GENITOURINARY EXAM
MASTER EXAM
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Questions and Verified Answers,
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This Exam contains: GENITOURINARY EXAM
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Trusted by thousands of nursing students worldwide Page 1 of 148
,Question 1
Case
A 62-year-old woman is being treated for chronic congestive heart failure. She has been put on
hydrochlorothiazide therapy. Her serum electrolyte levels are being monitored and show a persistent
hypokalemia.
Question
The addition of what to her therapeutic regimen would be most appropriate?
Correct Answer
Correct answer:
Amiloride
Explanation
Amiloride is a potassium-sparing diuretic. Its diuretic effect is not very potent; therefore, it is good to use
in combination with other diuretics.
Acetazolamide is a carbonic anhydrase inhibitor. It causes a mild diuresis, a marked elevation of urinary
pH, and a significant loss of potassium.
Furosemide is a loop diuretic. It has a rapid onset of action and is a potent diuretic. However, it also
causes potassium depletion and would only worsen the hypokalemia.
Indapamide is a thiazide analog with a long duration of action. If anything, it would exacerbate the
hypokalemia.
Mannitol is an osmotic diuretic and would not be recommended in this patient. Furthermore, it would not
have a potassium-sparing effect.
Trusted by thousands of nursing students worldwide Page 2 of 148
,Question 2
Case
A 42-year-old man presents with lower extremity swelling. His past medical history and review of symptoms
is otherwise negative. The patient looks comfortable, with vitals showing the following: BP 142/91 mm Hg,
HR 90 beats/min, RR 16 breaths/min, T 98°F, height 5'9'', and weight 158 lb. His examination is only
remarkable for 2+ pitting edema in the lower extremities. The patient is counseled on a low-salt diet. The
abnormal laboratory values are as follows:
Lab Result
Urinalysis 3+ protein, coarse granular casts, 2 - 5 WBCs, 0 - 2 RBCs
Serum albumin 2.1 gm/dL
Serum creatinine 2.0 mg/dL
Serum BUN 18 mg/dL
Hemoglobin 12.1 gm/dL
Question
What should be the next step in the management of this patient?
Correct Answer
Correct answer:
Order a 24-hour urine to quantitate urine protein
Explanation
The clinical picture is most consistent with nephrotic syndrome. This syndrome is characterized by
proteinuria in excess of 3.5 grams a day per 1.73 m3 body surface area. Other symptoms commonly seen
include edema, hypoalbuminemia, and hyperlipidemia. Patients may also exhibit anemia. Usually there is
not an active urine sediment. The correct diagnostic test to confirm nephrotic syndrome is a 24-hour urine
to quantitate the protein loss.
If the diagnosis is confirmed, a renal biopsy may be considered to aid in determining the cause of
nephrotic syndrome. However, because it is an invasive test, it should not be performed until the
diagnosis is established.
The patient has no symptoms of a urinary tract infection and only a small number of WBCs in her
urinalysis, so a urine culture and empiric treatment would not be indicated.
Since the patient does not have hematuria or pain, a kidney stone is unlikely; therefore, an intravenous
pyelogram would not be indicated.
Trusted by thousands of nursing students worldwide Page 3 of 148
, Question 3
Case
A 54-year-old man presents with a lump in his scrotum recently. After answering many questions about
possible symptoms and undergoing a thorough genitourinary examination, the patient is told that he most
likely has a hydrocele.
Question
What findings most closely support this diagnosis?
Correct Answer
orrect answer:
Non-tender, fluid-filled lesion that transilluminates
Explanation The correct answer is a non-tender, fluid-filled lesion that transilluminates. A hydrocele is a
collection of fluid within the tunica vaginalis. It is non-tender, usually develops slowly over time, and will
transilluminate when a light is held up to the scrotal wall. Patients can experience fluctuating size of the
hydrocele, swelling of the scrotum or inguinal canal, heavy sensation within the scrotum, and do not
typically experience any pain.
Solid mass within the testicle that does not transilluminate is not the correct answer. Solid masses that are
actually in the testicle itself are malignancies until proven otherwise. Patients may have a reactive
hydrocele in addition to the malignancy, but hydroceles do not actually present as solid masses. In
addition, hydroceles will transilluminate, whereas testicular malignancies will not transilluminate on
examination.
Painful swollen retracted testis that does not transilluminate is not the correct answer. This more closely
describes testicular torsion as opposed to a hydrocele. Testicular torsion is painful, whereas hydroceles are
not painful. Testicular torsion can also cause one testicle to retract and will not transilluminate upon
examination. Testicular torsion is a urologic emergency, whereas hydroceles are often not even treated.
Non-tender mass with the consistency of a "bag of worms" without transillumination is not the correct
answer, as this description is more closely associated with a varicocele. Both hydroceles and varicoceles
are non-tender, but hydroceles will transilluminate and varicoceles will not. Since a varicocele is a venous
varicosity without the spermatic vein, it is often described as having the consistency of a "bag of worms"
on examination. It will also decrease in size if the scrotum is elevated or the patient lies supine.
Painless cystic mass containing sperm that transilluminates is not the correct answer, as this more closely
describes a spermatocele. A spermatocele is usually a palpable cystic mass that is free-floating above the
testicle and will transilluminate upon examination. Spermatoceles and hydroceles are similar in that they
are painless, harmless, and usually do not require treatment.
