A 78-year-old male client presents to the emergency department complaining of a history of urinary frequency and a weak urinary stream. Today he complains of extreme pain in the pelvic area. The client urinates 50 mL, and an immediate bladder scan shows a post-void residual urine measurement of 600 mL. The nurse recognizes these symptoms are most likely related to which condition?
Benign prostatic hyperplasia (BPH)
End stage renal disease (ESRD)
Pre-renal acute kidney injury (AKI)
Polycystic kidney disease (PKD)
The Correct Answer is A
A. BPH is a common condition in older men that causes the prostate gland to enlarge, obstructing the urethra and leading to difficulty urinating, urinary retention, and pelvic pain. The symptoms described, including urinary frequency, weak urinary stream, severe pelvic pain, and a significantly elevated post- void residual urine volume, are consistent with BPH.
B. ESRD can cause urinary symptoms. However, the presentation in this case is more consistent with a urinary obstruction, not a kidney failure issue. ESRD typically involves more systemic symptoms like fatigue, edema, and electrolyte imbalances.
C. This is unlikely given the patient's age and lack of significant comorbidities. Additionally, the primary issue appears to be urinary obstruction, not a decrease in renal perfusion.
D. This is a chronic condition that typically presents with flank pain, and it does not usually cause acute urinary retention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Patients with PKD may have issues with kidney function over time, which can affect potassium levels. Typically, a high-potassium diet is not recommended for those with kidney problems because it can exacerbate hyperkalemia.
B. Polycystic kidney disease can lead to progressive loss of kidney function, and many patients eventually require dialysis or a kidney transplant as the disease advances and kidney function declines.
C. There is no general recommendation for a vasectomy solely based on having PKD. While PKD is a genetic condition, and individuals with PKD can pass the condition on to their children, there is no requirement for men with PKD to undergo sterilization.
D. People with PKD are potential candidates for kidney transplantation if their kidney function deteriorates to the point where dialysis is required. PKD itself does not disqualify individuals from receiving a kidney transplant.
Correct Answer is B
Explanation
A. This is incorrect and potentially dangerous. A non-functioning fistula will not provide adequate blood flow for dialysis and can lead to complications.
B. This is the correct action. The nurse should immediately inform the healthcare provider about the compromised fistula. The provider can order further diagnostic tests or interventions as needed.
C. This might improve blood flow temporarily, but it is not a definitive solution and does not address the underlying issue.
D. While warm packs can sometimes improve circulation, it is unlikely to resolve the serious issues found in this case.
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