Complete Course Study Guide |Midterm, Final &
Comprehensive Exam Review Study Guide (2026/2027) |
Complete Nursing Exam Study Guide MOST TESTED
QUESTIONS FROM PAST PAPERS WITH CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED ANSWERS)
|ALREADY GRADED A+||NEWEST VERSION REVIEW
Contents
Midterm.................................................................................................. 1
Final ................................................................................................... 50
Comprehensive Exam Review ...................................................... 126
Midterm
Question 1
A 26-year-old healthy woman presents with dysuria, urinary frequency, and urgency for 2 days.
She has no vaginal discharge or flank pain. What is the most likely diagnosis?
A. Acute pyelonephritis
B. Uncomplicated acute cystitis
C. Interstitial cystitis
D. Urethral stricture
Correct Answer: B. Uncomplicated acute cystitis
Rationale:
Classic lower UTI symptoms in a young, nonpregnant woman without systemic or flank findings
are consistent with uncomplicated cystitis.
,Question 2
Which organism most commonly causes uncomplicated community-acquired cystitis in women?
A. Staphylococcus aureus
B. Escherichia coli
C. Pseudomonas aeruginosa
D. Candida albicans
Correct Answer: B. Escherichia coli
Rationale:
E. coli is by far the most common pathogen in uncomplicated UTIs in women.
Question 3
A 35-year-old woman with uncomplicated cystitis is otherwise healthy and not pregnant. Which
empiric oral regimen is commonly used first-line in primary care (assuming local resistance
patterns support it)?
A. Nitrofurantoin for 5 days
B. IV ceftriaxone
C. Ciprofloxacin for 30 days
D. No antibiotics
Correct Answer: A. Nitrofurantoin for 5 days
Rationale:
Nitrofurantoin for 5 days is standard first-line therapy for uncomplicated cystitis in many
guidelines, alongside options like TMP-SMX depending on local resistance.
Question 4
Which clinical feature best distinguishes acute pyelonephritis from simple cystitis?
A. Dysuria only
B. Frequency only
C. Fever, flank pain, and costovertebral angle tenderness
D. Mild suprapubic discomfort
Correct Answer: C. Fever, flank pain, and costovertebral angle tenderness
,Rationale:
Systemic signs with flank pain and CVA tenderness indicate upper tract involvement
(pyelonephritis).
Question 5
A 40-year-old woman with diabetes presents with fever, flank pain, chills, and nausea. She has
CVA tenderness and positive urine culture. Which disposition is most appropriate?
A. Treat at home always
B. Consider hospital admission for IV antibiotics due to systemic illness and diabetes
C. No antibiotics needed
D. Treat with a single dose of oral nitrofurantoin
Correct Answer: B. Consider hospital admission for IV antibiotics
Rationale:
Pyelonephritis in patients with significant comorbidities like diabetes and systemic signs may
require inpatient treatment.
Question 6
A 32-year-old man presents with dysuria and clear urethral discharge after unprotected sex. UA
is normal; NAAT for gonorrhea/chlamydia is pending. What is the most likely diagnosis?
A. Acute bacterial cystitis
B. Urethritis due to sexually transmitted infection
C. BPH
D. Interstitial cystitis
Correct Answer: B. Urethritis due to STI
Rationale:
Urethritis presents with dysuria and urethral discharge, often with normal standard UA; STI
etiology is common in younger men.
Question 7
, A 55-year-old man reports urinary hesitancy, weak stream, and nocturia. DRE shows smoothly
enlarged, non-tender prostate. PSA is mildly elevated but stable. What is the most likely
diagnosis?
A. Prostate cancer
B. Benign prostatic hyperplasia (BPH)
C. Acute prostatitis
D. Urethral stricture
Correct Answer: B. Benign prostatic hyperplasia (BPH)
Rationale:
LUTS with smooth, symmetrically enlarged prostate strongly suggest BPH. Cancer often presents
with nodules or asymmetry and may have different PSA patterns.
Question 8
Which medication class is commonly used as first-line pharmacologic therapy for moderate
BPH symptoms?
A. Alpha-1 adrenergic blockers (e.g., tamsulosin)
B. Loop diuretics
C. Benzodiazepines
D. Steroids
Correct Answer: A. Alpha-1 adrenergic blockers
Rationale:
Alpha-1 blockers relax smooth muscle in prostate and bladder neck, improving urinary flow.
Question 9
A 67-year-old man with BPH and hypertension is started on tamsulosin. Which adverse effect is
particularly important to discuss?
A. Hyperglycemia
B. Orthostatic hypotension and dizziness
C. Rash only
D. Vision loss
Correct Answer: B. Orthostatic hypotension and dizziness