Pharmacology and the Nursing
Process
10th Edition
• Author(s)Linda Lane Lilley;
Shelly Rainforth Collins; Julie
S. Snyder
TEST BANK
,Question 1: Multiple-Choice Question (MCQ)
Clinical Scenario: A 68-year-old male with a history of benign
prostatic hyperplasia (BPH) and chronic stable angina is
prescribed prazosin to manage severe lower urinary tract
symptoms (LUTS).
Question Stem: Which physiological assessment finding should
the home health nurse prioritize as an unintended
pharmacodynamic effect during the initial titration phase of this
medication?
• A. Reflex bradycardia secondary to peripheral
vasoconstriction.
• B. First-dose orthostatic hypotension secondary to alpha-1
adrenergic blockade.
• C. Acute urinary retention due to detrusor muscle
relaxation.
• D. Paroxysmal hypertension during periods of emotional
stress.
Correct Answer: B
Comprehensive Rationale
Prazosin is a selective alpha-1 adrenergic antagonist. By
blocking alpha-1 receptors on vascular smooth muscle, it
induces peripheral vasodilation, which lowers blood pressure. It
,also relaxes smooth muscle in the bladder neck and prostate,
reducing urinary resistance in BPH. However, a well-
documented adverse effect of selective alpha-1 blockers is the
"first-dose phenomenon," characterized by profound
orthostatic hypotension and syncope occurring within 30 to 90
minutes of the initial dose.
Distractor Analysis
• A is incorrect: Alpha-1 blockade causes vasodilation, not
vasoconstriction. This drop in systemic vascular resistance
can trigger a compensatory reflex tachycardia, not
bradycardia.
• C is incorrect: Alpha-1 antagonists relieve urinary retention
by relaxing the bladder neck; they do not cause retention.
• D is incorrect: The drug lowers blood pressure; paroxysmal
hypertension is not an expected or plausible adverse effect
of an alpha-blocker.
Nursing Process & Clinical Judgment
• Primary Nursing Process: Assessment
• NCJMM Competency: Analyze Cues
• Difficulty Level: Moderate
• Bloom's Taxonomy: Analyze
, • NCLEX Client Needs: Pharmacological and Parenteral
Therapies
• Key Learning Objective: Identify the safe administration
parameters, hemodynamic effects, and patient-safety
considerations associated with alpha-1 adrenergic
antagonists.
Question 2: Select-All-That-Apply (SATA)
Clinical Scenario: A nurse is reviewing the morning laboratory
results for a 54-year-old patient diagnosed with chronic heart
failure who is receiving digoxin 0.125 mg PO daily and
furosemide 40 mg PO daily. The patient’s potassium level is
reported as 3.1 mEq/L (3.1 mmol/L), and the digoxin level is 1.4
ng/mL (1.8 nmol/L).
Question Stem: Which clinical manifestations or nursing
interventions are highly relevant to this specific
pharmacotherapeutic situation? Select all that apply.
• [ ] A. Assess the patient for visual disturbances such as
green-yellow halos or blurred vision.
• [ ] B. Administer the scheduled morning dose of
furosemide immediately to prevent fluid volume overload.
• [ ] C. Request an order for an electrocardiogram (ECG) to
monitor for prolonged PR intervals or ventricular ectopy.
Process
10th Edition
• Author(s)Linda Lane Lilley;
Shelly Rainforth Collins; Julie
S. Snyder
TEST BANK
,Question 1: Multiple-Choice Question (MCQ)
Clinical Scenario: A 68-year-old male with a history of benign
prostatic hyperplasia (BPH) and chronic stable angina is
prescribed prazosin to manage severe lower urinary tract
symptoms (LUTS).
Question Stem: Which physiological assessment finding should
the home health nurse prioritize as an unintended
pharmacodynamic effect during the initial titration phase of this
medication?
• A. Reflex bradycardia secondary to peripheral
vasoconstriction.
• B. First-dose orthostatic hypotension secondary to alpha-1
adrenergic blockade.
• C. Acute urinary retention due to detrusor muscle
relaxation.
• D. Paroxysmal hypertension during periods of emotional
stress.
Correct Answer: B
Comprehensive Rationale
Prazosin is a selective alpha-1 adrenergic antagonist. By
blocking alpha-1 receptors on vascular smooth muscle, it
induces peripheral vasodilation, which lowers blood pressure. It
,also relaxes smooth muscle in the bladder neck and prostate,
reducing urinary resistance in BPH. However, a well-
documented adverse effect of selective alpha-1 blockers is the
"first-dose phenomenon," characterized by profound
orthostatic hypotension and syncope occurring within 30 to 90
minutes of the initial dose.
Distractor Analysis
• A is incorrect: Alpha-1 blockade causes vasodilation, not
vasoconstriction. This drop in systemic vascular resistance
can trigger a compensatory reflex tachycardia, not
bradycardia.
• C is incorrect: Alpha-1 antagonists relieve urinary retention
by relaxing the bladder neck; they do not cause retention.
• D is incorrect: The drug lowers blood pressure; paroxysmal
hypertension is not an expected or plausible adverse effect
of an alpha-blocker.
Nursing Process & Clinical Judgment
• Primary Nursing Process: Assessment
• NCJMM Competency: Analyze Cues
• Difficulty Level: Moderate
• Bloom's Taxonomy: Analyze
, • NCLEX Client Needs: Pharmacological and Parenteral
Therapies
• Key Learning Objective: Identify the safe administration
parameters, hemodynamic effects, and patient-safety
considerations associated with alpha-1 adrenergic
antagonists.
Question 2: Select-All-That-Apply (SATA)
Clinical Scenario: A nurse is reviewing the morning laboratory
results for a 54-year-old patient diagnosed with chronic heart
failure who is receiving digoxin 0.125 mg PO daily and
furosemide 40 mg PO daily. The patient’s potassium level is
reported as 3.1 mEq/L (3.1 mmol/L), and the digoxin level is 1.4
ng/mL (1.8 nmol/L).
Question Stem: Which clinical manifestations or nursing
interventions are highly relevant to this specific
pharmacotherapeutic situation? Select all that apply.
• [ ] A. Assess the patient for visual disturbances such as
green-yellow halos or blurred vision.
• [ ] B. Administer the scheduled morning dose of
furosemide immediately to prevent fluid volume overload.
• [ ] C. Request an order for an electrocardiogram (ECG) to
monitor for prolonged PR intervals or ventricular ectopy.
