BPH NCLEX QUESTIONS

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Answer: C
1. To determine the severity of the symptoms for a patient with
Rationale: The American Urological Association (AUA) Symptom
benign prostatic hyperplasia (BPH), the nurse will ask the patient
Index for a patient with BPH asks questions about the force and
about
frequency of urination, nocturia, etc. Blood in the urine, ED, and
a. the presence of blood in the urine.
back or hip pain are not typical symptoms with BPH.
b. any erectile dysfunction (ED).
c. occurrence of a weak urinary stream.
Cognitive Level: Application Text Reference: pp. 1415-1416
d. lower back and hip pain.
Nursing Process: Assessment NCLEX: Physiological Integrity
2. A patient scheduled for a transurethral resection of the prostate
Answer: A
(TURP) for BPH tells the nurse that he has delayed having surgery
Rationale: Erectile problems are rare, but retrograde ejaculation
because he is afraid it will affect his sexual function. When re-
may occur after TURP. Erectile function is not usually affected
sponding to his concern, the nurse explains that
by a TURP, so the patient will not need information about penile
a. with this type of surgery, erectile problems are rare, but retro-
implants or reassurance that other forms of sexual expression
grade ejaculation may occur.
may be used. Because the patient has not asked about fertility,
b. information about penile implants used for ED is available if he
reassurance about sperm production does not address his con-
is interested.
cerns.
c. there are many methods of sexual expression that can be
alternatives to sexual intercourse.
Cognitive Level: Application Text Reference: p. 1418
d. sterility will not be a problem after surgery because sperm
Nursing Process: Implementation NCLEX: Physiological Integrity
production will not be affected.
Answer: C
3. A 41-year-old man asks the nurse what he can do to decrease
Rationale: A diet high in saturated fats, found in foods like butter,
the risk of BPH. The nurse explains that
is associated with an increased risk for BPH. Individuals who eat
a. riding a bicycle raises prostate specific antigen levels and may
more fruits and vegetables may be at lower risk. Riding a bicycle
increase BPH risk.
does increase prostate-specific antigen (PSA) levels, but this is
b. prevention is not possible because prostatic enlargement oc-
not associated with development of BPH. Dietary changes and
curs with normal aging.
increased exercise do appear to help prevent BPH. Vitamin E
c. decreasing butter and margarine and increasing fruits in the diet
supplements do not decrease prostate size.
may help.
d. taking a daily vitamin E supplement has reduced prostate size
Cognitive Level: Comprehension Text Reference: p. 1415
in some men.
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
Answer: A
on the AUA Symptom Index. When teaching the patient about the
Rationale: A decrease in libido is a side effect of finasteride
drug, the nurse informs him that
because of the androgen suppression that occurs with the drug.
a. his interest in sexual activity may decrease while he is taking the
Orthostatic hypotension is a side effect of the ±-
blocking agents.
medication.
Improvement in symptoms of obstruction takes 3 to 6 months. The
b. he should change position from lying to standing slowly to avoid
medication does not cause hypertension.
dizziness.
c. improvement in the obstructive symptoms should occur within
Cognitive Level: Application Text Reference: p. 1417
about 2 weeks.
Nursing Process: Implementation NCLEX: Physiological Integrity
d. he will need to monitor his blood pressure frequently to assess
for hypertension.
Answer: C
Rationale: In a patient with an abnormal DRE and elevated PSA,
transrectal ultrasound is used to help differentiate BPH from pro- 5. A patient with irritative and obstructive bladder symptoms has
static cancer. Uroflowmetry studies will help determine the extent an enlarged prostate on digital rectal examination (DRE) and an
of urine blockage and treatment, but a differential diagnosis will elevated PSA level. The nurse will anticipate that the patient will
be obtained first. Cystourethroscopy may be used after TRUS if need teaching about
the diagnosis is still uncertain. MRI is used to determine whether a. uroflometry studies.
prostatic cancer has metastasized but would not be ordered at b. cystourethroscopy.
this stage of the diagnostic process. c. transrectal ultrasonography (TRUS).
d. magnetic resonance imaging (MRI).
Cognitive Level: Application Text Reference: p. 1416
Nursing Process: Planning NCLEX: Physiological Integrity
7. The wife of a patient who has undergone a TURP and has
Answer: B continuous bladder irrigation asks the nurse about the purpose of
Rationale: The purpose of bladder irrigation is to remove clots the continuous bladder irrigation. Which response by the nurse is
from the bladder and to prevent obstruction of the catheter by appropriate?
clots. The irrigation does not decrease bleeding or maintain urine a. "The bladder irrigation is needed to stop the postoperative
bleeding in the bladder."
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b. "The irrigation is needed to keep the catheter from being oc-
production. Antibiotics are given by the IV route, not through the
cluded by blood clots."
bladder irrigation.
c. "Normal production of urine is maintained with the irrigations
until healing occurs."
Cognitive Level: Comprehension Text Reference: pp. 1420-1421
d. "Antibiotics are being administered into the bladder with the
Nursing Process: Implementation NCLEX: Physiological Integrity
irrigation solution."
Answer: A
Rationale: The patient will have indwelling catheter for up to a
8. A patient with symptomatic BPH is scheduled for visual laser
week and will need to be instructed on catheter care to avoid
ablation of the prostate (VLAP) at an outpatient surgical center.
problems such as infection. There is minimal bleeding with this
The nurse will plan to teach the patient
procedure. It will take several weeks before the full benefits of
a. how to care for an indwelling urinary catheter.
the procedure take effect. Stent placement is not included in the
b. that the urine will appear bloody for several days.
procedure.
c. to expect an immediate improvement in urinary force.
d. that an intraprostatic urethral stent will be placed.
Cognitive Level: Application Text Reference: pp. 1420-1422
Nursing Process: Planning NCLEX: Physiological Integrity
9. The health care provider orders a blood test for prostate-specific
Answer: D antigen (PSA) when an enlarged prostate is palpated during a
Rationale: PSA levels are usually elevated above the normal in routine examination of a 56-year-old man. When the patient asks
patients with prostate cancer. PSA testing does not determine the nurse the purpose of the test, the nurse's response is based
whether metastasis has occurred. A biopsy of the prostate is on the knowledge that
needed for a definitive diagnosis of prostate cancer. Success of
a. elevated levels of PSA are indicative of metastatic cancer of the
treatment is determined by a fall in PSA to an undetectable level;
prostate.
the patient's baseline PSA is not needed to determine the success
b. PSA testing is the "gold standard" for making a diagnosis of
of treatment. prostate cancer.
c. baseline PSA levels are necessary to determine whether treat-
Cognitive Level: Application Text Reference: p. 1423 ment is effective.
Nursing Process: Implementation NCLEX: Physiological Integrity d. PSA levels are usually elevated in patients with cancer of the
prostate.
Answer: A
Rationale: Pelvic floor muscle training (Kegel) exercises are rec-
ommended to strengthen the pelvic floor muscles and improve 11. Following a radical retropubic prostatectomy for prostate can-
urinary control. Belladonna and opium suppositories are used to cer, the patient is incontinent of urine. An appropriate nursing
reduce bladder spasms after surgery. Intermittent self-catheter- intervention for this patient is to teach the patient
ization may be taught before surgery if the patient has urinary a. pelvic floor muscle training.
retention, but it will not be useful in reducing incontinence after b. the use of belladonna and opium suppositories.
surgery. The patient should have a daily oral intake of 2 to 3 L. c. how to perform intermittent self-catheterization.
d. to restrict oral fluid intake.
Cognitive Level: Application Text Reference: p. 1428
Nursing Process: Planning NCLEX: Physiological Integrity
12. Following discharge teaching for a patient who has had
a transurethral prostatectomy for benign prostatic hyperplasia
Answer: B
(BPH), the nurse determines that additional instruction is needed
Rationale: Incontinence is common for several weeks after a
when the patient says,
TURP. The other patient statements indicate that the patient has
a. "I will increase fiber and fluids in my diet to prevent constipation."
a good understanding of post-TURP instructions.
b. "I should call the doctor if I have any incontinence at home."
c. "I will avoid heavy lifting or driving until I get approval from my
Cognitive Level: Application Text Reference: p. 1422
health care provider."
Nursing Process: Evaluation NCLEX: Physiological Integrity
d. "I should continue to schedule yearly appointments for prostate
exams."
Answer: B
Rationale: Because the patient's increase in symptoms has oc- 24. A patient with benign prostatic hyperplasia (BPH) with mild
curred abruptly, the nurse should ask about OTC medications obstruction tells the nurse, "My symptoms have gotten a lot worse
that might cause contraction of the smooth muscle in the prostate this week." Which response by the nurse is most appropriate?
and worsen obstruction. The prostate gland does not vary in size a. "The prostate gland normally changes slightly in size from day
from day to day. A TURP may be needed, but more assessment to day, and this may be making your symptoms worse."
about possible reasons for the sudden symptom change is a more b. "Have you been taking any over-the-counter (OTC) medications
appropriate first response by the nurse. PSA testing is done to recently?"
differentiate BPH from prostatic cancer and is not indicated in this c. "Have you talked to the doctor about surgical procedures such
patient, who has already been diagnosed with BPH. as transurethral resection of the prostate?"

