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 C
Explanation
Choice A: Tell the client to expect dark stools following chemotherapy
Dark stools are not a common side effect of chemotherapy. This symptom is more often associated with gastrointestinal bleeding or the use of certain medications, such as iron supplements or bismuth-containing compounds. Chemotherapy can cause a range of side effects, but dark stools are not typically one of them. Therefore, it is not necessary to inform the client to expect this symptom.
Choice B: Have the client swish with commercial mouthwash before therapy
While maintaining oral hygiene is important during chemotherapy, using a commercial mouthwash before therapy is not specifically recommended. Some commercial mouthwashes contain alcohol or other irritants that can exacerbate oral mucositis, a common side effect of chemotherapy. Instead, clients are often advised to use a gentle, alcohol-free mouthwash or a saline rinse to maintain oral hygiene and prevent infections.
Choice C: Administer an antiemetic prior to the procedure
Administering an antiemetic prior to chemotherapy is a standard practice to prevent nausea and vomiting, which are common side effects of many chemotherapeutic agents. Antiemetics help to improve the client’s comfort and adherence to the treatment regimen by reducing these distressing symptoms. This proactive approach is crucial in managing the side effects of chemotherapy and ensuring that the client can tolerate the treatment.
Choice D: Have the client floss 4 times daily
Flossing is an important part of oral hygiene, but flossing 4 times daily is excessive and can cause irritation or damage to the gums, especially in clients undergoing chemotherapy who may have a higher risk of oral mucositis and bleeding. It is generally recommended to floss once daily and to use a soft-bristled toothbrush to maintain oral health without causing additional trauma.
Correct Answer is B
Explanation
Choice A reason:
While articulating expectations is important, the nurse’s response is more focused on addressing the client’s feelings and encouraging participation in therapy. Simply stating expectations without addressing the client’s emotions may not be as effective.
Choice B reason:
The nurse’s response demonstrates empathy by acknowledging the client’s feelings and gently guiding them towards participating in group therapy. This approach helps build trust and rapport, which are essential in therapeutic relationships, especially with clients exhibiting delusional behavior.
Choice C reason:
Setting limits on manipulative behavior is important, but in this context, the nurse’s response is more about encouraging participation and showing understanding rather than strictly setting limits.
Choice D reason:
Reflection involves mirroring the client’s feelings or statements to show understanding. While the nurse’s response does show understanding, it is not a direct example of reflection. The primary focus is on empathy and encouragement.