McCuistion: Pharmacology: A Patient-Centered Nursing Process Approach,
11th Edition
MULTIPLE CHOICE
1. A 25-year-old female patient reports urinary frequency with pain on urination, flank pain,
fever, and chills. The nurse recognizes these symptoms as characteristic of which
condition?
a. Cystitis
b. Dysuria
c. Pyelonephritis
d. Urethritis
ANS: C
These are symptoms of pyelonephritis, characterized by fever, dysuria, flank pain, and
urinary frequency.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing
Process: Assessment MSC: NCLEX: Physiological Integrity:
Pathophysiology
2. A male patient reports urinary urgency and pain with burning on urination. The nurse
understands that this patient will likely be treated for which condition?
a. Cystitis
b. Prostatitis
c. Pyelonephritis
d. Urethritis
ANS: B
In a male patient, a lower urinary tract infection is most likely prostatitis with
symptoms similar to cystitis, such as pain and burning on urination and urinary
frequency and urgency.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing
Process: Assessment MSC: NCLEX: Physiological Integrity:
Pathophysiology
3. The nurse is caring for a woman diagnosed with a urinary tract infection (UTI). The
patient reports always having difficulty remembering to take medications. Which drug
could the provider select when treating this patient to help with medication adherence due
to its efficacy as a single-dose treatment?
a. Fosfomycin tromethamine (Monurol)
b. Ciprofloxacin (Cipro)
, c. Nitrofurantoin (Macrodantin)
d. Trimethoprim-sulfamethoxazole (Bactrim)
ANS: A
Fosfomycin is given as a one-time, single dose and is approved for the treatment of
uncomplicated UTIs in women. Ciprofloxacin is given daily or twice a day.
Nitrofurantoin is given four times daily. Trimethoprim-sulfamethoxazole is given
twice daily.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process:
Planning MSC: NCLEX: Physiological Integrity:
Pharmacological and Parenteral Therapies
4. The nurse is caring for a hospitalized patient who has symptoms characteristic of
pyelonephritis. Before administering the first dose of the intravenous antibiotic, the nurse
will ensure that which action is performed?
a. An antipyretic is administered.
b. A dose of oral antibiotic is given.
c. A urinary analgesic is given.
d. A urine culture is obtained.
ANS: D
A urinalysis, as well as a culture and sensitivity, is usually performed before initiating
drug therapy. An antipyretic is indicated for fever but does not need to be timed
before the antibiotic. An oral antibiotic is not indicated. A urinary analgesic is given
as needed.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process:
Nursing Intervention MSC: NCLEX: Physiological Integrity:
Pharmacological and Parenteral Therapies
5. The nurse provides teaching for a patient who will begin taking nitrofurantoin
(Macrodantin) to treat a urinary tract infection. Which statement by the patient indicates
understanding of the teaching?
a. “If I experience gastrointestinal upset, I may take an antacid.”
b. “I should notify my provider immediately if my urine is brown.”
c. “I should take the drug with food and increase my fluid intake.”
d. “There is no need to worry or contact my physician if I have sudden onset of chest
pain.”
ANS: C
Patients taking nitrofurantoin should take the drug with food and increase fluid intake.
The drug should not be taken with antacids. Brown urine is a harmless side effect.
Patients should contact their health care provider if the experience sudden onset of
dyspnea, chest pain, cough, fever, and chills.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process:
, Nursing Intervention: Patient Teaching MSC: NCLEX:
Physiological Integrity: Pharmacological and Parenteral Therapies
6. The nurse is preparing to administer methenamine (Hiprex) to a patient who is diagnosed
with a urinary tract infection. The nurse reviews the patient’s chart and notes a urinary pH
of 6.0. Which action will the nurse take?
a. Administer the drug as ordered.
b. Obtain an order for 8 ounces of cranberry juice three times daily.
c. Request an order for an increased dose.
d. Restrict fluids to concentrate the patient’s urine.
ANS: B
Methenamine produces a bactericidal effect when the urine pH is less than 5.5.
Cranberry juice, ascorbic acid, or ammonium chloride can be administered to help to
acidify the urine.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process:
Nursing Intervention MSC: NCLEX: Physiological Integrity:
Pharmacological and Parenteral Therapies
7. Which side effect listed below is NOT associated with the urinary analgesic
phenazopyridine?
a. Renal dysfunction
b. Altered blood glucose testing results
c. Reddish-orange urine
d. Hemolytic anemia
ANS: B
Phenazopyridine can cause hemolytic anemia, renal and hepatic dysfunction, and a
harmless discoloration of the urine to a reddish orange colour. Phenazopyridine can
alter urine glucose testing, but does not affect blood glucose test results.
DIF: Cognitive Level: Remembering (Knowledge) TOP: Nursing
Process: Evaluation MSC: NCLEX: Physiological Integrity:
Pharmacological and Parenteral Therapies
8. A patient who has pain with urination associated with cystitis will be discharged home
with a prescription for phenazopyridine (Pyridium). What instruction will the nurse
include when teaching the patient about this drug?
a. “Do not take this drug concurrently with an antibiotic.”
b. “Report reddish-brown urine to the provider immediately.”
c. “This drug has antiseptic and analgesic properties.”
d. “The drug provides symptomatic relief of pain.”
