A patient with urinary obstruction from benign prostatic hyperplasia (BPH) tells the nurse, "My symptoms are much worse this week." Which response by the nurse is most appropriate?
a. "Have you been taking any over-the-counter (OTC) medications recently?"
b. "I will talk to the doctor about ordering a prostate specific antigen (PSA) test."
c. "Have you talked to the doctor about surgery such as transurethral resection of the prostate (TURP)?"
d. "The prostate gland changes in size from day to day, and this may be making your symptoms worse."
ANS: A
Because the patient's increase in symptoms has occurred abruptly, the nurse should ask about OTC medications that might cause contraction of the smooth muscle in the prostate and worsen obstruction. The prostate gland does not vary in size from day to day. A TURP may be needed, but more assessment about possible reasons for the sudden symptom change is a more appropriate first response by the nurse. PSA testing is done to differentiate BPH from prostatic cancer.
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