NCLEX-RN Pharmacology Reproductive &
Genitourinary System Practice Questions with
Detailed Rationales |
20 Original NGN-Style MCQs |
Nursing Exam Prep
Question 1
Clinical Scenario
A 28-year-old female client presents to the clinic for a routine
prenatal visit at 10 weeks gestation. She reports a history of
epilepsy and has been taking valproic acid since age 16. Her
current dose is 750 mg twice daily. She states she has had no
seizures during pregnancy and asks if it is safe to continue her
medication.
Question Stem
Which action should the nurse take first?
A. Reassure the client that valproic acid is safe throughout
pregnancy.
B. Notify the provider immediately about the client’s current
antiseizure medication.
,C. Instruct the client to discontinue valproic acid and switch to
acetaminophen.
D. Document the client’s concern and schedule a follow-up in 4
weeks.
Correct Answer
B. Notify the provider immediately about the client’s current
antiseizure medication.
Detailed Rationale
Valproic acid carries a Black Box Warning for use during
pregnancy due to significant teratogenic risks, including neural
tube defects (e.g., spina bifida), craniofacial abnormalities, and
cognitive impairment. While seizure control is essential in
pregnancy, valproic acid is generally contraindicated unless no
safer alternatives exist. The nurse’s priority is to alert the
provider so a risk-benefit assessment can occur and, if
appropriate, transition to a safer antiseizure medication such as
lamotrigine or levetiracetam. Option A is incorrect and
dangerous—valproic acid is not considered safe in pregnancy.
Option C is unsafe; abrupt discontinuation of antiseizure meds
can trigger seizures, which also pose fetal risks. Option D delays
necessary intervention. This scenario emphasizes medication
safety in pregnancy, requiring prompt interdisciplinary
communication.
,Learning Objective
After completing this question, the learner should be able to:
• Recognize high-risk medications contraindicated in pregnancy.
• Prioritize actions when a pregnant client is on a teratogenic
drug.
• Understand the importance of provider notification before
altering antiseizure therapy.
Medication Safety Focus
Black Box Warning
Question 2
Clinical Scenario
A 62-year-old male with benign prostatic hyperplasia (BPH) is
prescribed tamsulosin 0.4 mg orally once daily. He also takes
lisinopril for hypertension and metformin for type 2 diabetes.
During his follow-up visit, he reports feeling dizzy when
standing up quickly.
Question Stem
Which statement by the client indicates understanding of his
medication regimen?
A. “I will take tamsulosin at bedtime to reduce dizziness.”
B. “I can stop taking lisinopril since tamsulosin lowers blood
pressure too.”
, C. “I should avoid grapefruit juice while taking tamsulosin.”
D. “Tamsulosin will cure my enlarged prostate over time.”
Correct Answer
A. “I will take tamsulosin at bedtime to reduce dizziness.”
Detailed Rationale
Tamsulosin is an alpha-1 adrenergic blocker that relaxes smooth
muscle in the prostate and bladder neck, improving urinary flow
in BPH. A common side effect is orthostatic hypotension,
especially during initiation. Taking the dose at bedtime
minimizes the risk of falls or syncope due to dizziness upon
standing. Option B is incorrect—tamsulosin is not an
antihypertensive substitute, and stopping lisinopril without
provider direction could worsen hypertension. Option C is
inaccurate; grapefruit juice interactions are more relevant with
calcium channel blockers or statins, not tamsulosin. Option D
reflects a misconception—tamsulosin manages symptoms but
does not cure BPH. This question assesses patient teaching and
understanding of side effect management.
Learning Objective
After completing this question, the learner should be able to:
• Educate clients on minimizing orthostatic hypotension with
alpha-blockers.
• Clarify that BPH medications are symptomatic, not curative.
Genitourinary System Practice Questions with
Detailed Rationales |
20 Original NGN-Style MCQs |
Nursing Exam Prep
Question 1
Clinical Scenario
A 28-year-old female client presents to the clinic for a routine
prenatal visit at 10 weeks gestation. She reports a history of
epilepsy and has been taking valproic acid since age 16. Her
current dose is 750 mg twice daily. She states she has had no
seizures during pregnancy and asks if it is safe to continue her
medication.
Question Stem
Which action should the nurse take first?
A. Reassure the client that valproic acid is safe throughout
pregnancy.
B. Notify the provider immediately about the client’s current
antiseizure medication.
,C. Instruct the client to discontinue valproic acid and switch to
acetaminophen.
D. Document the client’s concern and schedule a follow-up in 4
weeks.
Correct Answer
B. Notify the provider immediately about the client’s current
antiseizure medication.
Detailed Rationale
Valproic acid carries a Black Box Warning for use during
pregnancy due to significant teratogenic risks, including neural
tube defects (e.g., spina bifida), craniofacial abnormalities, and
cognitive impairment. While seizure control is essential in
pregnancy, valproic acid is generally contraindicated unless no
safer alternatives exist. The nurse’s priority is to alert the
provider so a risk-benefit assessment can occur and, if
appropriate, transition to a safer antiseizure medication such as
lamotrigine or levetiracetam. Option A is incorrect and
dangerous—valproic acid is not considered safe in pregnancy.
Option C is unsafe; abrupt discontinuation of antiseizure meds
can trigger seizures, which also pose fetal risks. Option D delays
necessary intervention. This scenario emphasizes medication
safety in pregnancy, requiring prompt interdisciplinary
communication.
,Learning Objective
After completing this question, the learner should be able to:
• Recognize high-risk medications contraindicated in pregnancy.
• Prioritize actions when a pregnant client is on a teratogenic
drug.
• Understand the importance of provider notification before
altering antiseizure therapy.
Medication Safety Focus
Black Box Warning
Question 2
Clinical Scenario
A 62-year-old male with benign prostatic hyperplasia (BPH) is
prescribed tamsulosin 0.4 mg orally once daily. He also takes
lisinopril for hypertension and metformin for type 2 diabetes.
During his follow-up visit, he reports feeling dizzy when
standing up quickly.
Question Stem
Which statement by the client indicates understanding of his
medication regimen?
A. “I will take tamsulosin at bedtime to reduce dizziness.”
B. “I can stop taking lisinopril since tamsulosin lowers blood
pressure too.”
, C. “I should avoid grapefruit juice while taking tamsulosin.”
D. “Tamsulosin will cure my enlarged prostate over time.”
Correct Answer
A. “I will take tamsulosin at bedtime to reduce dizziness.”
Detailed Rationale
Tamsulosin is an alpha-1 adrenergic blocker that relaxes smooth
muscle in the prostate and bladder neck, improving urinary flow
in BPH. A common side effect is orthostatic hypotension,
especially during initiation. Taking the dose at bedtime
minimizes the risk of falls or syncope due to dizziness upon
standing. Option B is incorrect—tamsulosin is not an
antihypertensive substitute, and stopping lisinopril without
provider direction could worsen hypertension. Option C is
inaccurate; grapefruit juice interactions are more relevant with
calcium channel blockers or statins, not tamsulosin. Option D
reflects a misconception—tamsulosin manages symptoms but
does not cure BPH. This question assesses patient teaching and
understanding of side effect management.
Learning Objective
After completing this question, the learner should be able to:
• Educate clients on minimizing orthostatic hypotension with
alpha-blockers.
• Clarify that BPH medications are symptomatic, not curative.
