A 75-year-old male has problems initiating urine, emptying his bladder, and complains of dribbling. A digital rectal exam is performed, what does he likely have?

Benign prostatic hyperplasia.

Urinary tract infection.

Stage 4 prostate cancer.

Renal disease.

Answer and Explanation

The Correct Answer is A

Choice A reason: Difficulty initiating urination, incomplete bladder emptying, and dribbling in a 75-year-old male, with likely prostate enlargement on rectal exam, indicate benign prostatic hyperplasia (BPH). BPH obstructs the urethra, common in aging men. Accurate diagnosis guides treatments like alpha-blockers, preventing complications like urinary retention or kidney damage in elderly patients.

Choice B reason: Urinary tract infections cause burning or cloudy urine, not primarily dribbling or initiation issues, which suggest BPH in older males. Assuming UTI risks missing prostate issues, delaying BPH treatment. This could lead to untreated obstruction, increasing risks of retention or infection, requiring distinct diagnostic and therapeutic approaches.

Choice C reason: Stage 4 prostate cancer may cause urinary symptoms, but initiation difficulty and dribbling in older males typically indicate BPH, especially without systemic symptoms. Assuming cancer risks unnecessary invasive testing, delaying BPH management like medications, critical for relieving obstruction and improving quality of life in elderly patients.

Choice D reason: Renal disease causes systemic symptoms like edema or hypertension, not primarily urinary flow issues like dribbling, which point to BPH. Misdiagnosing as renal disease risks overlooking prostate obstruction, delaying treatments like tamsulosin, potentially worsening urinary retention or kidney strain in older males with BPH symptoms.

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Correct Answer is A

Explanation

Choice A reason: Burning urination, cloudy urine, and urethral pain are classic UTI symptoms, caused by bacterial infection (e.g., Escherichia coli) irritating the urinary tract. Prompt recognition guides antibiotic therapy and hydration, preventing complications like pyelonephritis. Accurate diagnosis ensures timely treatment, critical for relieving discomfort and avoiding infection spread in affected patients.

Choice B reason: Kidney obstruction typically causes flank pain, reduced urine output, or hematuria, not burning urination or cloudy urine. These symptoms align with UTI, not obstruction. Misidentifying risks delaying UTI treatment, potentially leading to kidney damage or sepsis, while unnecessary imaging for obstruction complicates care unnecessarily.

Choice C reason: Stroke presents with neurological symptoms like weakness or confusion, not urinary symptoms like burning or cloudy urine. These indicate UTI, not stroke. Assuming stroke misdirects care, delaying antibiotic treatment for UTI, risking infection progression and overlooking neurological assessment needed for actual stroke symptoms.

Choice D reason: Heart failure causes edema, dyspnea, or fatigue, not urinary symptoms like burning or cloudy urine, which suggest UTI. Misidentifying as heart failure risks neglecting antibiotic therapy, allowing UTI to worsen, potentially causing sepsis. This error diverts focus from cardiac assessment needed for heart failure management.

A. Appendicitis B. Pancreatitis C. Cholecystitis D. Diverticulitis

Correct Answer is D

Explanation

Choice A reason: Rebound tenderness in the right lower quadrant, often at McBurney’s point, is a hallmark of appendicitis, indicating peritoneal irritation from an inflamed appendix. This sign, elicited by releasing pressure during palpation, suggests localized inflammation, requiring urgent surgical evaluation to prevent rupture and peritonitis.

Choice B reason: Pancreatitis typically presents with epigastric or left upper quadrant pain, radiating to the back, not right lower quadrant rebound tenderness. It involves pancreatic inflammation, often due to gallstones or alcohol, and is assessed via serum amylase and lipase, not RLQ findings, making this incorrect.

Choice C reason: Cholecystitis causes right upper quadrant pain and tenderness, often with Murphy’s sign, due to gallbladder inflammation. Rebound tenderness in the right lower quadrant is not characteristic, as cholecystitis affects the upper abdomen, making this choice misaligned with the clinical finding.

Choice D reason: Diverticulitis typically causes left lower quadrant pain, as diverticula are common in the sigmoid colon. Right lower quadrant rebound tenderness is not a typical finding, as it suggests appendicitis instead, making this choice incorrect for the described gastrointestinal assessment finding.

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A 75-year-old male has problems initiating urine, emptying his bladder, and complains of dribbling. A digital rectal exam is performed, what does he likely have?

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Naxlex Comprehensive Predictor Exams

A patient experiencing burning while urinating, cloudy urine, and pain in their urethra can be experiencing signs and symptoms of:

Correct Answer is A

Explanation

During a gastrointestinal assessment, the nurse detects rebound tenderness in the right lower quadrant (RLQ). What does this finding most likely indicate?

Correct Answer is D

Explanation

Which of the following are reasons to conduct a health history using an interpreter? (Select all that apply)

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