Mr. Smart is an 80-year-old patient who goes to see his primary care physician for complaints of nocturia. What is the patient experiencing?
Painful urination.
Frequent urination at night.
Bladder incontinence.
An inability to void.
The Correct Answer is B
Choice A reason: Painful urination, or dysuria, involves discomfort during voiding, often due to urinary tract infections or inflammation. It is not synonymous with nocturia, which specifically refers to frequent nighttime urination. Dysuria requires distinct clinical evaluation, including urinalysis, to identify causes like bacterial infection or urethral irritation, making this an incorrect description of the patient’s complaint.
Choice B reason: Nocturia is the medical term for frequent urination at night, disrupting sleep. In elderly patients, it may result from reduced bladder capacity, overactive bladder, or conditions like benign prostatic hyperplasia. This matches the patient’s complaint, as it directly addresses the symptom without implying unrelated issues like pain or incontinence, making it the accurate choice.
Choice C reason: Bladder incontinence involves involuntary urine leakage, distinct from nocturia, which is voluntary urination at night. Incontinence may stem from neurological disorders or weakened pelvic muscles but does not describe the patient’s symptom of frequent nighttime voiding. This choice is incorrect, as it misaligns with the clinical presentation described.
Choice D reason: An inability to void, or urinary retention, is the opposite of nocturia, where the patient voids frequently. Retention may result from obstructions like an enlarged prostate or neurological issues, requiring catheterization or imaging for diagnosis. This choice does not reflect the patient’s symptom of active, frequent urination at night.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
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.
Correct Answer is A
Explanation
Choice A reason: Gender, while influencing health outcomes, is not a social determinant of health, which includes modifiable environmental and societal factors like income or housing. Gender is a biological and social characteristic, not an external condition shaping health access or outcomes, making it the correct answer.
Choice B reason: Physical environment, including housing, air quality, and access to green spaces, is a social determinant of health. It directly impacts health outcomes by influencing exposure to pollutants or access to safe living conditions, making it a valid factor in health disparities.
Choice C reason: Economic stability, encompassing income, employment, and financial security, is a social determinant of health. It affects access to healthcare, nutrition, and stress levels, significantly influencing health outcomes, making it a critical factor in public health frameworks.
Choice D reason: Access to health care, including availability of services and insurance, is a social determinant of health. It determines timely medical interventions and preventive care, directly affecting health outcomes, making it a key component in health equity discussions.
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