NCLEX Prep II Renal and Urinary Medications Chapter 59 Test Questions with
Answers Rated A
4.Subcutaneously
Parenteral bethanechol chloride is prescribed for a client
with urinary retention. The nurse should plan to adminis-
Rationale:
ter this medication by which route?
The injectable form of bethanechol chloride is intended
for subcutaneous administration only. Bethanechol must
1. Intravenously
never be injected intramuscularly or intravenously be-
2. Intradermally
cause the resulting high medication level can cause severe
3. Intramuscularly
toxicity, resulting in bloody diarrhea, bradycardia, pro-
4. Subcutaneously
found hypotension, and cardiovascular collapse.
4.Tell the client that this is a harmless medication side
A client taking metronidazole telephones the home health
ettect.
nurse to report dark discoloration to the urine. The nurse
interprets that the client's complaint warrants which nurs-
Rationale:
ing action at this time?
Harmless darkening of the urine may occur, and the client
should be told of this ettect. Metronidazole can produce a
1. Instruct the client to increase fluid intake.
variety of side ettects, but they rarely require termination
2. Tell the client to discontinue the medication.
of treatment. Increasing fluid intake is a good health mea-
3. Instruct the client to call the health care provider (HCP).
sure but will not prevent this side ettect from occurring. It
4. Tell the client that this is a harmless medication side
is not necessary to discontinue the medication or call the
ettect.
HCP.
4.Overactive bladder
A client is receiving oxybutynin. The nurse should suspect
Rationale:
that this medication is prescribed to relieve which condi-
When medication therapy for overactive bladder is indi-
tion?
cated, anticholinergic agents are the medications gener-
ally prescribed. These medications block muscarinic re-
1. Gastritis
ceptors on the bladder detrusor and thereby inhibit blad-
2. Renal calculi
der contractions and decrease the urge to void. It is not
3. Ulcerative colitis
used to treat gastritis. The medication would not be used
4. Overactive bladder
to treat renal calculi or ulcerative colitis. In fact, it may make
those conditions worse.
,NCLEX Prep II Renal and Urinary Medications Chapter 59 Test Questions with
Answers Rated A
The nurse is taking care of a client receiving oxybutynin. 4.Dry mouth
Which finding should the nurse expect to note if the client
develops side or adverse ettects of this medication? Rationale:
Oxybutynin is an anticholinergic. Anticholinergic side ef-
1. Itching fects include dry mouth, constipation, tachycardia, urinary
2. Diarrhea hesitancy, urinary retention, mydriasis, blurred vision, and
3. Swelling dry eyes. Itching, diarrhea, and swelling are not associated
4. Dry mouth with this medication.
3.Bradycardia
The nurse, who is administering bethanechol chloride, is
Rationale:
monitoring for cholinergic overdose associated with the
Cholinergic overdose of bethanechol chloride produces
medication. The nurse should check the client for which
manifestations of excessive muscarinic stimulation such as
sign of overdose?
salivation, sweating, involuntary urination and defecation,
bradycardia, and severe hypotension. Remember that the
1. Dry skin
sympathetic nervous system speeds the heart rate and
2. Dry mouth
the cholinergic (parasympathetic) nervous system slows
3. Bradycardia
the heart rate. Treatment includes supportive measures
4. Signs of dehydration
and the administration of atropine sulfate (anticholiner-
gic) subcutaneously or intravenously.
Tamsulosin hydrochloride is prescribed for a client. The 3.Urinary obstruction
nurse should suspect that this medication is prescribed to
relieve which condition? Rationale:
Tamsulosin hydrochloride is used to relieve mild to mod-
1. Constipation erate manifestations that occur in benign prostatic hyper-
2. Muscle spasms trophy. The medication also improves urinary flow rates.
3. Urinary obstruction This medication is not used to treat constipation, muscle
4. Respiratory congestion spasms, or respiratory congestion.
2.Drink 8 to 10 glasses of water per day.
The nurse is providing discharge instructions to a client
receiving trimethoprim-sulfamethoxazole. Which instruc-
Rationale:
,NCLEX Prep II Renal and Urinary Medications Chapter 59 Test Questions with
Answers Rated A
Each dose of trimethoprim-sulfamethoxazole should be
tion should be included in the list?
administered with a full glass of water, and the client
should maintain a high fluid intake to avoid crystalluria.
