NURS 601 Pharmacology Renal Urinary Meds Questions and Answers- University of San Francisco
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NURS 601 Pharmacology Renal Urinary Meds Questions and Answers- University of San Francisco/NURS 601 Pharmacology Renal Urinary Meds Questions and Answers- University of San Francisco/NURS 601 Pharmacology Renal Urinary Meds Questions and Answers- University of San Francisco/NURS 601 Pharmacology R...
nurs 601 pharmacology renal urinary meds questions and answers university of san francisconurs 601 pharmacology renal urinary meds questions and answers university of san francisconurs 601 pharmac
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KEY:
All un-highlighted questions are required for Patho-Pharm 1
Red Text = Should Understand
Green Text = Absolutely Should Know
Yellow Highlight = Patho-Pharm 2 Material (Skip in Patho-Pharm 1)
Blue Highlight = Skip (In both Patho-Pharm 1 & 2)
Renal and Urinary Medications
1. A client who has a cold is seen in the emergency department with an inability to void.
Because the client has a history of benign prostatic hyperplasia, the nurse determines that the
client should be questioned about the use of which medication?
Rationale: In the client with benign prostatic hyperplasia, episodes of urinary retention can be
triggered by certain medications, such as decongestants, anticholinergics, and antidepressants.
These medications lessen the voluntary ability to contract the bladder. The client should be
questioned about the use of these medications if he has urinary retention. Diuretics increase
urine output. Antibiotics and antlipemics do not affect ability to urinate.
2. Nitrofurantoin is prescribed for a client with a urinary tract infection. The client contacts the
nurse and reports a cough, chills, fever, and difficulty breathing. The nurse should make which
interpretation about the client's complaints?
1. The client may have contracted the flu.
2. The client is experiencing anaphylaxis.
3. The client is experiencing expected effects of the medication.
4. The client is experiencing a pulmonary reaction requiring cessation of the medication.
Correct answer: 4
Rationale: Nitrofurantoin can induce 2 kinds of pulmonary reactions: acute and subacute. Acute
reactions, which are most common, manifest with dyspnea, chest pain, chills, fever, cough, and
alveolar infiltrates. These symptoms resolve 2 to 4 days after discontinuing the medication.
Acute pulmonary responses are thought to be hypersensitivity reactions. Subacute reactions are
,rare and occur during prolonged treatment. Symptoms (e.g., dyspnea, cough, malaise) usually
regress over weeks to months following nitrofurantoin withdrawal. However, in some clients,
permanent lung damage may occur. The remaining options are incorrect interpretations.
3. The nurse is providing discharge instructions to a client receiving trimethoprim-
sulfamethoxazole. Which instruction should be included in the list?
1. Advise that sunscreen is not needed.
2. Drink 8 to 10 glasses of water per day.
3. If the urine turns dark brown, call the health care provider (HCP) immediately.
4. Decrease the dosage when symptoms are improving to prevent an allergic response.
Correct answer: 2
Rationale: Each dose of trimethoprim-sulfamethoxazole should be administered with a full glass
of water, and the client should maintain a high fluid intake to avoid crystalluria. The medication
is more soluble in alkaline urine. The client should not be instructed to taper or discontinue the
dose. Clients should be advised to use sunscreen since the skin becomes sensitive to the sun.
Some forms of trimethoprim-sulfamethoxazole cause urine to turn dark brown or red. This does
not indicate the need to notify the HCP.
4. Trimethoprim-sulfamethoxazole is prescribed for a client. The nurse should instruct the client
to report which symptom if it develops during the course of this medication therapy?
1. Nausea
2. Diarrhea
3. Headache
4. Sore throat
Correct answer: 4
Rationale: Clients taking trimethoprim-sulfamethoxazole should be informed about early signs
and symptoms of blood disorders that can occur from this medication. These include sore
throat, fever, and pallor, and the client should be instructed to notify the health care provider
(HCP) if these occur. The other options do not require HCP notification.
5. Phenazopyridine is prescribed for a client with a urinary tract infection. The nurse evaluates
that the medication is effective based on which observation?
1. Urine is clear amber.
2. Urination is not painful.
3. Urge incontinence is not present.
4. A reddish-orange discoloration of the urine is present.
, Correct answer: 2
Rationale: Phenazopyridine is a urinary analgesic. It is effective when it eliminates pain and
burning with urination. It does not eliminate the bacteria causing the infection, so it would not
make the urine clear amber. It does not treat urge incontinence. It will cause the client to have
reddish-orange discoloration of urine but this is a side effect of the medication, not the desired
effect.
6. Bethanechol chloride is prescribed for a client with urinary retention. Which disorder would
be a contraindication to the administration of this medication?
Rationale: Bethanechol chloride can be hazardous to clients with urinary tract obstruction or
weakness of the bladder wall. The medication has the ability to contract the bladder and
thereby increase pressure within the urinary tract. Elevation of pressure within the urinary tract
could damage or rupture the bladder in clients with these conditions.
7. The nurse, who is administering bethanechol chloride, is monitoring for cholinergic overdose
associated with the medication. The nurse should check the client for which sign of overdose?
Rationale: Cholinergic overdose of bethanechol chloride produces manifestations of excessive
muscarinic stimulation such as salivation, sweating, involuntary urination and defecation,
bradycardia, and severe hypotension. Remember that the sympathetic nervous system speeds
the heart rate and the cholinergic (parasympathetic) nervous system slows the heart rate.
Treatment includes supportive measures and the administration of atropine sulfate
(anticholinergic) subcutaneously or intravenously.
8. Oxybutynin chloride is prescribed for a client with urge incontinence. Which sign would
indicate a possible toxic effect related to this medication?
1. Pallor
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