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 A
Explanation
Choice A reason:
Metoprolol is a beta-blocker commonly used to treat high blood pressure (hypertension). One of its primary therapeutic effects is the reduction of blood pressure. By blocking beta-adrenergic receptors, metoprolol decreases the heart rate and the force of contraction, leading to lower blood pressure.
Choice B reason:
While metoprolol can help manage certain types of dysrhythmias by slowing the heart rate and stabilizing the heart’s rhythm, the primary therapeutic effect for which it is most commonly prescribed is the reduction of blood pressure.
Choice C reason:
Increased urine output is not a direct therapeutic effect of metoprolol. This effect is more commonly associated with diuretics, which are often used in conjunction with beta-blockers to manage hypertension and heart failure.
Choice D reason:
Decreased pulse is a potential effect of metoprolol, as it slows the heart rate. However, this is not the primary therapeutic goal. The main therapeutic effect is the reduction of blood pressure.
Correct Answer is B
Explanation
Choice A: Tamoxifen
Tamoxifen is a medication primarily used to treat breast cancer. It works as a selective estrogen receptor modulator (SERM), which means it blocks estrogen receptors in breast tissue. Estrogen can promote the growth of breast cancer cells, so blocking its effects can help to slow or stop the growth of these cells. However, tamoxifen is not typically used for prostate cancer because prostate cancer is driven by androgens (male hormones) rather than estrogens.
Choice B: Leuprolide
Leuprolide is a medication commonly used in the treatment of prostate cancer. It is a type of hormone therapy known as a luteinizing hormone-releasing hormone (LHRH) agonist. Leuprolide works by reducing the production of testosterone, a hormone that can stimulate the growth of prostate cancer cells. By lowering testosterone levels, leuprolide helps to slow the progression of prostate cancer and can be used in various stages of the disease.
Choice C: Finasteride
Finasteride is a medication used to treat benign prostatic hyperplasia (BPH) and male pattern baldness. It works by inhibiting the enzyme 5-alpha-reductase, which converts testosterone to dihydrotestosterone (DHT). While finasteride can reduce the size of the prostate and improve urinary symptoms in BPH, it is not typically used as a primary treatment for prostate cancer. Its role in prostate cancer is more preventive, as it can lower the risk of developing the disease.
Choice D: Cyclophosphamide
Cyclophosphamide is a chemotherapy drug used to treat various types of cancer, including lymphomas, leukemias, and some solid tumors. It works by interfering with the DNA of cancer cells, preventing them from dividing and growing. While cyclophosphamide can be used in certain cancer treatments, it is not a standard treatment for prostate cancer. Prostate cancer is more commonly treated with hormone therapy, targeted therapy, or other specific chemotherapy agents.