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A nurse is caring for a client who has benign prostatic hyperplasia (BPH). The nurse should expect which of the following findings?

A.

Painful urination

B.

Urge incontinence

C.

Critically elevated prostate-specific antigen (PSA) level

D.

Difficulty starting the flow of urine

Answer and Explanation

The Correct Answer is D

Choice A: Painful urination

 

Painful urination, or dysuria, is not a typical symptom of benign prostatic hyperplasia (BPH). BPH primarily affects the flow of urine due to the enlargement of the prostate gland, which can obstruct the urethra. While BPH can cause discomfort, it does not usually result in painful urination. Painful urination is more commonly associated with urinary tract infections (UTIs) or other conditions affecting the urinary tract.

 

Choice B: Urge incontinence

 

Urge incontinence, characterized by a sudden and intense urge to urinate followed by involuntary loss of urine, can occur in some cases of BPH but is not the most common symptom. BPH typically causes symptoms related to urinary obstruction, such as difficulty starting urination, weak urine stream, and incomplete bladder emptying. Urge incontinence may develop if the bladder becomes overactive due to the obstruction, but it is not a primary symptom.

 

Choice C: Critically elevated prostate-specific antigen (PSA) level

 

While an elevated prostate-specific antigen (PSA) level can be associated with BPH, it is not a definitive finding. PSA levels can be elevated due to various conditions, including prostate cancer, prostatitis, and BPH. However, a critically elevated PSA level is more concerning for prostate cancer rather than BPH. Therefore, while PSA testing is useful in the evaluation of prostate conditions, it is not specific to BPH.

 

Choice D: Difficulty starting the flow of urine

 

Difficulty starting the flow of urine, also known as hesitancy, is a hallmark symptom of BPH. The enlarged prostate gland can compress the urethra, making it difficult for urine to pass through. This can lead to a weak urine stream, straining to urinate, and a feeling of incomplete bladder emptying. These symptoms are collectively known as lower urinary tract symptoms (LUTS) and are commonly associated with BPH.

 


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Correct Answer is D

Explanation

Choice A: Airborne

Airborne precautions are used for diseases that are transmitted through tiny airborne particles that can remain suspended in the air and be inhaled by others. Examples of diseases requiring airborne precautions include tuberculosis, measles, and chickenpox. These diseases can spread over long distances and through ventilation systems. Pertussis, however, is not transmitted via airborne particles but rather through larger respiratory droplets.

Choice B: Contact

Contact precautions are used for infections that are spread by direct or indirect contact with the patient or the patient’s environment. This includes infections like methicillin-resistant Staphylococcus aureus (MRSA) and Clostridioides difficile (C. diff). While contact precautions are important for preventing the spread of certain infections, pertussis is primarily spread through respiratory droplets, making droplet precautions more appropriate.

Choice C: Protective

Protective precautions, also known as reverse isolation, are used to protect immunocompromised patients from potential infections. This type of precaution is not intended to prevent the spread of infections from the patient to others but rather to protect the patient from external sources of infection. Examples include patients undergoing chemotherapy or those with severe immunodeficiency. Pertussis does not require protective precautions as it is not about protecting the patient from others.

Choice D: Droplet

Droplet precautions are the appropriate transmission-based precautions for pertussis. Pertussis, also known as whooping cough, is spread through respiratory droplets that are produced when an infected person coughs, sneezes, or talks. These droplets can travel short distances and can infect others who are in close proximity. Droplet precautions include wearing a mask when within 3 feet of the patient, placing the patient in a private room if possible, and ensuring that the patient wears a mask if they need to be transported.

Correct Answer is A

Explanation

Choice A: Office of Emergency Management (OEM)

The Office of Emergency Management (OEM) is typically the first agency to be notified in the event of a nonbiological or chemical incident. The OEM coordinates the local response efforts and ensures that all necessary resources and personnel are mobilized. They work closely with other local, state, and federal agencies to manage the incident effectively. The OEM’s role includes assessing the situation, providing information to the public, and coordinating evacuation or shelter-in-place orders if necessary.

Choice B: Federal Emergency Management Agency (FEMA)

The Federal Emergency Management Agency (FEMA) plays a crucial role in disaster response and recovery at the federal level. However, they are usually involved after the initial local response has been established. FEMA provides support and resources to local and state agencies, but the immediate notification should go to the local Office of Emergency Management.

Choice C: American Red Cross (ARC)

The American Red Cross (ARC) is a vital organization in disaster response, providing emergency shelter, food, and medical care. While they are an essential part of the response team, they are not typically the first agency to be notified. The ARC works in coordination with local emergency management agencies to support the affected community.

Choice D: U.S. Department of Homeland Security (DHS)

The U.S. Department of Homeland Security (DHS) oversees national efforts to protect against and respond to various threats, including chemical incidents. However, like FEMA, DHS is generally involved at a higher level of coordination and support. The immediate response is managed by local agencies, with DHS providing additional resources and expertise as needed