MSN 621 ACTUAL EXAM PAPER 2026
QUESTIONS WITH SOLUTIONS GRADED A+
▶ Uncomplicated UTI. Answer: Occurs in otherwise normal urinary tract
Usually involves only the bladder, may be treated with oral antibiotics
▶ Complicated UTI. Answer: occurs in individuals with structural or
functional urinary tract system or someone who is immunocompromised,
may require parental therapy until afebrile
▶ UTI signs and symptoms. Answer: dysuria, frequent urination, urgency,
fever, n/v, lower back pain, confusion if elderly, foul-smelling, hematuria,
chills, edema, bladder spasms
▶ UTI pathogens. Answer: Gram (-)
80-90% related to E.coli
- >70% - E. coli, klebsiella, proteus, enterobacter, pseudomonas
Gram (+)
10-15% related to gram positive
- Staph saprophyticus
- Enterococcus
▶ UTI diagnosis. Answer: urinalysis and urine culture
▶ UTI (ultrasound). Answer: Especially useful in children
▶ Urodynamic evaluation. Answer: a series of procedures to evaluate the
motor and sensory functions of the bladder and efficiency of micturition
▶ UTI management first line. Answer: nitrofurantoin monohydrate
(Macrobid)/macrocrystals, Bactrim
▶ UTI management second line. Answer: Cipro, Levaquin
Alternate therapies: Augmentin, Keflex
, pyridium for symptoms
▶ UTI management in pregnancy. Answer: Do not use Fluoroquinolones
(auditory and vestibular toxicity)
Do not use tetracycline (tooth staining)
Nitrofurantoin is contraindicated in pregnancy clients at term, during labor,
and during delivery
▶ UTI local antibiotic resistance. Answer: Use antiviral to check for local
resistance, these can be found at your local hospital
▶ pyelonephritis. Answer: Acute infection and inflammatory disease of the
upper urinary tract of one or both kidneys
▶ Acute pyelonephritis characterized by. Answer: Scarring to the kidneys
and may lead to significant damage, kidney failure, abscess formation, and
sepsis
▶ Upper UTI (pyelonephritis). Answer: Are less common, but more serious
than lower UTIs, may require hospitalization
▶ Pyelonephritis symptoms. Answer: 1) urinary frequency
2) urgency
3) fevers, chills, shaking
4) CVA tenderness
5) flank pain and tenderness.
6) nausea and vomiting
7) hematuria
8) abdominal pain or suprapubic heaviness
9) elderly may present with mental status change
**Pyelonephritis is also a more severe disease, so there is a higher fever
and the patient is much more ill.
▶ Pylonephritis diagnostic test. Answer: Urinalysis, urine cx and
sensitivity, blood cxs if indicated, CT/MRI, renal ultrasound, STI testing
▶ Pyelonephritis management. Answer: broad-spec antibiotics, pain
management (NSAIDS + anti-pyretic), adequate oral fluid
QUESTIONS WITH SOLUTIONS GRADED A+
▶ Uncomplicated UTI. Answer: Occurs in otherwise normal urinary tract
Usually involves only the bladder, may be treated with oral antibiotics
▶ Complicated UTI. Answer: occurs in individuals with structural or
functional urinary tract system or someone who is immunocompromised,
may require parental therapy until afebrile
▶ UTI signs and symptoms. Answer: dysuria, frequent urination, urgency,
fever, n/v, lower back pain, confusion if elderly, foul-smelling, hematuria,
chills, edema, bladder spasms
▶ UTI pathogens. Answer: Gram (-)
80-90% related to E.coli
- >70% - E. coli, klebsiella, proteus, enterobacter, pseudomonas
Gram (+)
10-15% related to gram positive
- Staph saprophyticus
- Enterococcus
▶ UTI diagnosis. Answer: urinalysis and urine culture
▶ UTI (ultrasound). Answer: Especially useful in children
▶ Urodynamic evaluation. Answer: a series of procedures to evaluate the
motor and sensory functions of the bladder and efficiency of micturition
▶ UTI management first line. Answer: nitrofurantoin monohydrate
(Macrobid)/macrocrystals, Bactrim
▶ UTI management second line. Answer: Cipro, Levaquin
Alternate therapies: Augmentin, Keflex
, pyridium for symptoms
▶ UTI management in pregnancy. Answer: Do not use Fluoroquinolones
(auditory and vestibular toxicity)
Do not use tetracycline (tooth staining)
Nitrofurantoin is contraindicated in pregnancy clients at term, during labor,
and during delivery
▶ UTI local antibiotic resistance. Answer: Use antiviral to check for local
resistance, these can be found at your local hospital
▶ pyelonephritis. Answer: Acute infection and inflammatory disease of the
upper urinary tract of one or both kidneys
▶ Acute pyelonephritis characterized by. Answer: Scarring to the kidneys
and may lead to significant damage, kidney failure, abscess formation, and
sepsis
▶ Upper UTI (pyelonephritis). Answer: Are less common, but more serious
than lower UTIs, may require hospitalization
▶ Pyelonephritis symptoms. Answer: 1) urinary frequency
2) urgency
3) fevers, chills, shaking
4) CVA tenderness
5) flank pain and tenderness.
6) nausea and vomiting
7) hematuria
8) abdominal pain or suprapubic heaviness
9) elderly may present with mental status change
**Pyelonephritis is also a more severe disease, so there is a higher fever
and the patient is much more ill.
▶ Pylonephritis diagnostic test. Answer: Urinalysis, urine cx and
sensitivity, blood cxs if indicated, CT/MRI, renal ultrasound, STI testing
▶ Pyelonephritis management. Answer: broad-spec antibiotics, pain
management (NSAIDS + anti-pyretic), adequate oral fluid
