Chapter 34: Drugs for Urinary Incontinence and Urinary Analgesia

Chapter 34: Drugs for Urinary Incontinence and Urinary Analgesia

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. The primary care nurse practitioner (NP) sees a 50-year-old woman who reports frequent leakage of urine. The NP learns that this occurs when she laughs or sneezes. She also reports having an increased urge to void even when her bladder is not full. She is not taking any medications. The NP should:

ANS:  A

A focused history with a careful physical examination is essential for determining the cause of incontinence. Urinalysis can rule out urinary tract infection (UTI), which can cause incontinence. Medications are prescribed after determining the cause, if any, and treating underlying conditions. Exercises to strengthen the pelvic muscles are part of treatment.

DIF:    Cognitive Level: Applying (Application)                           REF:   393

2. A patient who has diabetes reports intense discomfort when needing to void. A urinalysis is normal. To treat this, the primary care NP should consider prescribing:

ANS:  D

This patient is describing urge incontinence, or overactive bladder, which occurs when the detrusor muscle is hyperactive, causing an intense urge to void before the bladder is full. Urge incontinence is associated with many conditions, including diabetes. Oxybutynin chloride, which is an anticholinergic, acts to decrease detrusor overactivity and is indicated for treatment of urge incontinence. Flavoxate is used to treat dysuria associated with UTI. Bethanechol is indicated for urinary retention. Phenazopyridine is used to treat dysuria.

DIF:    Cognitive Level: Applying (Application)                           REF:   393

3. A patient reports having urinary frequency and discomfort associated with urination. After a careful physical examination and history to determine the cause, the NP should prescribe a medication from which drug class?

ANS:  B

Antispasmodics are smooth muscle relaxants. Use of these drugs can produce increased bladder capacity and exhibit local anesthetic and analgesic actions. Cholinergic agents increase detrusor muscle tone to improve initiation of voiding and bladder emptying. Anticholinergics decrease detrusor tone to treat urge incontinence. Urinary tract analgesics are used to treat pain via a local analgesic effect on urinary tract mucosa and are used in conjunction with antibiotics to treat UTI.

DIF:    Cognitive Level: Applying (Application)                           REF:   393 – 394

4. A parent brings an 8-year-old child to the clinic because the child continues to wet the bed despite using cognitive-behavioral measures and a bed alarm system. The NP should prescribe:

ANS:  C

Desmopressin is used as an antidiuretic and decreases urine output for approximately 6 hours and is often used to treat nocturia in children. Solifenacin and tolterodine are anticholinergics. Phenazopyridine is a urinary tract analgesic.

DIF:    Cognitive Level: Understanding (Comprehension)             REF:   394