Upon palpation, the nurse notices that the bladder is firm and distended; the patient expresses an urge to urinate. Which question is $\mathbf{most}$ appropriate?

A) "Does your urinary problem interfere with any activities?"
B) "Do you lose urine when you cough or sneeze?"
C) "When was the last time you voided?"
D) "Are you experiencing a fever or chills?"

To obtain an accurate assessment, the nurse should first determine the source of the discomfort. Urinary retention causes the bladder to be firm and distended; time of last void is most appropriate. Further assessment to determine the pathology of the condition can be performed later. Questions concerning fever and chills, interference with any activities, and losing urine during coughing or sneezing focus on specific pathological conditions.