RUHS, Jaipur, PB B.Sc Nursing Entrance-2022
Medical & Surgical Nursing
Easy
Most common symptom of bladder cancer is -
Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2022
Explanation
- Painless hematuria (blood in the urine) is the initial manifestation of an underlying urinary tract cancer for most patients.
- It is the most common presenting symptom, occurring in about 80-90% of individuals with bladder cancer.
- The bleeding is caused by the fragile and abnormal blood vessels within the bladder tumor, which rupture easily.
- Unlike symptoms of a urinary tract infection, this hematuria is often painless.
Why Other Options Were Wrong
- Option A: Frequency of urination is an irritative symptom and, while it can occur with bladder cancer, it is not the most common presenting sign. It is more often associated with bladder irritation or a secondary urinary tract infection.
- Option B: Urgency, the sudden need to void, is another irritative symptom. It is not the most frequent initial complaint for bladder cancer compared to hematuria.
- Option D: Dysuria, or painful urination, is an uncommon primary symptom of bladder cancer. It is much more indicative of an inflammatory or infectious process.
Related Visual
Clinical Relevance
- Nursing practice connection: Knowing Symptomatology of Bladder Cancer helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
- A key nursing responsibility is to educate patients that any instance of hematuria, especially if painless, requires immediate medical evaluation to rule out malignancy. This is particularly crucial for high-risk individuals like smokers and older adults.
- Nurses play a vital role in risk factor modification, primarily by providing resources and support for smoking cessation, as tobacco use is the leading cause of bladder cancer.
- What if? If a patient presents with hematuria accompanied by severe flank pain and fever, the nurse's assessment should prioritize investigating for a complicated urinary tract infection, kidney stones, or an upper urinary tract obstruction, in addition to the possibility of bladder cancer.
How to Approach the Question
- First, identify the keywords in the question: 'Most common symptom' and 'bladder cancer'. This indicates the question is asking for the most frequent initial sign of this specific disease.
- Recall the classic clinical presentation of bladder cancer. The hallmark sign is often taught as 'painless hematuria'.
- Evaluate the given options: Frequency, Urgency, Hematuria, and Dysuria.
- Differentiate between the options. Recognize that frequency, urgency, and dysuria are general 'irritative' urinary symptoms that can be caused by many conditions, most commonly infections.
- Contrast these with hematuria, which is a more specific 'alarm' symptom for malignancy in the urinary tract.
- Conclude that painless hematuria is the most common and classic presenting symptom of bladder cancer, making it the correct answer.
Concept Tested & Keywords
- Concept Tested: Symptomatology of Bladder Cancer
- Stem keywords: bladder cancer, symptom
- Lead-in keywords: Most common
Question ID
QCeGKxSllgL9uiYlfgxbQ7
Reference Book
E6 Medicine Harrison 22e Part 1 p. 732-734
E6 Nursing Brunner Adult Health 3SA Vol 2 Part 1 p. 127-129
Practise the full RUHS, Jaipur, PB B.Sc Nursing Entrance-2022
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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