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NR 507 FINAL EXAM WITH
CORRECT ANSWERS 2025
Which of the following is true regarding a complicated urinary tract infection? correct answers >> Can be caused by a structural urinary tract disorder Which of the following is a risk factor for the development of a urinary tract infection (UTI)? correct answers >> pregnancy A symptom of a lower urinary tract infection includes: correct answers >> urgency Women are at a higher risk for the development of a UTI because of having a shorter urethra. correct answers >> true Which of the following can help to prevent a UTI? correct answers >> increase water consumption
Risk factors for a UTI correct answers >> pregnancy sexually active post-menopause estrogen-deficiency women (shorter urethra) catheterization An upper UTI is less common in men due to the longer urethra and ureter structures that make it more difficult for bacteria to reach the kidney. correct answers >> true complicated UTI correct answers >> -A UTI that extends beyond the bladder -Caused by structural or functional urinary tract abnormalities or untreated UTI -Infants and older adults affected -Associated with:indwelling cathetersrenal calculiDiabetesPregnancy uncomplicated UTI correct answers >> -Occurs in the normal urinary tract
NP education correct answers >> -Drink more water. -Although there are differences of opinions, cranberry juice and vitamin C can help to acidify the urine. -Urinate before and after sexual intercourse to remove bacteria from the urethral area.- Encourage the female to avoid holding urine for extended periods of time -Avoid the use of hygiene sprays and spermicides because they alter the normal microbial flora to enhance the risk for infection. -Encourage the female to wipe from the front to the back after a bowel movement to avoid spreading bacteria to the urethra -Encourages showers rather than bathing to avoid the spread of bacteria. A 25 year- old female presents to the primary care office with urinary burning and frequency for the last 3 days. She denies any fever, chills, back pain. Her gynecological history is negative and reports no vaginal discharge. The only new information reported is that she recently had sexual intercourse with a new male partner. The NP obtains a urinalysis and determines that the urine contains leukocytes, RBCs, nitrites, and WBCs. No casts are
identified. Based on symptom presentation and UA results, the patient can be diagnosed with: correct answers >> cystitis J.S. is an 80 -year-old patient who resides in a local nursing home. He recently became confused and then fell while ambulating to the bathroom three days ago. Because of his confusion and fall, he was transferred to the acute care facility for evaluation and treatment. Lab work revealed that the patient was very dehydrated with hypernatremia identified and appropriate intravenous fluids started. Cystitis was also identified from the urinalysis. He was also noted to have red and excoriated skin between the buttocks and inner thighs due to urinary frequency and dribbling. To help with skin healing and to prevent further urine leakage, an indwelling catheter was inserted. Two days after the catheter was placed, the patient spiked a fever of 102 degrees Fahrenheit associated with shaking chills. An intense, foul odor was noted in the urine. On examination of the flank area, the patient yelled out when touched. A urine c correct answers
pyelonephritis Identify the major risk factor J.S. has that is associated with pyelonephritis: correct answers >> indwelling foley catheter
The purpose of straining in BPH is to overcome the obstruction encountered during urination. correct answers
true The peripheral zone of the prostate is the largest zone. correct answers >> true On a digital rectal exam to assess the quality of the prostate, the NP would be concerned with which of the following findings? correct answers >> a hard nodule There is a significant risk for men with benign prostatic hyperplasia (BPH) to develop cellular mutations that lead to prostate cancer. correct answers >> false - BPH does not lead to prostate cancer The patient most often develops symptoms of BPH when: correct answers >> The prostatic urethra becomes obstructed. A 72- year-old male presents to the primary care office with complaints of lower urinary frequency and urgency that have become progressively worse over the last 6 months. He also reports having to get up more than 5 times/night to urinate
where he feels like his bladder is never emptied. He is especially embarrassed because of "leaking" after urination. He denies any fever, weight loss or bone pain. His only medical history is hypertension where he takes atenolol 50 mg po daily and Aspirin 81 mg daily. His family history is negative for malignancy. A urinalysis was performed with negative results, ruling out UTI. The NP performs a focused urological exam and notes the following: Digital rectal exam (DRE): a profusely enlarged prostate with normal shape and symmetry. No nodularity or tenderness is noted. Palpation of the suprapubic area reveals some bladder distention and discomfort. Currently, the NP opts to prescri correct answers >> Irritative:
- Urinary frequency, nocturia, urgency that results from bladder hypertrophy and dysfunction Obstructive: -Incomplete emptying, postvoid dribbling The action of a 5-Alpha-reductase inhibitor causes: correct answers >> Shrinkage of the prostate gland
The most common type of stone is: correct answers >> calcium stone The gold standard for diagnosing a renal stone is a urinalysis. correct answers >> false (CT scan) A 45-year-old male presents to the primary care office with right flank pain that he describes as unremitting; he also reports nausea and vomiting. The NP performs an exam and observes him writhing in pain on the exam table with the inability to find a comfortable position. He is afebrile, BP 156/88 mmHg and HR 106/min. Right flank is mildly tender on palpation. Abdominal exam is negative for any abnormality. A urinalysis was performed and revealed 1+ blood. Urine microscopy also revealed 10-20 RBCs per high-power field (hpf). A kidney stone is suspected. The patient reports no prior history of a kidney stone. After providing the patient an analgesic, where the patient reported mild relief, the NP had the patient transferred to the emergency room for intravenous fluids, pain management and further work-up for the kidney stone. Upon follow-up in the office a week later, the patient reported that he was diagnosed with correct answers >> A balanced diet Adequate hydration
Lithotripsy is an invasive procedure used to break up the stone correct answers >> false The most common stone found in the patient with gout is: correct answers >> uric acid stone Hematuria can be seen with kidney stones because: correct answers >> The stone injures the urinary structures as it passes through them. Renal colic is caused by the passing of the stone through the ureter. correct answers >> true At least half of individuals with renal stones will have a reoccurrence within 10 years of the prior stone. correct answers >> Which of the following actions will relax the detrusor muscle of the bladder? correct answers >> Activation of Beta- receptors by the sympathetic nervous system.
