lOMoAR cPSD| 34983377
Actual NRNP 6531 Final Exam: 100 Verified Questions and
Answers with In-Depth Explanations (2025 Update) |
Walden University | Fully Verified Exam for NRNP 6531
1. A 35 year old sexually active man presents with a 1 week history of fever and pain over the left scrotum. It is
accompanied by frequency and dysuria. The scrotum is edematous and tender to touch. He denies flank pain,
nausea, and vomiting. He reports that eh pain is lessened when he uses scrotal-support briefs. The urinalysis
shows 2 + blood and a large number of leukocytes. What is the most likely diagnosis?
A. Acute urinary tract infection
B. Acute pyelonephritis
C. Acute orthitis
D. Acute epididymitis
2. A 17 year old boy reports feeling something on his left scrotum. On palpation, soft and movable blood vessels
that feel like a "bag of worms" are noted underneath the scrotal skin. It is not swollen or reddened. The most
likely diagnosis is
A. Chronic orchitis
B. Chronic epididymitis
C. Testicular torsion
D. Varicocele
3. A 24-year-old man presents with sudden onset of left-sided scrotal pain. He reports having intermittent
unilateral testicular pain in the past but not as severe as this current episode. Confirmation of testicular torsion
would include all of the following findings except:
A. unilateral loss of the cremasteric reflex.
B. the affected testicle held higher in the scrotum.
C. testicular swelling.
D. relief of pain with scrotal elevation.
4. A patient who has had a swollen, nontender scrotum for one week is found to have a mass within the tunica
vaginalis that transilluminates readily. The family nurse practitioner suspects:
a.) a hydrocele.
b.) a varicocele.
c.) an indirect inguinal hernia.
d.) carcinoma of the testis.
, lOMoAR cPSD| 34983377
5. Max, age 70, is obese. He is complaining of a bulge in his groin that has been there for months. He states that it
is not painful, but it is annoying. You note that the origin of swelling is above the inguinal ligament directly
behind and through the external ring. You diagnose this as a(n):
A. Indirect inguinal hernia.
B. direct inguinal hernia.
C. femoral hernia.
D. strangulated hernia.
6. A client had excessive blood loss and prolonged hypotension during surgery. His postoperative urine output is
sharply decreased, and his blood urea nitrogen (BUN) is elevated. The most likely cause for the change is acute:
A) Prerenal inflammation
B) Bladder outlet obstruction
C) Tubular necrosis
D) Intrarenal nephrotoxicity
7. Mr. S. comes to you with scrotal pain. The examinations of his scrotum, penis, and rectum are normal. Which
of the following conditions outside of the scrotum may present as scrotal pain?
A. Inguinal herniation and peritonitis
B. Renal colic and cardiac ischemia
C. Pancreatitis and Crohn ’ s disease
D. Polyarteritis nodosa and ulcerative colitis
8. The most common type of hernia is a(n):
A. indirect inguinal hernia.
B. direct inguinal hernia.
C. femoral hernia.
D. umbilical hernia.
9. Orchitis is caused by which of the following?
A. Mumps virus
B. Measles virus
C. Chlamydia trachomatis
D. Chronic urinary tract infections that are not treated adequately
10. A 10 year old boy complains of sudden onset of scrotal pain upon awakening that morning. He is also
complaining of severe nausea and vomiting. During the physical examination, the nurse practitioner finds a
tender, warm, and swollen left scrotum. The cremastic reflex is negative and the urine dipstick is negative for
leukocytes, nitrites, and blood. The most likely diagnosis is:
, lOMoAR cPSD| 34983377
A. Acute epididymitis
B. Severe salmonella infection
C. Testicular torsion
D. Acute orchitis
11. What type of follow up should this patient receive?
A. Refer to a urologist within 48 hours
B. Refer him to the emergency department as soon as possible
C. Prescribe ibuprofen (advil) 600 mg QID for pain
D. Order a testicular ultrasound for further evaluation
12. In assessing a man with testicular torsion, the NP is most likely to note:
A. elevated PSA level.
B. white blood cells reported in urinalysis.
C. left testicle most often affected.
D. increased testicular blood flow by color-flow Doppler ultrasound.
13. Anticipated organ survival exceeds 85% with testicular decompression within how many hours of torsion?
A. 1
B. 6
C. 16
D. 24
14. To prevent a recurrence of testicular torsion, which of the following is recommended?
A. use of a scrotal support
B. avoidance of testicular trauma
C. orchiopexy
D. limiting the number of sexual partners
15. Jordan appears with a rapid onset of unilateral scrotal pain radiating up to the groin and flank. You are trying to
differentiate between epididymitis and testicular torsion. Which test to determine whether swelling is in the
testis or the epididymis should be your first choice?
