1. The clinic nurse is admitting a 39-year-old woman who has come to the clinic
complaining of left-sided tenderness, fever, chills, and flank pain. What does the
nurse suspect the patient has?
a. Cystitis
b. Kidney stones
c. Neurogenic bladder
d. Pyelonephritis
Ans: D
Feedback:
The fever and chills indicate an inflammatory process. Flank pain and left-sided
tenderness indicate kidney swelling within the capsule. These symptoms indicate
pyelonephritis. Kidney stones cause intense pain; fever and chills would not be
present. Cystitis and neurogenic bladder present with bladder-related symptoms such
as frequency, urgency, burning, and bloating.
2. The nurse is caring for four patients. Which patient would flavoxate (Urispas), a
urinary tract medication, be indicated for?
a. A 1-year-old girl
b. A 6-year-old boy
c. A 10-year-old boy
d. A 14-year-old girl
Ans: D
Feedback:
Flavoxate prevents smooth muscle spasm in the urinary tract and can be given to
children older than 12 years of age. Oxybutynin and phenazopyridine may be given to
children 6 years old and older. Guidelines for use of an antispasmodic for a child
younger than 6 have not been established.
3. The nurse is discussing the effects of doxazosin (Cardura) with a 65-year-old man
who has just been diagnosed with benign prostatic hyperplasia (BPH). The patient
asks the nurse whether the drug will make him impotent. After the discussion with
the patient, the nurse determines that a potential priority nursing diagnosis could be
what?
a. Sexual dysfunction related to adverse effects
b. Deficient knowledge regarding drug therapy
, c. Noncompliance with drug therapy related to adverse effects
d. Acute pain related to adverse effects
Ans: C
Feedback:
The patient is concerned about his ability to perform sexually. Sexual dysfunction is a
possible adverse effect and would be a concern for this patient. However, he has not
started taking the drug. The nurse is concerned about noncompliance because of the
possibility of this adverse effect. This is an important part of a man’s life and most
men would not want to take medication that would cause sexual dysfunction.
Headache is an adverse effect of drugs used for BPH, but it can be tolerated and
treated with an analgesic. Deficient knowledge about the drug is a concern, but
usually men who know that sexual dysfunction is a possible adverse effect of a drug
will find out all they can about the drug. Acute pain is not related to this drug.
4. A businesswoman who is leaving on a business trip the next day tells the nurse she
knows she has cystitis and does not want to have to mess with medicine while she
is gone. What drug would be a good choice for this patient?
a. Fosfomycin (Monurol)
b. Methenamine (Hiprex)
c. Nitrofurantoin (Furadantin)
d. Norfloxacin (Noroxin)
Ans: A
Feedback:
Fosfomycin would be a good choice for this patient because it has the convenience of
a single dose. Methenamine is taken either twice a day or up to four times a day. This
drug could interfere with the patient’s busy schedule. Nitrofurantoin is also prescribed
four times a day and would also be inconvenient for the patient. Norfloxacin is taken
every 12 hours and could be inconvenient as well.
5. The nurse is performing patient teaching about the urinary anti-infective
methenamine (Hiprex). What information is most important for the nurse to share
with this patient?
a. Limit fluid intake.
b. Drink orange juice once a day.
c. Take the medication with food.
d. Take the medication at night before going to bed.
Ans: C
Feedback:
The patient should take the medication with food to decrease GI adverse effects. The
nurse would encourage the patient to increase fluid intake to flush the bladder and
urinary tract frequently and decrease the opportunity for bacteria growth. Orange juice