NR 507 Advanced Pathophysiology Final Questions and
Correct Answers. Updated Graded A+
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:
A. Upper UTI
B. Cystitis
C. Complicated UTI
D. Pyelonephritis - ANSWER - B. The patient presents with a simple cystitis and treated appropriately. In
addition, although the patient has a new sexual partner with risk for a STI, the patient reports no
itching and/or vaginal discharge with odor. The NP would determine if a pelvic exam is indicated at
that visit to rule out an STI.
.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 cu - ANSWER - A. This patient would be diagnosed with pyelonephritis.
pg. 1
,D. The major risk factor for the development of pyelonephritis in this patient is the indwelling Foley
catheter. Flank pain, dehydration and fever are symptoms rather than risk factors.
The urinalysis of a patient with a complicated UTI will show WBCs and casts:
True
False - ANSWER - True. Casts are present in a complicated UTI.
The NP would know that the patient most likely has an uncomplicated UTI because:
A. Flank pain is present but minimal.
B. There is low-grade fever.
C. The bacteria are contained within the bladder.
D. The UTI responds well to a short course of antibiotic therapy. - ANSWER - D. An uncomplicated UTI
responds to a short course of antibiotic therapy. The other choices are not typical of an
uncomplicated UTI.
A common organism that causes a urinary tract infection include:
A. Staphylococcus saprophyticus.
B. Streptococcus pneumonia.
C. Syncytial virus.
D. Methicillin Resistant Staphylococcus Aureus (MRSA). - ANSWER - A. Staphylococcus saprophyticus is
the only choice listed that commonly causes a UTI.
A 21-year-old patient reports to the primary care clinic complaining of urinary urgency, frequency and
burning. She also reports a small amount of vaginal discharge that contains an odor. It is likely that the
NP will perform a vaginal exam at this visit.
True
False - ANSWER - True. Because of the vaginal discharge that contains an odor, the NP will most likely
perform a vaginal exam to rule out an STD.
Upon examination of a urinalysis, the NP can highly suspect that the causative bacteria are
gram negative because of the presence of: A. Nitrites.
pg. 2
, B. WBCs.
C. RBCs.
D. Casts. - ANSWER - A. The presence of nitrites indicates that the causative bacteria is gram-negative.
On a digital rectal exam to assess the quality of the prostate, the NP would be concerned with which of
the following findings?
A soft-smooth prostate.
A hard nodule.
A rubber-like quality of the prostate.
A lack of pain on palpation. - ANSWER - A hard nodule can indicate prostate cancer.
The purpose of straining in BPH is to overcome the obstruction encountered during urination.
True
False - ANSWER - True. The individual strains to overcome the obstruction in order to release the urine.
There is a significant risk for men with benign prostatic hyperplasia (BPH) to develop cellular mutations
that lead to prostate cancer.
True
False - ANSWER - False. BPH does not lead to prostate cancer.
The peripheral zone of the prostate is the largest zone.
True
False - ANSWER - True. Anatomically, the peripheral zone is the largest one.
The patient most often develops symptoms of BPH when:
A. The bladder becomes obstructed.
B. The patient's PSA becomes elevated.
C. A nodule forms on the prostate.
pg. 3
Correct Answers. Updated Graded A+
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:
A. Upper UTI
B. Cystitis
C. Complicated UTI
D. Pyelonephritis - ANSWER - B. The patient presents with a simple cystitis and treated appropriately. In
addition, although the patient has a new sexual partner with risk for a STI, the patient reports no
itching and/or vaginal discharge with odor. The NP would determine if a pelvic exam is indicated at
that visit to rule out an STI.
.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 cu - ANSWER - A. This patient would be diagnosed with pyelonephritis.
pg. 1
,D. The major risk factor for the development of pyelonephritis in this patient is the indwelling Foley
catheter. Flank pain, dehydration and fever are symptoms rather than risk factors.
The urinalysis of a patient with a complicated UTI will show WBCs and casts:
True
False - ANSWER - True. Casts are present in a complicated UTI.
The NP would know that the patient most likely has an uncomplicated UTI because:
A. Flank pain is present but minimal.
B. There is low-grade fever.
C. The bacteria are contained within the bladder.
D. The UTI responds well to a short course of antibiotic therapy. - ANSWER - D. An uncomplicated UTI
responds to a short course of antibiotic therapy. The other choices are not typical of an
uncomplicated UTI.
A common organism that causes a urinary tract infection include:
A. Staphylococcus saprophyticus.
B. Streptococcus pneumonia.
C. Syncytial virus.
D. Methicillin Resistant Staphylococcus Aureus (MRSA). - ANSWER - A. Staphylococcus saprophyticus is
the only choice listed that commonly causes a UTI.
A 21-year-old patient reports to the primary care clinic complaining of urinary urgency, frequency and
burning. She also reports a small amount of vaginal discharge that contains an odor. It is likely that the
NP will perform a vaginal exam at this visit.
True
False - ANSWER - True. Because of the vaginal discharge that contains an odor, the NP will most likely
perform a vaginal exam to rule out an STD.
Upon examination of a urinalysis, the NP can highly suspect that the causative bacteria are
gram negative because of the presence of: A. Nitrites.
pg. 2
, B. WBCs.
C. RBCs.
D. Casts. - ANSWER - A. The presence of nitrites indicates that the causative bacteria is gram-negative.
On a digital rectal exam to assess the quality of the prostate, the NP would be concerned with which of
the following findings?
A soft-smooth prostate.
A hard nodule.
A rubber-like quality of the prostate.
A lack of pain on palpation. - ANSWER - A hard nodule can indicate prostate cancer.
The purpose of straining in BPH is to overcome the obstruction encountered during urination.
True
False - ANSWER - True. The individual strains to overcome the obstruction in order to release the urine.
There is a significant risk for men with benign prostatic hyperplasia (BPH) to develop cellular mutations
that lead to prostate cancer.
True
False - ANSWER - False. BPH does not lead to prostate cancer.
The peripheral zone of the prostate is the largest zone.
True
False - ANSWER - True. Anatomically, the peripheral zone is the largest one.
The patient most often develops symptoms of BPH when:
A. The bladder becomes obstructed.
B. The patient's PSA becomes elevated.
C. A nodule forms on the prostate.
pg. 3