A. X-ray
B. Ultrasound
C. Technetium scan
D. Physical examination
16. The nurse practitioner recognizes that the most common cause of epididymitis in a young man is:
A chlamydia
, lOMoAR cPSD| 34983377
B E. coli
C mycoplasma
D Proteus species
17. Your 25-year-old male patient has had a fever, dysuria, low back pain, and scrotal edema. Which of the
following is likely the diagnosis?
A acute bacteria prostatitis
B acute pyelonephritis
C epididymitis
D urinary tract infection
18. The action of a 5 alpha-reductace inhibitor in the treatment of BPH is to:
- reduce action of androgens in the prostate.
Milton, a 72 year old unmarried, sexually active white man presents to your clinic with complaints of hesitancy,
urgency, and occasional uncontrolled dribbling. Although you suspect benign prostatic hypertrophy, what else
should your differential diagnosis include?
- Urethral stricture (may develop as a result of sexually transmitted diseases and should be considered in a
sexually active individual no matter what the age)
Harry has BPH and complains of some incontinence. Your first step in diagnosing overflow incontinence would be
to order a:
- Post void residual urine measurement
Lower urinary tract symptoms in males can present as a constellation of storage or voiding symptoms. Storage
symptoms include:
- urgency and nocturia
A 63-year-old man presents to you with hematuria, hesitancy, and dribbling. DRE reveals a moderately enlarged
prostate that is smooth. The client’s PSA is 1.2. What is the most appropriate management strategy for you to follow
at this time?
- Prescribe an alpha adrenergic blocker, which will relax bladder and prostate smooth muscle to improve
flow and relieve symptoms.
According to the AUA guideline on the management of BPH, when is referral for invasive surgery automatically
warranted?
- With the presence of refractory retention and bladder stones.
Actual NRNP 6531 Final Exam: 100 Verified Questions and
Answers with In-Depth Explanations (2025 Update) |
Walden University | Fully Verified Exam for NRNP 6531
1. A 35 year old sexually active man presents with a 1 week history of fever and pain over the left scrotum. It is
accompanied by frequency and dysuria. The scrotum is edematous and tender to touch. He denies flank pain,
nausea, and vomiting. He reports that eh pain is lessened when he uses scrotal-support briefs. The urinalysis
shows 2 + blood and a large number of leukocytes. What is the most likely diagnosis?
A. Acute urinary tract infection
B. Acute pyelonephritis
C. Acute orthitis
D. Acute epididymitis
2. A 17 year old boy reports feeling something on his left scrotum. On palpation, soft and movable blood vessels
that feel like a "bag of worms" are noted underneath the scrotal skin. It is not swollen or reddened. The most
likely diagnosis is
A. Chronic orchitis
B. Chronic epididymitis
C. Testicular torsion
D. Varicocele
3. A 24-year-old man presents with sudden onset of left-sided scrotal pain. He reports having intermittent
unilateral testicular pain in the past but not as severe as this current episode. Confirmation of testicular torsion
would include all of the following findings except:
A. unilateral loss of the cremasteric reflex.
B. the affected testicle held higher in the scrotum.
C. testicular swelling.
D. relief of pain with scrotal elevation.
4. A patient who has had a swollen, nontender scrotum for one week is found to have a mass within the tunica
vaginalis that transilluminates readily. The family nurse practitioner suspects:
a.) a hydrocele.
b.) a varicocele.
c.) an indirect inguinal hernia.
d.) carcinoma of the testis.
