NURS 317 Unit 1 Chapter 52 Pharm Point Questions Flashcards
When explaining the action of terazosin to a client, what would the nurse include?
A) Interferes with DNA replication
B) Inhibits testosterone production
C) Blocks alpha1-adrenergic receptors
D) Adheres to the mucosal membrane of the urethra acting as a buffer
C) Blocks alpha1-adrenergic receptors
Rationale:Terazosin is an alpha1-adrenergic blocker. Urinary anti-infectives, such as norfloxacin, interfere with DNA replication in susceptible gram-negative bacteria, leading to cell death. Dutasteride blocks testosterone production by inhibiting the intracellular enzyme that converts testosterone to a potent androgen, DHT, which the prostate gland depends on for its development and maintenance. Pentosan, a urinary bladder protectant, acts as a buffer to control cell permeability.
The nurse is caring for a pregnant woman who has cystitis. What drug does the nurse anticipate being prescribed for this client?
A) Nitrofurantoin
B) Fosfomycin
C) Methylene blue
D) Methenamine
B) Fosfomycin
Rationale:Fosfomycin may be the drug of choice for cystitis during pregnancy or lactation because of the short exposure to the drug. (It is effective as a one-time dose.) Methenamine, methylene blue, and nitrofurantoin cross the placenta and enter breast milk and would not be appropriate choices for treatment of cystitis in pregnant and lactating women.
A group of students are reviewing the contraindications for the use of urinary tract antispasmodics. The students demonstrate the need for additional review when they identify what as a contraindication?
A) Myasthenia gravis
B) Glaucoma
C) Obstructive uropathy
D) Anticoagulant therapy
D) Anticoagulant therapy
Rationale:Anticoagulant therapy would be a contraindication for the use of pentosan because of the drug’s heparin-like effects. Myasthenia gravis is a contraindication for use of antispasmodics due to the anticholinergic effect of these drugs. Obstructive uropathy is a contraindication for the use of antispasmodics because the condition could be further aggravated by the blocking of muscle activity. Glaucoma is a contraindication for the use of antispasmodics because the condition could be exacerbated by the anticholinergic effects of the drugs.
When teaching a client who is to receive fosfomycin, the nurse would include what as possible adverse effects? Select all that apply.
A) Stained skin
B) Diaphoresis
C) Dizziness
D) Headache
E) Nausea
F) Fatigue
C) Dizziness
D) Headache
E) Nausea
Rationale:Nausea is a common adverse effect of fosfomycin. Dizziness is an adverse effect of fosfomycin. Headache is a common adverse effect of fosfomycin. Fatigue is not associated with the use of fosfomycin. Diaphoresis is not associated with the use of fosfomycin. Skin staining is an adverse effect associated with methylene blue
A client who is taking phenazopyridine has called the client to report “rusty” urine. What is the nurse’s best action?
A) Have the client withhold the next scheduled dose pending assessment.
B) Inform the client that this is an expected adverse effect.
C) Instruct the client to present to the emergency department.
D) Collaborate with the provider to arrange laboratory testing.
B) Inform the client that this is an expected adverse effect.
Rationale:Phenazopyridine can change the urine color to reddish-brown. This does not constitute hematuria and does not likely warrant follow-up.
What would the nurse identify as a drug that blocks testosterone production to relieve the symptoms of benign prostatic hypertrophy?
A) Tamsulosin
B) Doxazosin
C) Finasteride
D) Terazosin
C) Finasteride
Rationale:Finasteride blocks testosterone production to treat the symptoms of BPH. The other drugs are alpha-adrenergic blockers used to treat the symptoms of BPH.
A client has been diagnosed with a urinary tract infection and tells the nurse, “I suppose I should have been drinking more cranberry juice.” What is the nurse’s best response?
A) “Actually, media reports about the effect of cranberry juice on UTIs have been proven to be wrong.”
B) “Drinking three 8-oz glasses of cranberry juice each day can reduce your risk of UTIs by up to one-third.”
C) “Drinking three 8-oz glasses of cranberry juice each day can reduce your risk of UTIs by up to 50%.”
D) “The benefits of cranberry juice are not fully understood, but it’s certainly not harmful.”
D) “The benefits of cranberry juice are not fully understood, but it’s certainly not harmful.”
Rationale:There are conflicting research findings about the benefits of cranberry juice and its effects on UTIs. It has not been shown to be wholly ineffective, however.
The nurse is caring for a client who is receiving pentosan polysulfate sodium. The nurse is aware that this medication is prescribed for what condition?
