NCLEX-RN Pharmacology Practice Exam:
Reproductive & Genitourinary System |
20 ATI-Style Questions with Detailed
Rationales
Question 1
Clinical Scenario
A 28-year-old female is prescribed combined oral contraceptive
pills (ethinyl estradiol/norethindrone). During a follow-up visit,
she reports smoking one pack of cigarettes daily. She asks
whether smoking affects her medication.
Question Stem
Which response by the nurse is most appropriate?
A. Smoking does not affect oral contraceptive therapy.
B. Smoking increases the risk of serious cardiovascular
complications while taking oral contraceptives.
,C. Smoking decreases the effectiveness of oral contraceptives
but has no other effects.
D. Smoking prevents estrogen-related adverse effects.
Correct Answer
Correct Answer: B. Smoking increases the risk of serious
cardiovascular complications while taking oral contraceptives.
Detailed Rationale
Combined oral contraceptives contain estrogen, which
increases the risk of thromboembolic events. Smoking further
elevates the risk of myocardial infarction, stroke, deep vein
thrombosis, and pulmonary embolism, especially in women
older than 35 years. Patient education regarding smoking
cessation is a critical nursing responsibility when administering
estrogen-containing contraceptives.
Option A is incorrect because smoking significantly affects
safety. Option C is incorrect because the primary concern is
cardiovascular risk rather than decreased contraceptive
effectiveness. Option D is incorrect because smoking does not
protect against estrogen-related adverse effects.
Nurses should assess smoking history before initiating therapy,
reinforce smoking cessation strategies, and educate clients
about symptoms of thrombosis such as unilateral leg swelling,
chest pain, or sudden neurologic changes.
,Learning Objective
After completing this question, the learner should be able to:
• Identify major contraindications for combined oral
contraceptives.
• Recognize cardiovascular risks associated with estrogen
therapy.
• Educate patients regarding smoking cessation.
• Monitor for signs of thromboembolic complications.
Medication Safety Focus
Contraindication
Question 2
Clinical Scenario
A 66-year-old male with benign prostatic hyperplasia (BPH) is
prescribed tamsulosin. The nurse is preparing discharge
teaching.
Question Stem
Which instruction should the nurse include?
A. Take the medication at bedtime and change positions slowly.
B. Restrict fluid intake while taking this medication.
, C. Stop the medication if urinary flow improves.
D. Take the medication only when urinary symptoms occur.
Correct Answer
Correct Answer: A. Take the medication at bedtime and
change positions slowly.
Detailed Rationale
Tamsulosin is an alpha-1 adrenergic blocker that relaxes smooth
muscle in the prostate and bladder neck, improving urinary
flow. Orthostatic hypotension and dizziness may occur,
particularly after the first dose. Taking the medication at
bedtime and rising slowly helps reduce fall risk.
Option B is incorrect because adequate hydration is generally
encouraged unless contraindicated. Option C is incorrect
because therapy is usually continued as prescribed. Option D is
incorrect because tamsulosin requires consistent daily
administration for therapeutic benefit.
Nurses should monitor blood pressure, assess urinary
symptoms, and educate older adults regarding fall prevention
strategies.
Learning Objective
After completing this question, the learner should be able to:
• Describe the mechanism of alpha-1 blockers.
Reproductive & Genitourinary System |
20 ATI-Style Questions with Detailed
Rationales
Question 1
Clinical Scenario
A 28-year-old female is prescribed combined oral contraceptive
pills (ethinyl estradiol/norethindrone). During a follow-up visit,
she reports smoking one pack of cigarettes daily. She asks
whether smoking affects her medication.
Question Stem
Which response by the nurse is most appropriate?
A. Smoking does not affect oral contraceptive therapy.
B. Smoking increases the risk of serious cardiovascular
complications while taking oral contraceptives.
,C. Smoking decreases the effectiveness of oral contraceptives
but has no other effects.
D. Smoking prevents estrogen-related adverse effects.
Correct Answer
Correct Answer: B. Smoking increases the risk of serious
cardiovascular complications while taking oral contraceptives.
Detailed Rationale
Combined oral contraceptives contain estrogen, which
increases the risk of thromboembolic events. Smoking further
elevates the risk of myocardial infarction, stroke, deep vein
thrombosis, and pulmonary embolism, especially in women
older than 35 years. Patient education regarding smoking
cessation is a critical nursing responsibility when administering
estrogen-containing contraceptives.
Option A is incorrect because smoking significantly affects
safety. Option C is incorrect because the primary concern is
cardiovascular risk rather than decreased contraceptive
effectiveness. Option D is incorrect because smoking does not
protect against estrogen-related adverse effects.
Nurses should assess smoking history before initiating therapy,
reinforce smoking cessation strategies, and educate clients
about symptoms of thrombosis such as unilateral leg swelling,
chest pain, or sudden neurologic changes.
,Learning Objective
After completing this question, the learner should be able to:
• Identify major contraindications for combined oral
contraceptives.
• Recognize cardiovascular risks associated with estrogen
therapy.
• Educate patients regarding smoking cessation.
• Monitor for signs of thromboembolic complications.
Medication Safety Focus
Contraindication
Question 2
Clinical Scenario
A 66-year-old male with benign prostatic hyperplasia (BPH) is
prescribed tamsulosin. The nurse is preparing discharge
teaching.
Question Stem
Which instruction should the nurse include?
A. Take the medication at bedtime and change positions slowly.
B. Restrict fluid intake while taking this medication.
, C. Stop the medication if urinary flow improves.
D. Take the medication only when urinary symptoms occur.
Correct Answer
Correct Answer: A. Take the medication at bedtime and
change positions slowly.
Detailed Rationale
Tamsulosin is an alpha-1 adrenergic blocker that relaxes smooth
muscle in the prostate and bladder neck, improving urinary
flow. Orthostatic hypotension and dizziness may occur,
particularly after the first dose. Taking the medication at
bedtime and rising slowly helps reduce fall risk.
Option B is incorrect because adequate hydration is generally
encouraged unless contraindicated. Option C is incorrect
because therapy is usually continued as prescribed. Option D is
incorrect because tamsulosin requires consistent daily
administration for therapeutic benefit.
Nurses should monitor blood pressure, assess urinary
symptoms, and educate older adults regarding fall prevention
strategies.
Learning Objective
After completing this question, the learner should be able to:
• Describe the mechanism of alpha-1 blockers.