ANS: D
Phenazopyridine is used to provide symptomatic pain relief. It may be taken with
11th Edition
MULTIPLE CHOICE
1. A 25-year-old female patient reports urinary frequency with pain on urination, flank pain,
fever, and chills. The nurse recognizes these symptoms as characteristic of which
condition?
a. Cystitis
b. Dysuria
c. Pyelonephritis
d. Urethritis
ANS: C
These are symptoms of pyelonephritis, characterized by fever, dysuria, flank pain, and
urinary frequency.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing
Process: Assessment MSC: NCLEX: Physiological Integrity:
Pathophysiology
2. A male patient reports urinary urgency and pain with burning on urination. The nurse
understands that this patient will likely be treated for which condition?
a. Cystitis
b. Prostatitis
c. Pyelonephritis
d. Urethritis
ANS: B
In a male patient, a lower urinary tract infection is most likely prostatitis with
symptoms similar to cystitis, such as pain and burning on urination and urinary
frequency and urgency.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing
Process: Assessment MSC: NCLEX: Physiological Integrity:
Pathophysiology
3. The nurse is caring for a woman diagnosed with a urinary tract infection (UTI). The
patient reports always having difficulty remembering to take medications. Which drug
could the provider select when treating this patient to help with medication adherence due
to its efficacy as a single-dose treatment?
a. Fosfomycin tromethamine (Monurol)
b. Ciprofloxacin (Cipro)
, c. Nitrofurantoin (Macrodantin)
d. Trimethoprim-sulfamethoxazole (Bactrim)
ANS: A
Fosfomycin is given as a one-time, single dose and is approved for the treatment of
uncomplicated UTIs in women. Ciprofloxacin is given daily or twice a day.
Nitrofurantoin is given four times daily. Trimethoprim-sulfamethoxazole is given
twice daily.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process:
Planning MSC: NCLEX: Physiological Integrity:
Pharmacological and Parenteral Therapies
4. The nurse is caring for a hospitalized patient who has symptoms characteristic of
pyelonephritis. Before administering the first dose of the intravenous antibiotic, the nurse
will ensure that which action is performed?
a. An antipyretic is administered.
b. A dose of oral antibiotic is given.
c. A urinary analgesic is given.
d. A urine culture is obtained.
ANS: D
A urinalysis, as well as a culture and sensitivity, is usually performed before initiating
drug therapy. An antipyretic is indicated for fever but does not need to be timed
before the antibiotic. An oral antibiotic is not indicated. A urinary analgesic is given
as needed.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process:
Nursing Intervention MSC: NCLEX: Physiological Integrity:
Pharmacological and Parenteral Therapies
5. The nurse provides teaching for a patient who will begin taking nitrofurantoin
(Macrodantin) to treat a urinary tract infection. Which statement by the patient indicates
understanding of the teaching?
a. “If I experience gastrointestinal upset, I may take an antacid.”
b. “I should notify my provider immediately if my urine is brown.”
c. “I should take the drug with food and increase my fluid intake.”
d. “There is no need to worry or contact my physician if I have sudden onset of chest
pain.”
ANS: C
Patients taking nitrofurantoin should take the drug with food and increase fluid intake.
The drug should not be taken with antacids. Brown urine is a harmless side effect.
Patients should contact their health care provider if the experience sudden onset of
dyspnea, chest pain, cough, fever, and chills.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process:
, Nursing Intervention: Patient Teaching MSC: NCLEX:
Physiological Integrity: Pharmacological and Parenteral Therapies
6. The nurse is preparing to administer methenamine (Hiprex) to a patient who is diagnosed
with a urinary tract infection. The nurse reviews the patient’s chart and notes a urinary pH
of 6.0. Which action will the nurse take?
a. Administer the drug as ordered.
b. Obtain an order for 8 ounces of cranberry juice three times daily.
c. Request an order for an increased dose.
d. Restrict fluids to concentrate the patient’s urine.
ANS: B
Methenamine produces a bactericidal effect when the urine pH is less than 5.5.
Cranberry juice, ascorbic acid, or ammonium chloride can be administered to help to
acidify the urine.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process:
Nursing Intervention MSC: NCLEX: Physiological Integrity:
Pharmacological and Parenteral Therapies
7. Which side effect listed below is NOT associated with the urinary analgesic
phenazopyridine?
a. Renal dysfunction
b. Altered blood glucose testing results
c. Reddish-orange urine
d. Hemolytic anemia
ANS: B
Phenazopyridine can cause hemolytic anemia, renal and hepatic dysfunction, and a
harmless discoloration of the urine to a reddish orange colour. Phenazopyridine can
alter urine glucose testing, but does not affect blood glucose test results.
DIF: Cognitive Level: Remembering (Knowledge) TOP: Nursing
Process: Evaluation MSC: NCLEX: Physiological Integrity:
Pharmacological and Parenteral Therapies
8. A patient who has pain with urination associated with cystitis will be discharged home
with a prescription for phenazopyridine (Pyridium). What instruction will the nurse
include when teaching the patient about this drug?
a. “Do not take this drug concurrently with an antibiotic.”
b. “Report reddish-brown urine to the provider immediately.”
c. “This drug has antiseptic and analgesic properties.”
d. “The drug provides symptomatic relief of pain.”
ANS: D
Phenazopyridine is used to provide symptomatic pain relief. It may be taken with
