The nurse will anticipate that a 61-year-old patient who has an ...

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The nurse will anticipate that a 61-year-old patient who has an enlarged prostate detected by digital rectal examination (DRE) and an elevated prostate specific antigen (PSA) level will need teaching about
 
  a. cystourethroscopy.
  b. uroflowmetry studies.
  c. magnetic resonance imaging (MRI).
  d. transrectal ultrasonography (TRUS).

Question 2

The health care provider prescribes finasteride (Proscar) for a 67-year-old patient who has benign prostatic hyperplasia (BPH). When teaching the patient about the drug, the nurse informs him that
 
  a. he should change position from lying to standing slowly to avoid dizziness.
  b. his interest in sexual activity may decrease while he is taking the medication.
  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.

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Answer to Question 1

ANS: D
In a patient with an abnormal DRE and elevated PSA, transrectal ultrasound is used to visualize the prostate for biopsy. Uroflowmetry studies help determine the extent of urine blockage and treatment, but there is no indication that this is a problem for this patient. Cystoscopy may be used before prostatectomy but will not be done until after the TRUS and biopsy. MRI is used to determine whether prostatic cancer has metastasized but would not be ordered at this stage of the diagnostic process.

Answer to Question 2

ANS: B
A decrease in libido is a side effect of finasteride because of the androgen suppression that occurs with the drug. Although orthostatic hypotension may occur if the patient is also taking a medication for erectile dysfunction (ED), it should not occur with finasteride alone. Improvement in symptoms of obstruction takes about 6 months. The medication does not cause hypertension.

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Excellent

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TYSM