If a patient on testosterone therapy has a PSA level drawn that is below 4, what should the NP do?

In the context of a patient undergoing testosterone therapy, a PSA (prostate-specific antigen) level below 4 ng/mL is generally considered to be within the normal range. Testosterone therapy can stimulate the prostate and potentially lead to elevated PSA levels, but a PSA value below 4 typically indicates no immediate concern for prostatic pathology, such as prostate cancer.

Continuing therapy is appropriate when the PSA level is within this normal range, as long as the patient remains asymptomatic and there are no other risk factors or clinical concerns that would warrant a change in management. Regular monitoring of PSA levels is advisable while on testosterone therapy, but a stable and normal PSA does not necessitate the immediate adjustment of the treatment plan. As such, continuing testosterone therapy at this point aligns with standard clinical practice. Frequent PSA monitoring allows for timely intervention if any changes occur in the PSA trend or if the patient develops symptoms.

In summary, the correct action is to continue therapy while maintaining vigilance through regular follow-up and monitoring of PSA levels.