A nurse is caring for a client who has benign prostatic hyperplasia (BPH). The nurse should expect which of the following findings?
Painful urination
Urge incontinence
Critically elevated prostate-specific antigen (PSA) level
Difficulty starting the flow of urine
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 B
Explanation
Choice A reason:
Advising that the largest meal of the day should be in the evening is not typically recommended for clients with a colostomy. It is generally better to have smaller, more frequent meals throughout the day to aid digestion and reduce the risk of discomfort.
Choice B reason:
Eating yogurt can indeed help decrease the amount of gas. Yogurt contains probiotics, which can aid in digestion and reduce gas production. This is a beneficial dietary choice for clients with a colostomy.
Choice C reason:
Carbonated beverages are not recommended for controlling odor. In fact, they can increase gas production and lead to bloating, which can be uncomfortable for clients with a colostomy.
Choice D reason:
There is no need to eliminate pasta from the diet to prevent loose stools. Instead, clients should focus on a balanced diet that includes low-fiber foods initially and gradually reintroduce other foods while monitoring their effects.