Trusted by thousands of nursing students worldwide Page 4 of 148
MASTER EXAM
(2025/2026 UPDATE) with
Questions and Verified Answers,
100% Guarantee Pass
100% Guarantee Pass
This Exam contains: GENITOURINARY EXAM
✓ MASTER EXAM
✓ 100% Accurate Questions and Answers
✓ 100% Guarantee Pass - Verified by Experts
✓ Each Question Includes The Correct Answer
✓ Expert-Verified
Trusted by thousands of nursing students worldwide Page 1 of 148
,Question 1
Case
A 62-year-old woman is being treated for chronic congestive heart failure. She has been put on
hydrochlorothiazide therapy. Her serum electrolyte levels are being monitored and show a persistent
hypokalemia.
Question
The addition of what to her therapeutic regimen would be most appropriate?
Correct Answer
Correct answer:
Amiloride
Explanation
Amiloride is a potassium-sparing diuretic. Its diuretic effect is not very potent; therefore, it is good to use
in combination with other diuretics.
Acetazolamide is a carbonic anhydrase inhibitor. It causes a mild diuresis, a marked elevation of urinary
pH, and a significant loss of potassium.
Furosemide is a loop diuretic. It has a rapid onset of action and is a potent diuretic. However, it also
causes potassium depletion and would only worsen the hypokalemia.
Indapamide is a thiazide analog with a long duration of action. If anything, it would exacerbate the
hypokalemia.
Mannitol is an osmotic diuretic and would not be recommended in this patient. Furthermore, it would not
have a potassium-sparing effect.
Trusted by thousands of nursing students worldwide Page 2 of 148
,Question 2
Case
A 42-year-old man presents with lower extremity swelling. His past medical history and review of symptoms
is otherwise negative. The patient looks comfortable, with vitals showing the following: BP 142/91 mm Hg,
HR 90 beats/min, RR 16 breaths/min, T 98°F, height 5'9'', and weight 158 lb. His examination is only
remarkable for 2+ pitting edema in the lower extremities. The patient is counseled on a low-salt diet. The
abnormal laboratory values are as follows:
Lab Result
Urinalysis 3+ protein, coarse granular casts, 2 - 5 WBCs, 0 - 2 RBCs
Serum albumin 2.1 gm/dL
Serum creatinine 2.0 mg/dL
Serum BUN 18 mg/dL
Hemoglobin 12.1 gm/dL
Question
What should be the next step in the management of this patient?
Correct Answer
Correct answer:
Order a 24-hour urine to quantitate urine protein
Explanation
The clinical picture is most consistent with nephrotic syndrome. This syndrome is characterized by
proteinuria in excess of 3.5 grams a day per 1.73 m3 body surface area. Other symptoms commonly seen
include edema, hypoalbuminemia, and hyperlipidemia. Patients may also exhibit anemia. Usually there is
not an active urine sediment. The correct diagnostic test to confirm nephrotic syndrome is a 24-hour urine
to quantitate the protein loss.
If the diagnosis is confirmed, a renal biopsy may be considered to aid in determining the cause of
nephrotic syndrome. However, because it is an invasive test, it should not be performed until the
diagnosis is established.
The patient has no symptoms of a urinary tract infection and only a small number of WBCs in her
urinalysis, so a urine culture and empiric treatment would not be indicated.
Since the patient does not have hematuria or pain, a kidney stone is unlikely; therefore, an intravenous
pyelogram would not be indicated.
Trusted by thousands of nursing students worldwide Page 3 of 148
, Question 3
Case
A 54-year-old man presents with a lump in his scrotum recently. After answering many questions about
possible symptoms and undergoing a thorough genitourinary examination, the patient is told that he most
likely has a hydrocele.
Question
What findings most closely support this diagnosis?
Correct Answer
orrect answer:
Non-tender, fluid-filled lesion that transilluminates
Explanation The correct answer is a non-tender, fluid-filled lesion that transilluminates. A hydrocele is a
collection of fluid within the tunica vaginalis. It is non-tender, usually develops slowly over time, and will
transilluminate when a light is held up to the scrotal wall. Patients can experience fluctuating size of the
hydrocele, swelling of the scrotum or inguinal canal, heavy sensation within the scrotum, and do not
typically experience any pain.
Solid mass within the testicle that does not transilluminate is not the correct answer. Solid masses that are
actually in the testicle itself are malignancies until proven otherwise. Patients may have a reactive
hydrocele in addition to the malignancy, but hydroceles do not actually present as solid masses. In
addition, hydroceles will transilluminate, whereas testicular malignancies will not transilluminate on
examination.
Painful swollen retracted testis that does not transilluminate is not the correct answer. This more closely
describes testicular torsion as opposed to a hydrocele. Testicular torsion is painful, whereas hydroceles are
not painful. Testicular torsion can also cause one testicle to retract and will not transilluminate upon
examination. Testicular torsion is a urologic emergency, whereas hydroceles are often not even treated.
Non-tender mass with the consistency of a "bag of worms" without transillumination is not the correct
answer, as this description is more closely associated with a varicocele. Both hydroceles and varicoceles
are non-tender, but hydroceles will transilluminate and varicoceles will not. Since a varicocele is a venous
varicosity without the spermatic vein, it is often described as having the consistency of a "bag of worms"
on examination. It will also decrease in size if the scrotum is elevated or the patient lies supine.
Painless cystic mass containing sperm that transilluminates is not the correct answer, as this more closely
describes a spermatocele. A spermatocele is usually a palpable cystic mass that is free-floating above the
testicle and will transilluminate upon examination. Spermatoceles and hydroceles are similar in that they
are painless, harmless, and usually do not require treatment.
Trusted by thousands of nursing students worldwide Page 4 of 148