, lOMoAR cPSD| 34983377
5. Max, age 70, is obese. He is complaining of a bulge in his groin that has been there for months. He states that it
is not painful, but it is annoying. You note that the origin of swelling is above the inguinal ligament directly
behind and through the external ring. You diagnose this as a(n):
A. Indirect inguinal hernia.
B. direct inguinal hernia.
C. femoral hernia.
D. strangulated hernia.
6. A client had excessive blood loss and prolonged hypotension during surgery. His postoperative urine output is
sharply decreased, and his blood urea nitrogen (BUN) is elevated. The most likely cause for the change is acute:
A) Prerenal inflammation
B) Bladder outlet obstruction
C) Tubular necrosis
D) Intrarenal nephrotoxicity
7. Mr. S. comes to you with scrotal pain. The examinations of his scrotum, penis, and rectum are normal. Which
of the following conditions outside of the scrotum may present as scrotal pain?
A. Inguinal herniation and peritonitis
B. Renal colic and cardiac ischemia
C. Pancreatitis and Crohn ’ s disease
D. Polyarteritis nodosa and ulcerative colitis
8. The most common type of hernia is a(n):
A. indirect inguinal hernia.
B. direct inguinal hernia.
C. femoral hernia.
D. umbilical hernia.
9. Orchitis is caused by which of the following?
A. Mumps virus
B. Measles virus
C. Chlamydia trachomatis
D. Chronic urinary tract infections that are not treated adequately
10. A 10 year old boy complains of sudden onset of scrotal pain upon awakening that morning. He is also
complaining of severe nausea and vomiting. During the physical examination, the nurse practitioner finds a
tender, warm, and swollen left scrotum. The cremastic reflex is negative and the urine dipstick is negative for
leukocytes, nitrites, and blood. The most likely diagnosis is:
, lOMoAR cPSD| 34983377
A. Acute epididymitis
B. Severe salmonella infection
C. Testicular torsion
D. Acute orchitis
11. What type of follow up should this patient receive?
A. Refer to a urologist within 48 hours
B. Refer him to the emergency department as soon as possible
C. Prescribe ibuprofen (advil) 600 mg QID for pain
D. Order a testicular ultrasound for further evaluation
12. In assessing a man with testicular torsion, the NP is most likely to note:
A. elevated PSA level.
B. white blood cells reported in urinalysis.
C. left testicle most often affected.
D. increased testicular blood flow by color-flow Doppler ultrasound.
13. Anticipated organ survival exceeds 85% with testicular decompression within how many hours of torsion?
A. 1
B. 6
C. 16
D. 24
14. To prevent a recurrence of testicular torsion, which of the following is recommended?
A. use of a scrotal support
B. avoidance of testicular trauma
C. orchiopexy
D. limiting the number of sexual partners
15. Jordan appears with a rapid onset of unilateral scrotal pain radiating up to the groin and flank. You are trying to
differentiate between epididymitis and testicular torsion. Which test to determine whether swelling is in the
testis or the epididymis should be your first choice?
A. X-ray
B. Ultrasound
C. Technetium scan
D. Physical examination
16. The nurse practitioner recognizes that the most common cause of epididymitis in a young man is:
A chlamydia
, lOMoAR cPSD| 34983377
B E. coli
C mycoplasma
D Proteus species
17. Your 25-year-old male patient has had a fever, dysuria, low back pain, and scrotal edema. Which of the
following is likely the diagnosis?
A acute bacteria prostatitis
B acute pyelonephritis
C epididymitis
D urinary tract infection
18. The action of a 5 alpha-reductace inhibitor in the treatment of BPH is to:
- reduce action of androgens in the prostate.
Milton, a 72 year old unmarried, sexually active white man presents to your clinic with complaints of hesitancy,
urgency, and occasional uncontrolled dribbling. Although you suspect benign prostatic hypertrophy, what else
should your differential diagnosis include?
- Urethral stricture (may develop as a result of sexually transmitted diseases and should be considered in a
sexually active individual no matter what the age)
Harry has BPH and complains of some incontinence. Your first step in diagnosing overflow incontinence would be
to order a:
- Post void residual urine measurement
Lower urinary tract symptoms in males can present as a constellation of storage or voiding symptoms. Storage
symptoms include:
- urgency and nocturia
A 63-year-old man presents to you with hematuria, hesitancy, and dribbling. DRE reveals a moderately enlarged
prostate that is smooth. The client’s PSA is 1.2. What is the most appropriate management strategy for you to follow
at this time?
- Prescribe an alpha adrenergic blocker, which will relax bladder and prostate smooth muscle to improve
flow and relieve symptoms.
According to the AUA guideline on the management of BPH, when is referral for invasive surgery automatically
warranted?
- With the presence of refractory retention and bladder stones.
