A 72-year-old man reports painful urination. What should the GNP assess for first?

In cases of painful urination, particularly in older adults, the most common and urgent cause to assess for first is a urinary tract infection (UTI). Older individuals, especially men, may not exhibit typical symptoms of UTIs, so the presentation of painful urination can be a significant indicator of this condition.

UTIs can result from various factors, including urinary retention, which may be influenced by an enlarged prostate. Given the patient's age, assessing for a UTI is critical because if diagnosed early, appropriate treatment can prevent complications, such as kidney infections or sepsis.

While other potential issues, such as an enlarged prostate, bladder cancer, or sexually transmitted infections (STIs), are also important considerations, they may not present as urgently or commonly as a UTI in this specific scenario. Thus, starting with an assessment for a urinary tract infection aligns with clinical practices focused on managing the most prevalent and treatable causes of urinary symptoms in the geriatric population.