NCLEX-RN Pharmacology Reproductive &
Genitourinary System Practice Exam | 20 Original
NGN-Style MCQs with Detailed Rationales | ATI-
Inspired Nursing Study Gude
Question 1
Clinical Scenario
A 24-year-old client is prescribed nitrofurantoin for an
uncomplicated urinary tract infection. The nurse is providing
discharge teaching. The client asks how to take the medication.
Question Stem
Which instruction should the nurse include?
A. Take the medication on an empty stomach.
B. Take the medication with meals.
C. Stop taking the medication when symptoms improve.
D. Avoid drinking fluids while taking the medication.
Correct Answer: B. Take the medication with meals.
,Detailed Rationale
Nitrofurantoin should be taken with food or milk to enhance
absorption and reduce gastrointestinal irritation such as
nausea. This is an important patient teaching point because
adherence improves when side effects are minimized. Clients
should also complete the full prescribed course even if
symptoms resolve early.
Option A is incorrect because taking nitrofurantoin on an empty
stomach may increase gastrointestinal upset. Option C is
incorrect because stopping the antibiotic early can lead to
incomplete eradication of the infection and antibiotic
resistance. Option D is incorrect because clients with urinary
tract infections should generally maintain adequate hydration
unless contraindicated.
Nurses should also teach clients that nitrofurantoin may cause
harmless brown discoloration of the urine. Monitoring for
improvement in urinary symptoms and signs of adverse
reactions, such as pulmonary symptoms or peripheral
neuropathy with long-term use, is also important.
Learning Objective
• Teach correct administration of nitrofurantoin.
• Identify strategies to reduce gastrointestinal side effects.
• Reinforce the importance of completing antibiotic therapy.
,Medication Safety Focus
Patient education
Question 2
Clinical Scenario
A 68-year-old male client is prescribed tamsulosin for benign
prostatic hyperplasia (BPH). The client reports feeling dizzy
when getting out of bed in the morning.
Question Stem
Which nursing instruction is most appropriate?
A. Take the medication only at bedtime.
B. Increase fluid intake rapidly when dizziness occurs.
C. Rise slowly from lying or sitting positions.
D. Skip the medication if dizziness occurs.
Correct Answer: C. Rise slowly from lying or sitting positions.
Detailed Rationale
Tamsulosin is an alpha-1 adrenergic blocker that relaxes smooth
muscle in the prostate and bladder neck to improve urine flow.
A common adverse effect is orthostatic hypotension, especially
when therapy is initiated. Clients should be instructed to
change positions slowly to reduce the risk of dizziness, falls, and
injury.
, Option A is incorrect because although the first dose may be
taken at bedtime in some cases, the key safety teaching is slow
position changes. Option B is incorrect because rapidly
increasing fluids will not immediately correct orthostatic
hypotension and may not be safe for all clients. Option D is
incorrect because the client should not stop the medication
without consulting the healthcare provider.
Older adults are at increased risk for falls related to
antihypertensive effects. The nurse should assess blood
pressure, particularly when changing positions, and reinforce
fall prevention strategies.
Learning Objective
• Recognize orthostatic hypotension as an adverse effect of
tamsulosin.
• Provide fall-prevention education.
• Teach safe position changes.
Medication Safety Focus
Adverse effect
Question 3
Clinical Scenario
Genitourinary System Practice Exam | 20 Original
NGN-Style MCQs with Detailed Rationales | ATI-
Inspired Nursing Study Gude
Question 1
Clinical Scenario
A 24-year-old client is prescribed nitrofurantoin for an
uncomplicated urinary tract infection. The nurse is providing
discharge teaching. The client asks how to take the medication.
Question Stem
Which instruction should the nurse include?
A. Take the medication on an empty stomach.
B. Take the medication with meals.
C. Stop taking the medication when symptoms improve.
D. Avoid drinking fluids while taking the medication.
Correct Answer: B. Take the medication with meals.
,Detailed Rationale
Nitrofurantoin should be taken with food or milk to enhance
absorption and reduce gastrointestinal irritation such as
nausea. This is an important patient teaching point because
adherence improves when side effects are minimized. Clients
should also complete the full prescribed course even if
symptoms resolve early.
Option A is incorrect because taking nitrofurantoin on an empty
stomach may increase gastrointestinal upset. Option C is
incorrect because stopping the antibiotic early can lead to
incomplete eradication of the infection and antibiotic
resistance. Option D is incorrect because clients with urinary
tract infections should generally maintain adequate hydration
unless contraindicated.
Nurses should also teach clients that nitrofurantoin may cause
harmless brown discoloration of the urine. Monitoring for
improvement in urinary symptoms and signs of adverse
reactions, such as pulmonary symptoms or peripheral
neuropathy with long-term use, is also important.
Learning Objective
• Teach correct administration of nitrofurantoin.
• Identify strategies to reduce gastrointestinal side effects.
• Reinforce the importance of completing antibiotic therapy.
,Medication Safety Focus
Patient education
Question 2
Clinical Scenario
A 68-year-old male client is prescribed tamsulosin for benign
prostatic hyperplasia (BPH). The client reports feeling dizzy
when getting out of bed in the morning.
Question Stem
Which nursing instruction is most appropriate?
A. Take the medication only at bedtime.
B. Increase fluid intake rapidly when dizziness occurs.
C. Rise slowly from lying or sitting positions.
D. Skip the medication if dizziness occurs.
Correct Answer: C. Rise slowly from lying or sitting positions.
Detailed Rationale
Tamsulosin is an alpha-1 adrenergic blocker that relaxes smooth
muscle in the prostate and bladder neck to improve urine flow.
A common adverse effect is orthostatic hypotension, especially
when therapy is initiated. Clients should be instructed to
change positions slowly to reduce the risk of dizziness, falls, and
injury.
, Option A is incorrect because although the first dose may be
taken at bedtime in some cases, the key safety teaching is slow
position changes. Option B is incorrect because rapidly
increasing fluids will not immediately correct orthostatic
hypotension and may not be safe for all clients. Option D is
incorrect because the client should not stop the medication
without consulting the healthcare provider.
Older adults are at increased risk for falls related to
antihypertensive effects. The nurse should assess blood
pressure, particularly when changing positions, and reinforce
fall prevention strategies.
Learning Objective
• Recognize orthostatic hypotension as an adverse effect of
tamsulosin.
• Provide fall-prevention education.
• Teach safe position changes.
Medication Safety Focus
Adverse effect
Question 3
Clinical Scenario
