NCLEX-RN Pharmacology Reproductive &
Genitourinary System Practice Exam |
20 Original NGN-Style MCQs with Rationales
Question 1
Clinical Scenario
A 68-year-old male patient with benign prostatic hyperplasia
(BPH) and a history of hypertension is admitted to the medical-
surgical unit with acute urinary retention. The patient has been
taking tamsulosin 0.4 mg daily for the past 6 months. His
current vital signs are blood pressure 142/88 mmHg, heart rate
88 bpm, respiratory rate 18/min, and temperature 37.0°C
(98.6°F). The nurse notes that the patient's morning dose of
tamsulosin was administered 2 hours ago. The healthcare
provider orders a straight catheterization to relieve the
retention and then restart the patient on his home medications.
Question Stem
,Which action should the nurse prioritize before catheterizing
this patient?
A. Administer the patient's prescribed antihypertensive
medication first
B. Assess the patient's post-void residual volume with a bladder
scanner
C. Place the patient in a high-Fowler's position to promote
voiding
D. Review the patient's medication administration record for
alpha-blocker administration
Correct Answer: B. Assess the patient's post-void residual
volume with a bladder scanner
Detailed Rationale
The correct answer is B. Before performing a straight
catheterization, the nurse should first assess the post-void
residual (PVR) volume using a bladder scanner. This non-
invasive assessment confirms the presence of significant urinary
retention and provides objective data about bladder volume. A
bladder scanner is the standard of care for assessing urinary
retention before invasive catheterization, as it prevents
unnecessary catheterizations and reduces the risk of catheter-
associated urinary tract infections (CAUTIs).
Option A is incorrect because administering antihypertensive
medication without assessing the current blood pressure and
,the patient's response to tamsulosin could lead to hypotension.
Tamsulosin, an alpha-1 blocker, has antihypertensive effects and
can cause orthostatic hypotension, particularly in older adults.
The nurse should assess vital signs before administering any
additional medications.
Option C is incorrect because while positioning may help some
patients void, this patient has acute urinary retention that has
not resolved with his usual medication. High-Fowler's position
may assist with voiding in some cases, but it is not the priority
action when the patient has already failed to void despite being
on tamsulosin therapy.
Option D is incorrect because reviewing the MAR is important
but should have been done at the beginning of the shift or
before medication administration. While it is valuable to
confirm that tamsulosin was administered, the priority is to
assess the patient's current bladder status using non-invasive
technology.
Learning Objective
After completing this question, the learner should be able to:
• Prioritize nursing assessments before invasive procedures
• Identify appropriate use of bladder scanning technology
• Recognize the importance of non-invasive assessment
before catheterization
, Medication Safety Focus
Medication administration and nursing assessment
Question 2
Clinical Scenario
A 32-year-old female patient who is 28 weeks pregnant
presents to the obstetric clinic with complaints of painful,
burning urination and urinary frequency for the past 2 days. She
reports no fever, flank pain, or nausea. Her urinalysis reveals
positive leukocyte esterase and nitrites. The healthcare provider
prescribes nitrofurantoin 100 mg twice daily for 7 days. The
patient asks the nurse if this medication is safe for her baby.
Question Stem
Which response by the nurse is most appropriate?
A. "This medication should be avoided during pregnancy due to
teratogenic effects"
B. "This medication is contraindicated in pregnancy because it
crosses the placenta"
C. "This medication is safe to use during pregnancy but should
be avoided near term"
D. "This medication is completely safe throughout all stages of
pregnancy"
Genitourinary System Practice Exam |
20 Original NGN-Style MCQs with Rationales
Question 1
Clinical Scenario
A 68-year-old male patient with benign prostatic hyperplasia
(BPH) and a history of hypertension is admitted to the medical-
surgical unit with acute urinary retention. The patient has been
taking tamsulosin 0.4 mg daily for the past 6 months. His
current vital signs are blood pressure 142/88 mmHg, heart rate
88 bpm, respiratory rate 18/min, and temperature 37.0°C
(98.6°F). The nurse notes that the patient's morning dose of
tamsulosin was administered 2 hours ago. The healthcare
provider orders a straight catheterization to relieve the
retention and then restart the patient on his home medications.
Question Stem
,Which action should the nurse prioritize before catheterizing
this patient?
A. Administer the patient's prescribed antihypertensive
medication first
B. Assess the patient's post-void residual volume with a bladder
scanner
C. Place the patient in a high-Fowler's position to promote
voiding
D. Review the patient's medication administration record for
alpha-blocker administration
Correct Answer: B. Assess the patient's post-void residual
volume with a bladder scanner
Detailed Rationale
The correct answer is B. Before performing a straight
catheterization, the nurse should first assess the post-void
residual (PVR) volume using a bladder scanner. This non-
invasive assessment confirms the presence of significant urinary
retention and provides objective data about bladder volume. A
bladder scanner is the standard of care for assessing urinary
retention before invasive catheterization, as it prevents
unnecessary catheterizations and reduces the risk of catheter-
associated urinary tract infections (CAUTIs).
Option A is incorrect because administering antihypertensive
medication without assessing the current blood pressure and
,the patient's response to tamsulosin could lead to hypotension.
Tamsulosin, an alpha-1 blocker, has antihypertensive effects and
can cause orthostatic hypotension, particularly in older adults.
The nurse should assess vital signs before administering any
additional medications.
Option C is incorrect because while positioning may help some
patients void, this patient has acute urinary retention that has
not resolved with his usual medication. High-Fowler's position
may assist with voiding in some cases, but it is not the priority
action when the patient has already failed to void despite being
on tamsulosin therapy.
Option D is incorrect because reviewing the MAR is important
but should have been done at the beginning of the shift or
before medication administration. While it is valuable to
confirm that tamsulosin was administered, the priority is to
assess the patient's current bladder status using non-invasive
technology.
Learning Objective
After completing this question, the learner should be able to:
• Prioritize nursing assessments before invasive procedures
• Identify appropriate use of bladder scanning technology
• Recognize the importance of non-invasive assessment
before catheterization
, Medication Safety Focus
Medication administration and nursing assessment
Question 2
Clinical Scenario
A 32-year-old female patient who is 28 weeks pregnant
presents to the obstetric clinic with complaints of painful,
burning urination and urinary frequency for the past 2 days. She
reports no fever, flank pain, or nausea. Her urinalysis reveals
positive leukocyte esterase and nitrites. The healthcare provider
prescribes nitrofurantoin 100 mg twice daily for 7 days. The
patient asks the nurse if this medication is safe for her baby.
Question Stem
Which response by the nurse is most appropriate?
A. "This medication should be avoided during pregnancy due to
teratogenic effects"
B. "This medication is contraindicated in pregnancy because it
crosses the placenta"
C. "This medication is safe to use during pregnancy but should
be avoided near term"
D. "This medication is completely safe throughout all stages of
pregnancy"
