A nurse is caring for a client who has benign prostatic hyperplasia (BPH). Which of the following findings should the nurse expect?

Choice A rationale Dysuria, or painful urination, is a common symptom in benign prostatic hyperplasia (BPH) due to the mechanical compression of the urethra by the enlarged prostate, which increases resistance to urine flow. This obstruction leads to bladder overdistention and subsequent irritation, often causing a burning sensation upon voiding as the bladder muscles strain against the increased outflow resistance. Choice B rationale Polyuria, characterized by abnormally frequent urination, especially at night (nocturia), is a hallmark of BPH resulting from bladder irritation and incomplete emptying. The residual urine reduces the functional bladder capacity, leading to more frequent urges to void, as the detrusor muscle senses distension at lower volumes, especially during periods of decreased fluid reabsorption at night. Choice C rationale While benign prostatic hyperplasia causes an increase in the total amount of prostate-specific antigen (PSA) produced, the levels are usually only mildly to moderately elevated (often 10 ng/mL or a very high rate of rise) are more suggestive of prostate cancer, not typically benign BPH, which involves non-malignant tissue proliferation. Choice D rationale Difficulty starting the flow of urine (hesitancy) is a classic lower urinary tract symptom (LUTS) in BPH caused by the mechanical narrowing of the prostatic urethra. The bladder detrusor muscle must generate significantly increased pressure to overcome this outflow obstruction, resulting in a delay between the sensation of needing to void and the actual initiation of the urine stream.