Which of the following symptoms is characteristic of urinary obstruction?
Nocturia
Frequent daytime voiding
Poor force of urinary stream
All the choices are correct
The Correct Answer is D
A. Nocturia, or the need to wake up during the night to urinate, is a common symptom of urinary obstruction, such as benign prostatic hyperplasia. Obstruction causes the bladder muscle to work harder, eventually leading to bladder wall thickening and increased sensitivity. This reduced functional capacity forces the patient to void more frequently, even during sleep hours.
B. Frequent daytime voiding occurs in obstructive states because the bladder often fails to empty completely due to the blockage. The residual urine volume means the bladder reaches its capacity much faster than normal. This leads to a persistent sensation of urgency and a high frequency of small-volume voids throughout the day to compensate for incomplete emptying.
C. Poor force of urinary stream is a direct mechanical consequence of an obstruction narrowing the urethral lumen. As the resistance to flow increases, the velocity and trajectory of the urine decrease, resulting in a weak or hesitant stream. This is one of the most specific obstructive symptoms reported by patients with lower urinary tract blockage.
D. All the choices are correct because urinary obstruction creates a constellation of storage and voiding symptoms known as lower urinary tract symptoms (LUTS). The combination of mechanical blockage and the secondary changes in bladder physiology leads to nocturia, frequency, and a diminished stream. Recognizing this group of symptoms is essential for diagnosing conditions like urethral strictures or prostatic enlargement.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. While a decreased residual volume can occur in restrictive lung disease, it is not the defining diagnostic criterion used to differentiate it from obstructive patterns. The FVC and TLC reductions are the primary indicators of a loss of lung compliance or thoracic expansion. RV changes are variable and depend on the specific underlying etiology of the restriction.
B. A decreased FEV1/FVC ratio is the hallmark of obstructive lung diseases, such as asthma or chronic obstructive pulmonary disease. In these conditions, air trapping leads to a disproportionate reduction in expiratory flow compared to volume. This ratio indicates an increased resistance to airflow, which is the physiological opposite of pure restrictive lung disease.
C. In restrictive lung disease, the FEV1 and FVC both decrease proportionally, which results in a normal or even slightly elevated ratio. This occurs because the lung tissue is stiff or the chest wall movement is limited, but the airways remain patent. This pattern confirms that the primary pathology involves reduced lung volumes rather than airway obstruction.
D. Restrictive lung disease is fundamentally defined by a reduction in total lung capacity below the 80 percent predicted value. A normal TLC would effectively rule out a restrictive diagnosis, as it indicates the lungs can still achieve their full physiological volume. Identifying a normal TLC suggests that any reduction in FVC is likely due to other factors.
Correct Answer is D
Explanation
A. Blood glucose levels are essential for monitoring diabetes mellitus, which is a leading cause of renal failure, but they do not measure kidney function. High glucose levels indicate poor metabolic control rather than the degree of nephron loss or filtration impairment. They are an indirect risk factor rather than a diagnostic tool for renal staging.
B. Urinary pH and specific gravity provide information about the concentration of urine and the kidney's ability to acidify it, but they are non-specific. These values fluctuate significantly based on hydration status and diet and do not quantify the glomerular filtration rate. They are used for general screening rather than assessing the severity of CKD.
C. Blood urea nitrogen (BUN) levels reflect the concentration of urea in the blood, but they are heavily influenced by diet, protein intake, and hydration. While BUN typically rises in renal failure, it is not as reliable or specific as creatinine for calculating filtration capacity. It is considered a secondary marker in the assessment of renal health.
D. Serum creatinine and the estimated glomerular filtration rate (eGFR) are the primary clinical standards used to diagnose and stage chronic kidney disease. Creatinine is a metabolic byproduct excreted almost entirely by glomerular filtration, making it a reliable marker. The eGFR provides a numerical value that directly correlates with the percentage of remaining kidney function.
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