Lehne's Pharmacology for Nursing
Care
12th Edition
• Author(s)Jacqueline Rosenjack
Burchum; Laura D. Rosenthal
,TEST BANK
Question Bank
Question 1
Type: MCQ
Clinical Scenario: A nurse is caring for a 68-year-old patient with
a history of glaucoma and benign prostatic hyperplasia (BPH).
The provider prescribes tamsulosin (Flomax) 0.4 mg daily for
the BPH.
Question Stem: Which assessment finding would be the highest
priority for the nurse to evaluate before administering this
medication?
Answer Options:
A. Blood pressure
B. Intraocular pressure
C. Serum creatinine level
D. Urinary output
Correct Answer: A. Blood pressure
Detailed Rationale: Tamsulosin is a selective alpha-1 adrenergic
antagonist. While it is effective for BPH by relaxing smooth
muscle in the prostate and bladder neck, it also causes
,peripheral vasodilation. The most significant and immediate risk
associated with this vasodilation is orthostatic hypotension,
particularly in older adults. Therefore, assessing blood pressure
and monitoring for hypotension are critical nursing priorities to
prevent falls and injury. While tamsulosin has little effect on
intraocular pressure and does not affect serum creatinine
directly, the immediate safety concern is the potent
vasodilatory effect.
Incorrect Option Analysis:
• Why It Is Incorrect: Intraocular pressure (B) is not the
primary immediate concern with tamsulosin as it is with
non-selective alpha blockers.
o Common Clinical Misconception: The student may
associate all "alpha-blockers" with the same side
effect profile (e.g., lowering IOP).
o Potential Medication Safety Risk: Missing the risk of
severe orthostatic hypotension could lead to patient
falls.
o Appropriate Nursing Consideration: Patients taking
tamsulosin should be advised to rise slowly from a
sitting or lying position.
• Why It Is Incorrect: Serum creatinine (C) is not a direct
concern for this medication's immediate safety.
, o Common Clinical Misconception: Believing that all
kidney-related medications require a BUN/Cr check
before administration.
o Potential Medication Safety Risk: Wasting time on a
less relevant lab value while the patient is at risk for a
fall.
o Appropriate Nursing Consideration: A baseline renal
function is standard but not the highest priority.
• Why It Is Incorrect: Urinary output (D) is an expected
outcome of the therapy but not an immediate safety risk
before the first dose.
o Common Clinical Misconception: Focusing on the
therapeutic endpoint rather than the potential
adverse effect.
o Potential Medication Safety Risk: Administering the
drug without knowing the baseline BP, leading to a
hypotensive episode.
o Appropriate Nursing Consideration: Monitoring
urinary output is for evaluating therapeutic
effectiveness, not for pre-administration safety.
Nursing Process Linkage: Assessment
Clinical Judgment Competencies (NCJMM): Recognize Cues,
Analyze Cues
Care
12th Edition
• Author(s)Jacqueline Rosenjack
Burchum; Laura D. Rosenthal
,TEST BANK
Question Bank
Question 1
Type: MCQ
Clinical Scenario: A nurse is caring for a 68-year-old patient with
a history of glaucoma and benign prostatic hyperplasia (BPH).
The provider prescribes tamsulosin (Flomax) 0.4 mg daily for
the BPH.
Question Stem: Which assessment finding would be the highest
priority for the nurse to evaluate before administering this
medication?
Answer Options:
A. Blood pressure
B. Intraocular pressure
C. Serum creatinine level
D. Urinary output
Correct Answer: A. Blood pressure
Detailed Rationale: Tamsulosin is a selective alpha-1 adrenergic
antagonist. While it is effective for BPH by relaxing smooth
muscle in the prostate and bladder neck, it also causes
,peripheral vasodilation. The most significant and immediate risk
associated with this vasodilation is orthostatic hypotension,
particularly in older adults. Therefore, assessing blood pressure
and monitoring for hypotension are critical nursing priorities to
prevent falls and injury. While tamsulosin has little effect on
intraocular pressure and does not affect serum creatinine
directly, the immediate safety concern is the potent
vasodilatory effect.
Incorrect Option Analysis:
• Why It Is Incorrect: Intraocular pressure (B) is not the
primary immediate concern with tamsulosin as it is with
non-selective alpha blockers.
o Common Clinical Misconception: The student may
associate all "alpha-blockers" with the same side
effect profile (e.g., lowering IOP).
o Potential Medication Safety Risk: Missing the risk of
severe orthostatic hypotension could lead to patient
falls.
o Appropriate Nursing Consideration: Patients taking
tamsulosin should be advised to rise slowly from a
sitting or lying position.
• Why It Is Incorrect: Serum creatinine (C) is not a direct
concern for this medication's immediate safety.
, o Common Clinical Misconception: Believing that all
kidney-related medications require a BUN/Cr check
before administration.
o Potential Medication Safety Risk: Wasting time on a
less relevant lab value while the patient is at risk for a
fall.
o Appropriate Nursing Consideration: A baseline renal
function is standard but not the highest priority.
• Why It Is Incorrect: Urinary output (D) is an expected
outcome of the therapy but not an immediate safety risk
before the first dose.
o Common Clinical Misconception: Focusing on the
therapeutic endpoint rather than the potential
adverse effect.
o Potential Medication Safety Risk: Administering the
drug without knowing the baseline BP, leading to a
hypotensive episode.
o Appropriate Nursing Consideration: Monitoring
urinary output is for evaluating therapeutic
effectiveness, not for pre-administration safety.
Nursing Process Linkage: Assessment
Clinical Judgment Competencies (NCJMM): Recognize Cues,
Analyze Cues
