A patient taking nitrofurantoin whose urine turns brown can be told this is an expected effect that is not harmful.
Correct Answer
True
True. Nitrofurantoin can darken the urine to a rust-yellow or brown color. The change is expected and harmless, and knowing about it keeps the patient from stopping the drug in alarm.
Category: Urinary Anti-infectives
Question 2
Nitrofurantoin is contraindicated in pregnant patients at term because the newborn may develop hemolytic anemia.
Correct Answer
True
True. Near term, during labor and at delivery nitrofurantoin is avoided because the immature red blood cell enzyme systems of the fetus or newborn make hemolytic anemia possible.
Category: Urinary Anti-infectives
Question 3
Nitrofurantoin is a good choice for pyelonephritis because it reaches high concentrations in kidney tissue.
Correct Answer
False
False. Nitrofurantoin concentrates in the urine but does not reach effective levels in kidney tissue or the bloodstream, so it is used for cystitis and is not indicated for pyelonephritis.
Category: Urinary Anti-infectives
Question 4
Urinary alkalinizing agents such as sodium bicarbonate make methenamine more effective.
Correct Answer
False
False. Methenamine needs acidic urine to release its antibacterial product, so alkalinizing agents and some antacids reduce its effectiveness and are avoided.
Category: Urinary Anti-infectives
Question 5
Methenamine should not be taken with sulfonamides because the two can form an insoluble precipitate in the urine.
Correct Answer
True
True. Some sulfonamides combine with the formaldehyde released from methenamine to form an insoluble precipitate, so the combination is avoided.
Category: Urinary Anti-infectives
Question 6
Fosfomycin for uncomplicated cystitis is given as a long daily course over several weeks.
Correct Answer
False
False. Fosfomycin for uncomplicated cystitis is given as a single dose of granules mixed in water.
Category: Urinary Anti-infectives
Question 7
Phenazopyridine is contraindicated in patients with renal insufficiency.
Correct Answer
True
True. Phenazopyridine is cleared by the kidneys, and poor renal function lets it accumulate and raises the risk of toxicity, so renal insufficiency is a contraindication.
Category: Urinary Analgesics
Question 8
Phenazopyridine turns the urine a blue-green color.
Correct Answer
False
False. Phenazopyridine is an azo dye that turns the urine reddish orange. The color is harmless but can stain clothing and soft contact lenses, so patients are told to expect it.
Category: Urinary Analgesics
Question 9
Alpha-1 blockers usually relieve BPH symptoms sooner than 5-alpha-reductase inhibitors, which must first shrink the gland.
Correct Answer
True
True. Alpha-1 blockers relax prostate and bladder neck smooth muscle and work fairly quickly, while 5-alpha-reductase inhibitors act by gradually reducing prostate size, so their benefit takes months.
Category: BPH Drugs
Question 10
Mirabegron is a beta-3 adrenergic antagonist.
Correct Answer
False
False. Mirabegron is a beta-3 adrenergic agonist; stimulating these receptors relaxes the detrusor during bladder filling and increases bladder capacity.
Category: Overactive Bladder Drugs
Question 11
Mirabegron can cause urinary retention, especially in patients with bladder outlet obstruction or those also taking an antimuscarinic.
Correct Answer
True
True. Labeling warns of urinary retention with mirabegron in patients with bladder outlet obstruction and in those taking antimuscarinic drugs for overactive bladder.
Category: Overactive Bladder Drugs
Question 12
Tolterodine levels fall when it is combined with a strong CYP3A4 inhibitor such as ketoconazole.
Correct Answer
False
False. Strong CYP3A4 inhibitors raise tolterodine levels, so a lower dose is used when they are combined.
Category: Overactive Bladder Drugs
Question 13
Drinking alcohol while taking oxybutynin can add to drowsiness.
Correct Answer
True
True. Oxybutynin can cause drowsiness and blurred vision, and alcohol adds to the CNS depressant effect, so patients are taught to avoid alcohol and use caution with driving.
Category: Overactive Bladder Drugs
Question 14
Flavoxate is safe to use in a patient with an obstructive intestinal lesion or ileus.
Correct Answer
False
False. Flavoxate is contraindicated in pyloric or duodenal obstruction, obstructive intestinal lesions or ileus, achalasia, gastrointestinal bleeding and obstructive uropathy of the lower urinary tract.
Category: Overactive Bladder Drugs
Question 15
Bethanechol is contraindicated in active peptic ulcer disease because it increases gastric acid secretion.
Correct Answer
True
True. Muscarinic stimulation increases gastric acid secretion and gut motility, so peptic ulcer disease is a contraindication to bethanechol.
Category: Urinary Stimulants
Question 16
Bethanechol is safe to give to a patient with hyperthyroidism.
Correct Answer
False
False. Labeling lists hyperthyroidism among the contraindications to bethanechol, along with conditions such as asthma, peptic ulcer disease, bradycardia and hypotension.
Category: Urinary Stimulants
Question 17
A 5-alpha-reductase inhibitor may be combined with an alpha-1 blocker to treat BPH.
Correct Answer
True
True. Combining a 5-alpha-reductase inhibitor such as dutasteride with an alpha-1 blocker such as tamsulosin pairs gland shrinkage with smooth muscle relaxation, though it adds to dizziness and orthostatic hypotension.
Category: BPH Drugs
Question 18
Finasteride lowers the risk of high-grade prostate cancer.
Correct Answer
False
False. Labeling warns that 5-alpha-reductase inhibitors such as finasteride may increase the risk of high-grade prostate cancer, so other urologic conditions, including cancer, are ruled out before therapy.
Category: BPH Drugs
Question 19
Tadalafil combined with an alpha-1 blocker is not recommended for treating BPH because the pair adds to blood pressure lowering.
Correct Answer
True
True. Labeling does not recommend tadalafil plus an alpha-1 blocker for BPH because the combination can cause additive hypotension and its benefit has not been adequately studied.
Category: BPH Drugs
Question 20
Silodosin is a 5-alpha-reductase inhibitor that shrinks the prostate.
Correct Answer
False
False. Silodosin is a uroselective alpha-1 blocker that relaxes prostate and bladder neck smooth muscle; finasteride and dutasteride are the 5-alpha-reductase inhibitors.
Category: BPH Drugs