A) Pyelonephritis
B) Dysuria
C) Interstitial cystitis
D) Cystitis
C) Interstitial cystitis
Rationale:Pentosan polysulfate sodium is used specifically to decrease the pain and discomfort associated with interstitial cystitis. Pyelonephritis and cystitis must be treated with an anti-infective agent. Pentosan polysulfate sodium adheres to the bladder wall mucosal membrane and acts as a buffer to control cell permeability, preventing irritating solutes in the urine from reaching the bladder wall cells. Dysuria is treated with a urinary tract analgesic.
The nurse is caring for a client who has a urinary tract infection. What laboratory tests does the nurse expect will be ordered for this client? Select all that apply.
A) Liver function tests
B) Urine culture and sensitivity
C) Urinalysis
D) Sodium level
E) Potassium level
A) Liver function tests
B) Urine culture and sensitivity
C) Urinalysis
Rationale:The laboratory tests that would be ordered include a urinalysis, urine culture and sensitivity, and renal and hepatic function tests. Potassium and sodium levels would not routinely be ordered for a client with a UTI.
A client is to receive methenamine. The nurse anticipates administering this drug by which route?
A) Oral
B) Intramuscular
C) Subcutaneous
D) Intravenous
A) Oral
Rationale:Methenamine is administered orally, not subcutaneously, intramuscularly, or intravenously.
A client with a UTI is receiving a urinary tract anti-infective and phenazopyridine. What nursing action is priority?
A) Caution client that drug is a dye and urine may be reddish brown.
B) Confirm that the client will not take phenazopyridine for more than 2 days.
C) Ensure the client has liver function testing performed.
D) Instruct client to take phenazopyridine with food.
B) Confirm that the client will not take phenazopyridine for more than 2 days.
Rationale:The risk of toxic effects of phenazopyridine increases if it is combined with antibacterial agents used for treating UTIs. When used, phenazopyridine should not be used for longer than 2 days. Laboratory testing should be performed but reducing the risk of toxicity is higher priority. The client should be educated that taking phenazopyridine with food can help alleviate gastrointestinal upset and that phenazopyridine is a dye that turns urine a reddish brown color. This education, however, is not as high a priority as reducing the risk of toxicity.
The nurse has administered a scheduled dose of tolterodine to a client. What outcome would indicate successful therapy?
A) Reduction in the size of the client’s prostate
B) Absence of incontinence, frequency, or urgency
C) Urine output of at least 1.5 L/d
D) Negative urine culture and sensitivity results
B) Absence of incontinence, frequency, or urgency
Rationale:Tolterodine is a bladder antispasmodic. As a result, success of therapy would be determined by the resumption of normal bladder function. It does not treat infection, BPH, or oliguria.
What actions would the nurse teach the client who is taking tamsulosin to do to assist with adverse effects of this medication? Select all that apply.
A) Take medication with food.
B) Change positions slowly.
C) Expect severe headaches unrelieved by pain medications.
D) Refrain from sexual intercourse until the medication is no longer being used.
E) Return for scheduled laboratory tests.
A) Take medication with food.
B) Change positions slowly.
E) Return for scheduled laboratory tests.
Rationale:Tamsulosin is an alpha-adrenergic blocker, which can cause lowered blood pressure, so the client should be taught to change positions slowly. The medication may cause GI upset so it may be taken with food. The client should be counseled to return for scheduled laboratory tests such as urinalysis and PSA. The client may experience a headache, but it can be relieved by analgesics. This medication can cause a decrease in sexual functioning, but there is no need to refrain from sexual intercourse.
What would a nurse expect to be prescribed for a client experiencing bladder spasms?
A) Oxybutynin
B) Phenazopyridine
C) Nitrofurantoin
D) Alfuzosin
A) Oxybutynin
Rationale:Oxybutynin is a urinary antispasmodic used to treat bladder spasms. Nitrofurantoin is a urinary tract anti-infective used to treat UTIs. Phenazopyridine is a urinary tract analgesic used for symptomatic relief of discomforts associated with urinary tract trauma or infection. Alfuzosin is an alpha-adrenergic blocker used for relief of symptoms of BPH.
The nurse is discharging a client who is going home with a prescription for nitrofurantoin. What must the client understand about this medication before going home? Select all that apply.
A) Take the medication until all of the pills are gone.
B) Call the physician if confusion occurs.
C) Take the medication with orange juice.
D) Keep taking the medication as prescribed even if symptoms improve.
E) Try to limit urination to three times a day.
A) Take the medication until all of the pills are gone.
B) Call the physician if confusion occurs.
D) Keep taking the medication as prescribed even if symptoms improve.
Rationale:It is important for the client to understand the drug name, dosage, intended and adverse effects, when to call the doctor, and schedule for administration. It is important that the client understands that the medication must be taken until it is all gone. The client should avoid orange juice because it can produce alkaline urine, and the client should increase fluids and void frequently to promote flushing of the bladder and prevent urinary stasis.
