Chapter 43 Drugs for Urologic Disorders
1. The clinic nurse is admitting a 39-year-old woman who has come to the clinic
complaining of left-sided tenderness, fever, chills, and flank pain. What does the
nurse suspect the patient has?
A) Cystitis
B) Kidney stones
C) Neurogenic bladder
D) Pyelonephritis
Ans D
Feedback
The fever and chills indicate an inflammatory process. Flank pain and left-sided
tenderness indicate kidney swelling within the capsule. These symptoms indicate
pyelonephritis. Kidney stones cause intense pain; fever and chills would not be present.
Cystitis and neurogenic bladder present with bladder-related symptoms such as
frequency, urgency, burning, and bloating.
2. The nurse is caring for four patients. Which patient would flavoxate (Urispas), a urinary
tract medication, be indicated for?
A) A 1-year-old girl
B) A 6-year-old boy
C) A 10-year-
old boy
D) A 14-year-old girl
Ans D
Feedback
Flavoxate prevents smooth muscle spasm in the urinary tract and can be given to children
older than 12 years of age. Oxybutynin and phenazopyridine may be given to children 6
years old and older. Guidelines for use of an antispasmodic for a child younger than 6
have not been established.
3. The nurse is discussing the effects of doxazosin (Cardura) with a 65-year-old man who has
just been diagnosed with benign prostatic hyperplasia (BPH). The patient asks the nurse
whether the drug will make him impotent. After the discussion with the patient, the nurse
determines that a potential priority nursing diagnosis could be what?
A) Sexual dysfunction related to adverse effects
B) Deficient knowledge regarding drug therapy
C) Noncompliance with drug therapy related to adverse effects
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D) Acute pain related to adverse effects
Ans C
Feedback
The patient is concerned about his ability to perform sexually. Sexual dysfunction is a
possible adverse effect and would be a concern for this patient. However, he has not
started taking the drug. The nurse is concerned about noncompliance because of the
possibility of this adverse effect. This is an important part of a mans life and most men
would not want to take medication that would cause sexual dysfunction. Headache is an
adverse effect of drugs used for BPH, but it can be tolerated and treated with an
analgesic. Deficient knowledge about the drug is a concern, but usually men who know
that sexual dysfunction is a possible adverse effect of a drug will find out all they can
about the drug. Acute pain is not related to this drug.
4. A businesswoman who is leaving on a business trip the next day tells the nurse she knows
she has cystitis and does not want to have to mess with medicine while she is gone. What
drug would be a good choice for this patient?
A) Fosfomycin (Monurol)
B) Methenamine (Hiprex)
C) Nitrofurantoin (Furadantin)
D) Norfloxacin (Noroxin)
Ans A
Feedback
Fosfomycin would be a good choice for this patient because it has the convenience of a
single dose. Methenamine is taken either twice a day or up to four times a day. This drug
could interfere with the patients busy schedule. Nitrofurantoin is also prescribed four
times a day and would also be inconvenient for the patient. Norfloxacin is taken every 12
hours and could be inconvenient as well.
5. The nurse is performing patient teaching about the urinary anti-infective methenamine
(Hiprex). What information is most important for the nurse to share with this patient?
A) Limit fluid intake.
B) Drink orange juice once a day.
C) Take the medication with food.
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D) Take the medication at night before going to bed.
Ans C
Feedback
The patient should take the medication with food to decrease GI adverse effects. The
nurse would encourage the patient to increase fluid intake to flush the bladder and urinary
tract frequently and decrease the opportunity for bacteria growth. Orange juice would be
contraindicated because it could cause an alkaline rash and produce alkaline urine, which
encourages bacterial growth. This drug is taken two to three times a day and not in a
single dose at night.
6. The nurse is assessing a patient who is taking oxybutynin (Ditropan). What would be the
priority nursing assessment for this patient?
A) Skin condition
B) Cardiac arrhythmia
C) Vision changes
D) Mental status
Ans C
Feedback
The nurse should assess for vision changes and recommend an ophthalmologic
examination during treatment to evaluate drug effects on intraocular pressure so that the
drug can be stopped if intraocular pressure increases. A rash and changes in cardiac
rhythm and rate are possible adverse effects. Also, disorientation (mental status) could be
a concern. However, these effects can be treated and may not necessitate stopping the
medication.
7. A patient is taking phenazopyridine (Azo-Standard) and ciprofloxacin (Cipro) for a
urinary tract infection. What is the most important instruction the nurse needs to
provide to the patient concerning this drug combination?
A) Do not be alarmed if your urine is a reddish-brown color.
B) Be sure to take your medication with food if you have GI irritation.
C) Increase your fluid intake. Drink lots of water.