1. Advise that sunscreen is not needed.
The medication is more soluble in alkaline urine. The client
2. Drink 8 to 10 glasses of water per day.
should not be instructed to taper or discontinue the dose.
3. If the urine turns dark brown, call the health care
Clients should be advised to use sunscreen since the skin
provider (HCP) immediately.
becomes sensitive to the sun. Some forms of trimetho-
4. Decrease the dosage when symptoms are improving to
prim-sulfamethoxazole cause urine to turn dark brown or
prevent an allergic response.
red. This does not indicate the need to notify the HCP.
The nurse is administering a dose of a prescribed diuretic 1. Bumetanide
to an assigned client. The nurse should monitor the client
for hypokalemia as a side ettect of therapy if the client has Rationale:
been receiving which medication? Bumetanide is a loop diuretic that places the client at risk
for hypokalemia. The nurse would monitor this client care-
1. Bumetanide fully for signs of hypokalemia, monitor serum potassium
2. Triamterene levels, and encourage intake of high-potassium foods. The
3. Amiloride HCl other medications listed are potassium-retaining diuret-
4. Spironolactone ics.
Trimethoprim-sulfamethoxazole is prescribed to be ad- 2. Over 60 to 90 minutes
ministered by intravenous infusion to a client with a re-
current urinary tract infection. How should the nurse ad- Rationale:
minister this medication? Trimethoprim-sulfamethoxazole may be administered by
1.Over 30 minutes 2.Over 60 to 90 minutes 3.Piggybacked intravenous infusion but should not be mixed with
into the peripheral line containing parenteral nutrition any other medications or solutions. Trimethoprim-sul-
4.Piggybacked into the existing infusion of normal saline famethoxazole is infused over 60 to 90 minutes, and bolus
and potassium chloride infusions or rapid infusions must be avoided.
2. Scallops
The home health nurse is caring for a client who is taking
probenecid. The client has been instructed to restrict the
Rationale:
diet to low-purine foods. Which food item should the
Probenecid is a medication used for clients with gout to
nurse instruct the client to avoid?
inhibit the reabsorption of uric acid by the kidneys and
Answers Rated A
4.Subcutaneously
Parenteral bethanechol chloride is prescribed for a client
with urinary retention. The nurse should plan to adminis-
Rationale:
ter this medication by which route?
The injectable form of bethanechol chloride is intended
for subcutaneous administration only. Bethanechol must
1. Intravenously
never be injected intramuscularly or intravenously be-
2. Intradermally
cause the resulting high medication level can cause severe
3. Intramuscularly
toxicity, resulting in bloody diarrhea, bradycardia, pro-
4. Subcutaneously
found hypotension, and cardiovascular collapse.
4.Tell the client that this is a harmless medication side
A client taking metronidazole telephones the home health
ettect.
nurse to report dark discoloration to the urine. The nurse
interprets that the client's complaint warrants which nurs-
Rationale:
ing action at this time?
Harmless darkening of the urine may occur, and the client
should be told of this ettect. Metronidazole can produce a
1. Instruct the client to increase fluid intake.
variety of side ettects, but they rarely require termination
2. Tell the client to discontinue the medication.
of treatment. Increasing fluid intake is a good health mea-
3. Instruct the client to call the health care provider (HCP).
sure but will not prevent this side ettect from occurring. It
4. Tell the client that this is a harmless medication side
is not necessary to discontinue the medication or call the
ettect.
HCP.
4.Overactive bladder
A client is receiving oxybutynin. The nurse should suspect
Rationale:
that this medication is prescribed to relieve which condi-
When medication therapy for overactive bladder is indi-
tion?
cated, anticholinergic agents are the medications gener-
ally prescribed. These medications block muscarinic re-
1. Gastritis
ceptors on the bladder detrusor and thereby inhibit blad-
2. Renal calculi
der contractions and decrease the urge to void. It is not
3. Ulcerative colitis
used to treat gastritis. The medication would not be used
4. Overactive bladder
to treat renal calculi or ulcerative colitis. In fact, it may make
those conditions worse.
