A client is receiving tamsulosin, an alpha-adrenergic blocking agent, for the management of urinary retention due to benign prostatic hyperplasia (BPH). Which instruction is most important for the nurse to provide?
Take the medication early in the day.
Stand and sit up slowly.
Reduce daily fluid intake.
Use a twice-a-week dosing schedule.
The Correct Answer is B
Choice A reason: Taking tamsulosin early in the day is not necessary. Tamsulosin should be taken approximately 30 minutes after the same meal each day to ensure consistent absorption and effectiveness1. The timing of the dose is less critical than ensuring it is taken after the same meal daily.
Choice B reason: Tamsulosin can cause orthostatic hypotension, which is a sudden drop in blood pressure when standing up from a sitting or lying position. This can lead to dizziness or fainting. Therefore, it is crucial to instruct patients to stand and sit up slowly to prevent falls and injuries.
Choice C reason: Reducing daily fluid intake is not recommended for patients taking tamsulosin. Adequate hydration is important for overall health and can help manage urinary symptoms associated with BPH. There is no evidence suggesting that fluid restriction improves the effectiveness of tamsulosin.
Choice D reason: Tamsulosin should be taken daily, not on a twice-a-week dosing schedule. Consistent daily dosing is necessary to maintain stable blood levels of the medication and ensure its effectiveness in managing urinary retention due to BPH.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason:
Decreased night vision is a significant concern for clients receiving miotics for open-angle glaucoma. Miotics, such as pilocarpine, work by constricting the pupil (miosis), which can reduce the amount of light entering the eye. This effect is particularly problematic in low-light conditions, leading to decreased night vision and increasing the risk of injury due to poor visibility
Choice B reason:
Increased sensitivity to light, also known as photophobia, can occur with the use of miotics, but it is not the primary concern related to the risk of injury. While photophobia can cause discomfort and avoidance of bright environments, it does not directly contribute to the risk of injury as significantly as decreased night vision.
Choice C reason:
Increased frequency of lacrimation (tearing) can be a side effect of miotics, but it is not a major factor in the risk of injury. Excessive tearing can cause discomfort and blurred vision temporarily, but it does not pose a significant risk for injury compared to decreased night vision.
Choice D reason:
Diminished color perception is not a common side effect of miotics. Miotics primarily affect the pupil size and accommodation, rather than color vision. Therefore, this choice is not relevant to the risk of injury associated with the use of miotics.

Correct Answer is B
Explanation
Choice A reason:
Insomnia is a known side effect of St. John’s wort. While it can be bothersome, it does not typically require further instruction beyond standard advice on managing insomnia. Patients should be advised to take the medication earlier in the day to minimize sleep disturbances.
Choice B reason:
St. John’s wort can interact with hormonal contraceptives, reducing their effectiveness and increasing the risk of unintended pregnancy. This interaction occurs because St. John’s wort induces the enzymes that metabolize contraceptive hormones, leading to lower levels of these hormones in the body. Therefore, it is crucial to instruct the client to use an additional form of contraception to prevent pregnancy.
Choice C reason:
Sensitivity to the sun, or photosensitivity, is a documented side effect of St. John’s wort. Patients should be advised to use sunscreen and wear protective clothing when exposed to sunlight. While this side effect requires caution, it does not necessitate further instruction beyond these preventive measures.
Choice D reason:
Using hard candy to alleviate dry mouth is a common and effective strategy. St. John’s wort can cause dry mouth, and sucking on sugar-free hard candy can help stimulate saliva production. This advice is appropriate and does not require further instruction.
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