FNP III - Exam Study Guide –
Practice Questions with
Answers. GRADED A+. Updated
2026
Pre-renal causes of Hematuria - Ans✔✔-Coagulopathies (ITP, Hemophilia),
Medications (OACs, aspirin), SCD or trait, Lupus, Wilm's tumor
Renal (Non-glomerular) causes of Hematuria - Ans✔✔-Pyelonephritis, PCKD,
granulomatous disease, malignant neoplasm, congenital and vascular
anomalies (medullary sponge kidney)
Renal (Glomerular) causes of Hematuria - Ans✔✔-Immune-complex mediated
(IgA, lupus, infection-related)
Anti-GBM disease
ANCA-associated vasculitis
Glomerulonephritis, Berger's disease, Lupus nephritis, Benign familial
hematuria, Vasculitis, Alport syndrome (familial nephritis).
Post-Renal causes of Hematuria - Ans✔✔-Renal calculi, ureteritis, cystitis,
prostatitis, BPH, Epididymitis, Urethritis, Malignant neoplasms
,False hematuria - Ans✔✔-Vaginal bleeding, menstruation, recent circumcision,
pigmentation from foods (beets, blackberries) or medications (quinine sulfate,
phenazopyridine, rifampin). Rhabdo (myoglobinuria), hemolytic anemia,
porphyria.
Other causes of hematuria - Ans✔✔-Trauma, strenuous exercise, fever
Definition of Microscopic Hematuria - Ans✔✔-3 or more red blood cells per
high-power field on a microscopic evaluation of urine. A positive dipstick for
heme (1+ heme = 3 RBC) merits a microscopic examination to confirm or
refute.
Most common cause of hematuria - Ans✔✔-UTI
Send a urine culture in any cause of unexplained hematuria.
Diagnostic tests for hematuria - Ans✔✔-Gold Standard - Urine dipstick (if
positive --> Urinalysis)
Urine C&S
CBC w/ diff, BUN/Creatinine, PT, pTT, INR.
If indicated - STI testing, Sickle cell testing, Strep testing (glomerulonephritis),
ANA for lupus
Imaging - CT urography (CTU) is preferred for most clients with unexplained
persistent hematuria. Cystoscopy. CT of ab/pelvis should be considered in hx of
trauma.
Medical management of Hematuria - Ans✔✔-In patients under 35 with normal
PE - limited: CBC/CMP, repeat UA in 2 weeks.
In patients >35 yr - detailed investigation and referral
, All patients on anticoagulants should get referral to urology/nephrology.
Women with Hematuria - Ans✔✔-Rule on menstruation and recent sexual
activity.
If pregnant, rule out vaginal bleeding.
If imaging necessary - US should be used.
Pediatric Hematuria - Ans✔✔-UTI is most common cause, followed by irritation
or ulceration of perineum/urethral meatus, followed by trauma.
If imaging needed, Renal US is preferred. Cystoscopy is rarely indicated unless
mass is noted on US
Can develop secondary to streptococcal infection.
Geriatric Hematuria - Ans✔✔-Risk of malignancy increases among older
individuals with significant hx of smoking or analgesic abuse. High use of
anticoagulants in this age group, be sure to review medications.
When to refer for hematuria - Ans✔✔-When benign conditions are ruled out
and hematuria persists.
New gross hematuria
The presence of significant proteinuria (>1000/24 hr), renal insufficiency, red
cell casts, or a predominance of dysmorphic RBCs = indicates renal
parenchymal disease.
Low-risk Hematuria guidelines - Ans✔✔-Discuss repeat urinalysis over the next
6 months or proceeding immediately with cystoscopy and renal US.
If hematuria persists on repeat, then reclassify as intermediate and send for
both upper/lower tract imaging.
Practice Questions with
Answers. GRADED A+. Updated
2026
Pre-renal causes of Hematuria - Ans✔✔-Coagulopathies (ITP, Hemophilia),
Medications (OACs, aspirin), SCD or trait, Lupus, Wilm's tumor
Renal (Non-glomerular) causes of Hematuria - Ans✔✔-Pyelonephritis, PCKD,
granulomatous disease, malignant neoplasm, congenital and vascular
anomalies (medullary sponge kidney)
Renal (Glomerular) causes of Hematuria - Ans✔✔-Immune-complex mediated
(IgA, lupus, infection-related)
Anti-GBM disease
ANCA-associated vasculitis
Glomerulonephritis, Berger's disease, Lupus nephritis, Benign familial
hematuria, Vasculitis, Alport syndrome (familial nephritis).
Post-Renal causes of Hematuria - Ans✔✔-Renal calculi, ureteritis, cystitis,
prostatitis, BPH, Epididymitis, Urethritis, Malignant neoplasms
,False hematuria - Ans✔✔-Vaginal bleeding, menstruation, recent circumcision,
pigmentation from foods (beets, blackberries) or medications (quinine sulfate,
phenazopyridine, rifampin). Rhabdo (myoglobinuria), hemolytic anemia,
porphyria.
Other causes of hematuria - Ans✔✔-Trauma, strenuous exercise, fever
Definition of Microscopic Hematuria - Ans✔✔-3 or more red blood cells per
high-power field on a microscopic evaluation of urine. A positive dipstick for
heme (1+ heme = 3 RBC) merits a microscopic examination to confirm or
refute.
Most common cause of hematuria - Ans✔✔-UTI
Send a urine culture in any cause of unexplained hematuria.
Diagnostic tests for hematuria - Ans✔✔-Gold Standard - Urine dipstick (if
positive --> Urinalysis)
Urine C&S
CBC w/ diff, BUN/Creatinine, PT, pTT, INR.
If indicated - STI testing, Sickle cell testing, Strep testing (glomerulonephritis),
ANA for lupus
Imaging - CT urography (CTU) is preferred for most clients with unexplained
persistent hematuria. Cystoscopy. CT of ab/pelvis should be considered in hx of
trauma.
Medical management of Hematuria - Ans✔✔-In patients under 35 with normal
PE - limited: CBC/CMP, repeat UA in 2 weeks.
In patients >35 yr - detailed investigation and referral
, All patients on anticoagulants should get referral to urology/nephrology.
Women with Hematuria - Ans✔✔-Rule on menstruation and recent sexual
activity.
If pregnant, rule out vaginal bleeding.
If imaging necessary - US should be used.
Pediatric Hematuria - Ans✔✔-UTI is most common cause, followed by irritation
or ulceration of perineum/urethral meatus, followed by trauma.
If imaging needed, Renal US is preferred. Cystoscopy is rarely indicated unless
mass is noted on US
Can develop secondary to streptococcal infection.
Geriatric Hematuria - Ans✔✔-Risk of malignancy increases among older
individuals with significant hx of smoking or analgesic abuse. High use of
anticoagulants in this age group, be sure to review medications.
When to refer for hematuria - Ans✔✔-When benign conditions are ruled out
and hematuria persists.
New gross hematuria
The presence of significant proteinuria (>1000/24 hr), renal insufficiency, red
cell casts, or a predominance of dysmorphic RBCs = indicates renal
parenchymal disease.
Low-risk Hematuria guidelines - Ans✔✔-Discuss repeat urinalysis over the next
6 months or proceeding immediately with cystoscopy and renal US.
If hematuria persists on repeat, then reclassify as intermediate and send for
both upper/lower tract imaging.