,NCLEX Prep II Renal and Urinary Medications Chapter 59 Test Questions with
Answers Rated A
The nurse is taking care of a client receiving oxybutynin. 4.Dry mouth
Which finding should the nurse expect to note if the client
develops side or adverse ettects of this medication? Rationale:
Oxybutynin is an anticholinergic. Anticholinergic side ef-
1. Itching fects include dry mouth, constipation, tachycardia, urinary
2. Diarrhea hesitancy, urinary retention, mydriasis, blurred vision, and
3. Swelling dry eyes. Itching, diarrhea, and swelling are not associated
4. Dry mouth with this medication.
3.Bradycardia
The nurse, who is administering bethanechol chloride, is
Rationale:
monitoring for cholinergic overdose associated with the
Cholinergic overdose of bethanechol chloride produces
medication. The nurse should check the client for which
manifestations of excessive muscarinic stimulation such as
sign of overdose?
salivation, sweating, involuntary urination and defecation,
bradycardia, and severe hypotension. Remember that the
1. Dry skin
sympathetic nervous system speeds the heart rate and
2. Dry mouth
the cholinergic (parasympathetic) nervous system slows
3. Bradycardia
the heart rate. Treatment includes supportive measures
4. Signs of dehydration
and the administration of atropine sulfate (anticholiner-
gic) subcutaneously or intravenously.
Tamsulosin hydrochloride is prescribed for a client. The 3.Urinary obstruction
nurse should suspect that this medication is prescribed to
relieve which condition? Rationale:
Tamsulosin hydrochloride is used to relieve mild to mod-
1. Constipation erate manifestations that occur in benign prostatic hyper-
2. Muscle spasms trophy. The medication also improves urinary flow rates.
3. Urinary obstruction This medication is not used to treat constipation, muscle
4. Respiratory congestion spasms, or respiratory congestion.
2.Drink 8 to 10 glasses of water per day.
The nurse is providing discharge instructions to a client
receiving trimethoprim-sulfamethoxazole. Which instruc-
Rationale:
,NCLEX Prep II Renal and Urinary Medications Chapter 59 Test Questions with
Answers Rated A
Each dose of trimethoprim-sulfamethoxazole should be
tion should be included in the list?
administered with a full glass of water, and the client
should maintain a high fluid intake to avoid crystalluria.
1. Advise that sunscreen is not needed.
The medication is more soluble in alkaline urine. The client
2. Drink 8 to 10 glasses of water per day.
should not be instructed to taper or discontinue the dose.
3. If the urine turns dark brown, call the health care
Clients should be advised to use sunscreen since the skin
provider (HCP) immediately.
becomes sensitive to the sun. Some forms of trimetho-
4. Decrease the dosage when symptoms are improving to
prim-sulfamethoxazole cause urine to turn dark brown or
prevent an allergic response.
red. This does not indicate the need to notify the HCP.
The nurse is administering a dose of a prescribed diuretic 1. Bumetanide
to an assigned client. The nurse should monitor the client
for hypokalemia as a side ettect of therapy if the client has Rationale:
been receiving which medication? Bumetanide is a loop diuretic that places the client at risk
for hypokalemia. The nurse would monitor this client care-
1. Bumetanide fully for signs of hypokalemia, monitor serum potassium
2. Triamterene levels, and encourage intake of high-potassium foods. The
3. Amiloride HCl other medications listed are potassium-retaining diuret-
4. Spironolactone ics.
Trimethoprim-sulfamethoxazole is prescribed to be ad- 2. Over 60 to 90 minutes
ministered by intravenous infusion to a client with a re-
current urinary tract infection. How should the nurse ad- Rationale:
minister this medication? Trimethoprim-sulfamethoxazole may be administered by
1.Over 30 minutes 2.Over 60 to 90 minutes 3.Piggybacked intravenous infusion but should not be mixed with
into the peripheral line containing parenteral nutrition any other medications or solutions. Trimethoprim-sul-
4.Piggybacked into the existing infusion of normal saline famethoxazole is infused over 60 to 90 minutes, and bolus
and potassium chloride infusions or rapid infusions must be avoided.
2. Scallops
The home health nurse is caring for a client who is taking
probenecid. The client has been instructed to restrict the
Rationale:
diet to low-purine foods. Which food item should the
Probenecid is a medication used for clients with gout to
nurse instruct the client to avoid?
inhibit the reabsorption of uric acid by the kidneys and
