output Click to see answer

Correct Answer is B

Explanation

A client with BPH complains of dribbling and difficulty fully emptying the bladder after urination. The nurse should identify these symptoms as indicative of: A Overflow urinary incontinence B Stress urinary incontinence C Postvoid dribbling D Urinary urgency Click to see answer

Correct Answer is C

Explanation

A client reports a sensation of incomplete bladder emptying and a feeling of "fullness" in the lower abdomen. The nurse should document this as: A Urinary retention B Urinary urgency C Urinary frequency D Nocturia Click to see answer

Correct Answer is A

Explanation

A client with BPH is experiencing recurrent urinary tract infections (UTIs). The nurse should identify which factor as contributing to this complication? A Reduced urine output B Increased fluid intake C Decreased prostate size D Residual urine in the bladder Click to see answer

Correct Answer is D

Explanation

Correct Answer is B

Explanation

Correct Answer is A

Explanation

Correct Answer is D

Explanation

A client with suspected BPH is scheduled for a prostate-specific antigen (PS A test. The nurse should explain that this test is primarily used to:A. Diagnose BPH B Screen for prostate cancer C Assess renal function D Evaluate urinary flow rate Click to see answer

Correct Answer is B

Explanation

Correct Answer is D

Explanation

A client with BPH is experiencing recurrent urinary tract infections (UTIs). The nurse should recognize that this complication is likely due to: A Increased urine output B Residual urine in the bladder C Decreased fluid intake D Reduced bladder capacity Click to see answer

Correct Answer is B

Explanation

Correct Answer is C

Explanation

A client with BPH is experiencing difficulty starting the urine stream and a weak urinary flow. The nurse should identify these symptoms as indicative of: A Stress urinary incontinence B Overflow urinary incontinence C Urinary retention D Urge urinary incontinence Click to see answer

Correct Answer is C

Explanation

A nurse is providing education to a client diagnosed with BPH. The nurse explains that the initial management of BPH may involve: A Radiation therapy B Hormone therapy C Watchful waiting D Invasive surgery Click to see answer

Correct Answer is C

Explanation

A client with BPH is experiencing bothersome lower urinary tract symptoms (LUTS). The nurse should anticipate the healthcare provider to prescribe: A Alpha-blockers B Antibiotics C Diuretics D Anticholinergics Click to see answer

Correct Answer is A

Explanation

A client with BPH is experiencing urinary retention and is unable to void. The nurse should anticipate the healthcare provider to recommend: A Prostate massage B Double voiding technique C Catheterization D Pelvic floor exercises Click to see answer

A client with BPH reports experiencing difficulty starting the urinary stream and a feeling of incomplete bladder emptying. The nurse should recognize these symptoms as: A Urinary retention B Hematuria C Stress incontinence D Urgency Click to see answer

A nurse is caring for a client with BPH who suddenly reports severe pain in the lower abdomen, groin, and testicles. The nurse should suspect: A Urinary tract infection B Testicular cancer C Kidney stones D Prostate cancer Click to see answer

A client with BPH is experiencing recurrent urinary tract infections (UTIs). The nurse should recognize this as a potential complication due to: A Decreased urine production B Bacterial colonization of the prostate C Increased bladder capacity D Inadequate fluid intake Click to see answer

A client with BPH is experiencing recurrent episodes of hematuria. The nurse should recognize this as a potential complication due to: A Chronic kidney disease B Urinary tract infections C Prostate cancer D Bladder stones Click to see answer

A client with BPH is experiencing nocturia and has reported difficulty sleeping due to frequent nighttime urination. The nurse should recognize these symptoms as related to: A Decreased bladder capacity B Nocturnal enuresis C Hormonal changes D Urinary retention Click to see answer

A client with BPH is experiencing acute urinary retention and is unable to void. The nurse should anticipate the healthcare provider to recommend: A Frequent catheterization B Medications to reduce bladder spasms C Invasive surgical intervention D Increased fluid intake Click to see answer

A client with BPH is prescribed an alpha-blocker medication. The nurse should instruct the client about which potential side effect of this medication? A Dry mouth B Constipation C Hypertension D Dizziness Click to see answer

A client with BPH is experiencing urinary frequency and urgency. Which dietary modification should the nurse recommend to the client to help manage these symptoms? A Increase calcium intake B Limit fluid intake C Avoid caffeine and alcohol D Eat a high-protein diet Click to see answer

A nurse is reviewing the diagnostic tests used to confirm BPH in a client. Which test directly assesses the size and shape of the prostate gland? A Digital rectal exam (DRE) B Prostate-specific antigen (PSA) blood test C Transrectal ultrasound (TRUS) D Urinalysis Click to see answer

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