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NCLEX-Pharmacology - Renal and Urinary / practice for hesi questions and answers
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NCLEX-Pharmacology - Renal and Urinary / practice for hesi questions and answers
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NCLEX-Pharmacology-
Renal
and
Urinary
/
practice
for
hesi
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?
-
ANSWER-Decongestants
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?
-
ANSWER-The
client
is
experiencing
a
pulmonary
reaction
requiring
cessation
of
the
medication.
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.
The
nurse
is
providing
discharge
instructions
to
a
client
receiving
trimethoprim-sulfamethoxazole.
Which
instruction
should
be
included
in
the
list?
-
ANSWER-Drink
8
to
10
glasses
of
water
per
day.
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
PHCP.
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?
-
ANSWER-Sore
throat
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
primary
health
care
provider
(PHCP)
if
these
occur.
The
other
options
do
not
require
PHCP
notification.
Phenazopyridine
is
prescribed
for
a
client
with
a
urinary
tract
infection.
The
nurse
evaluates
that
the
medication
is
effective
based
on
which
observation?
-
ANSWER-Urination
is
not
painful.
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.
Bethanechol
chloride
is
prescribed
for
a
client
with
urinary
retention.
Which
disorder
would
be
a
contraindication
to
the
administration
of
this
medication?
-
ANSWER-Urinary
strictures
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.
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