Chapter 33: Male Genitourinary Agents

Chapter 33: Male Genitourinary Agents

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A man who has benign prostatic hypertrophy (BPH), in whom prostate carcinoma has been ruled out, asks the primary care nurse practitioner (NP) about beginning drug therapy to treat his symptoms. The NP notes that he consistently has blood pressure readings around 145/90 mm Hg. The NP should prescribe:

ANS:  B

Doxazosin is a nonspecific a-blocker, which also lowers blood pressure and should be considered to treat BPH in patients who also have hypertension. Tadalafil is used to treat erectile dysfunction. Tamsulosin is a specific á-blocker and is first-line treatment for patients with BPH who do not have hypertension. Finasteride is a 5a-reductase inhibitor, which is not a first-line medication.

DIF:    Cognitive Level: Applying (Application)                           REF:   385 – 386

2. A patient who has BPH is taking tamsulosin and dutasteride and asks the primary care NP why he needs to take both medications. The NP should tell him:

ANS:  D

A 5a-reductase inhibitor is given to shrink the size of the prostate, but maximum benefit is not achieved until 6 months of therapy. The a-blocker is given to provide more rapid relief. The combination does not decrease the risk of carcinoma. The drug therapy is not a prerequisite to surgery, although it may be used before surgical intervention. The combination therapy does not affect the dose of either drug.

DIF:    Cognitive Level: Applying (Application)                           REF:   385 – 386

3. A patient who has BPH is taking alfuzosin (Uroxatral) and finasteride (Proscar). The patient has had two urinary tract infections (UTIs) in the past 2 months. A urinalysis in the clinic is negative for leukocyte esterase but positive for hematuria. The primary care NP should:

ANS:  B

Surgery is indicated for patients who are refractory to treatment with medications or who have recurrent UTIs or hematuria. The NP should refer the patient to a urologist. All a-blockers are considered equally efficacious, so changing the drug regimen is not indicated.

DIF:    Cognitive Level: Applying (Application)                           REF:   385 – 386