NCLEX-RN Pharmacology Practice Questions:
Reproductive & Genitourinary System |
20 Original ATI & NGN-Style MCQs with Detailed
Rationales, Clinical Judgment, Medication Safety,
Nursing Exam Review
Question 1
Clinical Scenario
A 28-year-old female (G2P1, 38 weeks gestation) is admitted to
the labor and delivery unit for labor induction due to
gestational hypertension. The nurse initiates an intravenous
infusion of oxytocin. Two hours after starting the infusion, the
nurse notes that contractions are occurring every 1.5 to 2
minutes, lasting 90 seconds, and the fetal heart rate (FHR)
tracing displays late decelerations with a baseline of 110 bpm
and decreased variability.
Question Stem
Which priority action should the nurse take first?
,A. Increase the primary IV fluid rate.
B. Stop the oxytocin infusion immediately.
C. Administer oxygen at 8–10 L/min via non-rebreather mask.
D. Reposition the client onto her left side.
Correct Answer
Correct Answer: B. Stop the oxytocin infusion immediately.
Detailed Rationale
Oxytocin is a high-alert hormone used to stimulate uterine
contractions. Uterine tachysystole (defined as more than 5
contractions in 10 minutes, or contractions occurring every 1.5–
2 minutes lasting longer than 90 seconds) compromises
uteroplacental blood flow during contractions. Late
decelerations and decreased variability indicate fetal hypoxia
and distress secondary to placental insufficiency. The nurse's
first priority in managing uterine tachysystole with non-
reassuring fetal heart patterns is to stop the exogenous
stimulating agent (oxytocin) to allow the uterus to relax and
restore oxygenation to the fetus.
After stopping the infusion, the nurse should reposition the
client to her left side to relieve vena cava compression, increase
the primary IV fluids (a non-medicated IV solution) to boost
placental perfusion, and administer oxygen via non-rebreather
mask at 8 to 10 L/min. While all these interventions
,(intrauterine resuscitation) are appropriate, stopping the
oxytocin directly eliminates the cause of excessive uterine
stimulation and is the mandatory first step.
• A is incorrect: Increasing primary IV fluids helps increase
blood volume and perfusion, but leaving oxytocin running
will continue to cause uterine hyperstimulation and fetal
hypoxia.
• C is incorrect: Supplemental oxygen provides additional
oxygenation to the fetus, but it is ineffective if uterine
hypertonicity continues to impede placental blood flow.
• D is incorrect: Repositioning reduces inferior vena cava
compression and improves venous return, but removing
the offending drug (oxytocin) must occur first.
Learning Objective
After completing this question, the learner should be able to:
• Recognize signs of oxytocin-induced uterine tachysystole
and fetal distress.
• Prioritize emergency nursing actions for high-alert
medications used in labor and delivery.
• Execute intrauterine resuscitation protocols systematically.
Medication Safety Focus
High-alert medication / Adverse effect
, Question 2
Clinical Scenario
A 68-year-old male with a history of benign prostatic
hyperplasia (BPH) and hypertension presents to the clinic
complaining of urinary frequency, hesitancy, and weak stream.
The healthcare provider prescribes tamsulosin 0.4 mg orally
once daily.
Question Stem
Which instruction is most important for the nurse to include
when teaching the client about taking tamsulosin?
A. Take the medication on an empty stomach at least 1 hour
before breakfast.
B. Change positions slowly when rising from a sitting or lying
position.
C. Limit fluid intake to less than 1,000 mL per day while taking
this drug.
D. Crushing or chewing the capsule will help speed up drug
absorption.
Correct Answer
Correct Answer: B. Change positions slowly when rising from a
sitting or lying position.
Detailed Rationale
Reproductive & Genitourinary System |
20 Original ATI & NGN-Style MCQs with Detailed
Rationales, Clinical Judgment, Medication Safety,
Nursing Exam Review
Question 1
Clinical Scenario
A 28-year-old female (G2P1, 38 weeks gestation) is admitted to
the labor and delivery unit for labor induction due to
gestational hypertension. The nurse initiates an intravenous
infusion of oxytocin. Two hours after starting the infusion, the
nurse notes that contractions are occurring every 1.5 to 2
minutes, lasting 90 seconds, and the fetal heart rate (FHR)
tracing displays late decelerations with a baseline of 110 bpm
and decreased variability.
Question Stem
Which priority action should the nurse take first?
,A. Increase the primary IV fluid rate.
B. Stop the oxytocin infusion immediately.
C. Administer oxygen at 8–10 L/min via non-rebreather mask.
D. Reposition the client onto her left side.
Correct Answer
Correct Answer: B. Stop the oxytocin infusion immediately.
Detailed Rationale
Oxytocin is a high-alert hormone used to stimulate uterine
contractions. Uterine tachysystole (defined as more than 5
contractions in 10 minutes, or contractions occurring every 1.5–
2 minutes lasting longer than 90 seconds) compromises
uteroplacental blood flow during contractions. Late
decelerations and decreased variability indicate fetal hypoxia
and distress secondary to placental insufficiency. The nurse's
first priority in managing uterine tachysystole with non-
reassuring fetal heart patterns is to stop the exogenous
stimulating agent (oxytocin) to allow the uterus to relax and
restore oxygenation to the fetus.
After stopping the infusion, the nurse should reposition the
client to her left side to relieve vena cava compression, increase
the primary IV fluids (a non-medicated IV solution) to boost
placental perfusion, and administer oxygen via non-rebreather
mask at 8 to 10 L/min. While all these interventions
,(intrauterine resuscitation) are appropriate, stopping the
oxytocin directly eliminates the cause of excessive uterine
stimulation and is the mandatory first step.
• A is incorrect: Increasing primary IV fluids helps increase
blood volume and perfusion, but leaving oxytocin running
will continue to cause uterine hyperstimulation and fetal
hypoxia.
• C is incorrect: Supplemental oxygen provides additional
oxygenation to the fetus, but it is ineffective if uterine
hypertonicity continues to impede placental blood flow.
• D is incorrect: Repositioning reduces inferior vena cava
compression and improves venous return, but removing
the offending drug (oxytocin) must occur first.
Learning Objective
After completing this question, the learner should be able to:
• Recognize signs of oxytocin-induced uterine tachysystole
and fetal distress.
• Prioritize emergency nursing actions for high-alert
medications used in labor and delivery.
• Execute intrauterine resuscitation protocols systematically.
Medication Safety Focus
High-alert medication / Adverse effect
, Question 2
Clinical Scenario
A 68-year-old male with a history of benign prostatic
hyperplasia (BPH) and hypertension presents to the clinic
complaining of urinary frequency, hesitancy, and weak stream.
The healthcare provider prescribes tamsulosin 0.4 mg orally
once daily.
Question Stem
Which instruction is most important for the nurse to include
when teaching the client about taking tamsulosin?
A. Take the medication on an empty stomach at least 1 hour
before breakfast.
B. Change positions slowly when rising from a sitting or lying
position.
C. Limit fluid intake to less than 1,000 mL per day while taking
this drug.
D. Crushing or chewing the capsule will help speed up drug
absorption.
Correct Answer
Correct Answer: B. Change positions slowly when rising from a
sitting or lying position.
Detailed Rationale
