EXAM 2026 LATEST EDITION 100 QUESTIONS
AND SOLUTIONS
1. An older male patient reports urinary frequency, back pain, and nocturia. A dipstick
urinalysis reveals hematuria. What will the provider do next to evaluate this condition?
A. Treat for UTI
B. Prescribe diuretics
C. PSA and perform a digital rectal exam
D. Monitor symptoms at home
Answer: C
Rationale: Hematuria, back pain, and urinary symptoms in an older male warrant evaluation for prostate
pathology including PSA testing and digital rectal exam.
2. An older male patient has a screening PSA which is 12 ng/ml. What does this value
indicate?
A. Normal PSA
B. Mild BPH
C. Requires further evaluation for prostate malignancy
D. Indicative of UTI
Answer: C
Rationale: A PSA above 10 ng/ml is significantly elevated and suggests the need for further evaluation
for prostate cancer.
3. A male patient reports nocturia and daytime urinary frequency and urgency without
changes in the force of the urine stream. What is the likely cause of this?
A. Benign prostatic hyperplasia
B. Urinary tract infection
C. Prostate cancer
D. Renal calculi
Answer: B
Rationale: Irritative urinary symptoms without decreased stream strength are more consistent with a
urinary tract infection than obstructive prostate disease.
4. A 70-year-old male reports urinary hesitancy, post void dribbling, and a diminished urine
stream. A digital rectal exam reveals an enlarged prostate gland that feels rubbery and smooth.
Which tests will the primary care provider order based on these findings?
A. PSA and cystoscopy
,B. Urinalysis and serum creatinine
C. CT scan of the abdomen
D. Prostate biopsy
Answer: B
Rationale: Findings suggest benign prostatic hyperplasia. Urinalysis and serum creatinine assess for
infection and renal impairment.
5. The provider orders the oral phosphodiesterase type 5 inhibitor Sildenafil to treat erectile
dysfunction in a 65-year-old male patient. What will be included when teaching this patient
about taking this medication? Select all that apply.
A. Take on an empty stomach
B. The medication effects may last for 24–36 hours
C. Medication may be taken once daily
D. Take with nitrates if chest pain occurs
Answer: A, B, C
Rationale: Sildenafil is best absorbed on an empty stomach, may last up to 36 hours, and is dosed once
daily. It must not be taken with nitrates.
6. Which is true about hypoactive sexual desire in older men?
A. It is always pathological
B. It is related to sexual aversion
C. It occurs only with erectile dysfunction
D. It requires medication therapy
Answer: B
Rationale: Hypoactive sexual desire in older men is often related to psychosocial factors and sexual
aversion.
7. A young adult male reports a dull pain in the scrotum and the provider notes a bluish color
showing through the skin on the affected side. Palpation reveals a “bag of worms” on the
proximal spermatic cord. What is an important next step in managing this patient?
A. Prescribe antibiotics
B. Apply ice and rest
C. Referral to an emergency department for surgical consultation
D. Reassurance only
Answer: C
Rationale: These findings are consistent with a varicocele that may require surgical evaluation.
, 8. An adolescent male reports severe pain in one testicle. The examiner notes edema and
erythema of the scrotum with absence of the cremasteric reflex. What is the most important
intervention?
A. NSAIDs
B. Doppler ultrasound to assess testicular blood flow
C. Antibiotics
D. Scrotal support
Answer: B
Rationale: Testicular torsion is a surgical emergency and Doppler ultrasound confirms impaired blood
flow.
9. A high school athlete collapses during outdoor practice on a hot day and presents with
confusion, tachycardia, dry mucous membranes, and sodium of 152 mEq/mL. What is the
initial rehydration approach?
A. Oral fluids
B. Hypotonic saline
C. Intravenous fluid resuscitation with an isotonic solution
D. Hypertonic saline
Answer: C
Rationale: Initial treatment of dehydration and hypernatremia is isotonic IV fluids to restore volume.
10. An elderly patient on a thiazide diuretic presents with vomiting, oliguria, tachycardia, and
a sodium level of 118 mEq/mL. What is the treatment?
A. Fluid restriction
B. Emergency volume repletion with 3% NaCl
C. D5W infusion
D. Oral salt
Answer: B
Rationale: Severe symptomatic hyponatremia requires hypertonic saline.
11. Which thyroid-stimulating hormone level indicates hyperthyroidism?
A. 4.5 uIU/L
B. 2.0 uIU/L
C. 0.2 uIU/L
D. 6.0 uIU/L
Answer: C
Rationale: Suppressed TSH levels indicate hyperthyroidism.