Family Nurse Practitioner Exam

What is the next step when an elderly male on finasteride shows a PSA result of 10 ng/mL, down from a baseline of 30 ng/mL?

1. Add the baseline PSA value to the treatment PSA value

2. The treatment PSA value is the correct value

3. Multiply the treatment PSA value by 2

4. Divide the baseline PSA value by the treatment PSA value

The correct answer is: Multiply the treatment PSA value by 2

When an elderly male on finasteride has a PSA result of 10 ng/mL, down from a baseline of 30 ng/mL, the next appropriate step is to multiply the treatment PSA value by 2. Finasteride is known to reduce PSA levels by approximately 50%. Therefore, to interpret the current PSA level accurately, one must account for the effect of the medication. By multiplying the treatment PSA level (10 ng/mL) by 2, the adjusted PSA estimate would be 20 ng/mL, providing a clearer picture of the patient's baseline risk for prostate conditions. This approach is significant for patient management, as it helps to distinguish the effects of treatment on PSA levels and assists in identifying whether further diagnostic intervention is warranted, particularly when there is a concern for prostate cancer or other abnormalities. This calculation plays a critical role in determining the next steps for screening and diagnosis, ensuring the patient receives appropriate care.