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 BPH NCLEX QUESTIONS
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Cognitive Level: Application Text Reference: p. 1421 d. "I will talk to the doctor about ordering a prostate specific antigen
Nursing Process: Assessment NCLEX: Physiological Integrity test."
Answer: B
27. A patient with acute urinary retention associated with BPH is
Rationale: The patient data indicate that the patient may have
admitted to the emergency department. The patient has had no
hydronephrosis and acute renal failure caused by the BPH; the
urine output for 16 hours, and the laboratory work shows a blood
initial therapy will be to insert a catheter. Hemodialysis may be
urea nitrogen (BUN) level of 50 mg/dl and a creatinine of 3.0 mg/dl.
needed if the elevation in BUN and creatinine persists, but it
The nurse will anticipate a health care provider order to
will not be ordered initially. Fluid administration and furosemide
a. schedule the patient for inpatient hemodialysis.
administration will increase the bladder distension.
b. insert a retention catheter.
c. start an IV line for fluid administration.
Cognitive Level: Application Text Reference: p. 1415
d. administer furosemide (Lasix).
Nursing Process: Planning NCLEX: Physiological Integrity
An older male patient visits his primary care provider because of
burning on urination and production of urine that he describes as
C. Benign prostatic hyperplasia (BPH) "foul smelling." The health care provider should assess the patient
for what factor that may put him at risk for a urinary tract infection
BPH causes urinary stasis, which is a predisposing factor for (UTI)?
UTIs. A sedentary lifestyle and recent antibiotic use are unlikely
to contribute to UTIs, whereas a diet high in purines is associated A. High-purine diet
with renal calculi. B. Sedentary lifestyle
C. Benign prostatic hyperplasia (BPH)
D. Recent use of broad-spectrum antibiotics

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