Page 3 of 17
1. The clinic nurse is admitting a 39-year-old woman who has come to the clinic
complaining of left-sided tenderness, fever, chills, and flank pain. What does the
nurse suspect the patient has?
A) Cystitis
B) Kidney stones
C) Neurogenic bladder
D) Pyelonephritis
Ans D
Feedback
The fever and chills indicate an inflammatory process. Flank pain and left-sided
tenderness indicate kidney swelling within the capsule. These symptoms indicate
pyelonephritis. Kidney stones cause intense pain; fever and chills would not be present.
Cystitis and neurogenic bladder present with bladder-related symptoms such as
frequency, urgency, burning, and bloating.
2. The nurse is caring for four patients. Which patient would flavoxate (Urispas), a urinary
tract medication, be indicated for?
A) A 1-year-old girl
B) A 6-year-old boy
C) A 10-year-
old boy
D) A 14-year-old girl
Ans D
Feedback
Flavoxate prevents smooth muscle spasm in the urinary tract and can be given to children
older than 12 years of age. Oxybutynin and phenazopyridine may be given to children 6
years old and older. Guidelines for use of an antispasmodic for a child younger than 6
have not been established.
3. The nurse is discussing the effects of doxazosin (Cardura) with a 65-year-old man who has
just been diagnosed with benign prostatic hyperplasia (BPH). The patient asks the nurse
whether the drug will make him impotent. After the discussion with the patient, the nurse
determines that a potential priority nursing diagnosis could be what?
A) Sexual dysfunction related to adverse effects
B) Deficient knowledge regarding drug therapy
C) Noncompliance with drug therapy related to adverse effects
Page 1 of 17
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D) Acute pain related to adverse effects
Ans C
Feedback
The patient is concerned about his ability to perform sexually. Sexual dysfunction is a
possible adverse effect and would be a concern for this patient. However, he has not
started taking the drug. The nurse is concerned about noncompliance because of the
possibility of this adverse effect. This is an important part of a mans life and most men
would not want to take medication that would cause sexual dysfunction. Headache is an
adverse effect of drugs used for BPH, but it can be tolerated and treated with an
analgesic. Deficient knowledge about the drug is a concern, but usually men who know
that sexual dysfunction is a possible adverse effect of a drug will find out all they can
about the drug. Acute pain is not related to this drug.
4. A businesswoman who is leaving on a business trip the next day tells the nurse she knows
she has cystitis and does not want to have to mess with medicine while she is gone. What
drug would be a good choice for this patient?
A) Fosfomycin (Monurol)
B) Methenamine (Hiprex)
C) Nitrofurantoin (Furadantin)
D) Norfloxacin (Noroxin)
Ans A
Feedback
Fosfomycin would be a good choice for this patient because it has the convenience of a
single dose. Methenamine is taken either twice a day or up to four times a day. This drug
could interfere with the patients busy schedule. Nitrofurantoin is also prescribed four
times a day and would also be inconvenient for the patient. Norfloxacin is taken every 12
hours and could be inconvenient as well.
5. The nurse is performing patient teaching about the urinary anti-infective methenamine
(Hiprex). What information is most important for the nurse to share with this patient?
A) Limit fluid intake.
B) Drink orange juice once a day.
C) Take the medication with food.
Page 2 of 17
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D) Take the medication at night before going to bed.
Ans C
Feedback
The patient should take the medication with food to decrease GI adverse effects. The
nurse would encourage the patient to increase fluid intake to flush the bladder and urinary
tract frequently and decrease the opportunity for bacteria growth. Orange juice would be
contraindicated because it could cause an alkaline rash and produce alkaline urine, which
encourages bacterial growth. This drug is taken two to three times a day and not in a
single dose at night.
6. The nurse is assessing a patient who is taking oxybutynin (Ditropan). What would be the
priority nursing assessment for this patient?
A) Skin condition
B) Cardiac arrhythmia
C) Vision changes
D) Mental status
Ans C
Feedback
The nurse should assess for vision changes and recommend an ophthalmologic
examination during treatment to evaluate drug effects on intraocular pressure so that the
drug can be stopped if intraocular pressure increases. A rash and changes in cardiac
rhythm and rate are possible adverse effects. Also, disorientation (mental status) could be
a concern. However, these effects can be treated and may not necessitate stopping the
medication.
7. A patient is taking phenazopyridine (Azo-Standard) and ciprofloxacin (Cipro) for a
urinary tract infection. What is the most important instruction the nurse needs to
provide to the patient concerning this drug combination?
A) Do not be alarmed if your urine is a reddish-brown color.
B) Be sure to take your medication with food if you have GI irritation.
C) Increase your fluid intake. Drink lots of water.
Page 3 of 17