neurogenic incontinence correct answers >> Unimpeded urine leakage Neurological lesions alter nervous system impulses that innervate the detrusor muscle. The result is decreased bladder compliance and decreased sphincter tone overflow incontinence correct answers >> Leakage of urine is associated with urgency, frequency, dribbling and hesitancy Leakage is due to retained urine in the bladder that leads to overdistention A 54-year-old female reports to the primary care office with complaints of frequent urination. She reports that she is "leaking" urine several times a day, especially when she coughs, sneezes, or lifts a heavy object. She indicates that she has not experienced any dysuria or any urgency. The NP looked at the patient's previous urine culture obtained approximately 1 month ago and determined that it was negative. Other than her urinary complaints, she is in otherwise good health. BP 128/76; HR 78 bpm; T 98.6; Ht. 5'4"; Wt: 180lbs.; BMI 30.9. The NP performs a physical exam and
all findings are normal. The urinalysis obtained was negative as well. Based on patient's symptoms and negative physical exam, she has a typical BLANK. The leaking occurs when the abdominal pressure increases during coughing, sneezing, and lifting. We can rule out urge incontinence because the denied urgency with her urination. We could not diagn correct answers >> 1. stress incontinence
- stress incontinence A sphincter malfunction that prevents urine from flowing out of the bladder would most likely result in: correct answers
overflow incontinence The major cause of stress incontinence in women is hypermobility of the external sphincter. correct answers >> true The pathophysiology of neurogenic bladder is: correct answers >> Lesions alter nervous system impulses that innervate the detrusor muscle to decrease bladder compliance and decreased sphincter tone.
Acute-renal failure correct answers >> Oliguria (< 30ml/hr). Increased blood urea nitrogen (BUN) and creatinine. Fluid and electrolyte abnormalities. pre-renal correct answers >> sudden and severe drop in blood pressure (shock) or interruption of blood flow to the kidneys from severe injury or illness Intra-renal correct answers >> direct damage to the kidneys by inflammation, toxins, drugs, infection, or reduced blood supply post-renal correct answers >> sudden obstruction of urine flow due to enlarged prostate, kidney stones, bladder tumor, or injury In post-renal failure, the damage occurs in the collecting duct. correct answers >> true In intrinsic renal failure, sodium and water excretion is increased which leads to a dilute urine. correct answers >> true
Which of the following is the best indicator of a good prognosis for recovery from acute renal failure? correct answers >> The kidney responds to furosemide Which of the following is true regarding creatinine? correct answers >> Creatinine gets freely filtered from the glomerulus One of the issues that requires management of a patient with acute renal failure is hypokalemia correct answers >> false The result of vitamin D deficiency results in: correct answers >> hypocalcemia The number one cause of end-stage renal disease is diabetes mellitus and hypertension combined. correct answers >> true Stage III kidney disease is signified when the GFR drops below
- correct answers >> true
Medication avoidance: patients will avoid nephrotoxic drugs such as non-steroidal anti-inflammatory drugs (NSAIDS) and aminoglycosides. The decision to begin dialysis is guided by the patient's symptoms rather than GFR. correct answers >> true End-stage renal disease is signified by a GFR of: correct answers >> less than 15 Diuretic therapy is used in Stage IV kidney failures to stimulate kidney function. correct answers >> false The major acid/base disturbance in renal failure is: correct answers >> metabolic acidosis Dietary management of a patient with CKD includes: correct answers >> Low potassium, low sodium, and low phosphate diet.
