NR667 WEEK 8 EXIT EXAM COMPREHENSIVE
STUDY GUIDE 2026 PRACTICE QUESTIONS
AND ACCURATE ANSWERS GRADED A+
◉ Expected course: Fibromyalgia. Answer: -Fluctuating, chronic
course
-Consider dual diagnosis of autoimmune disease
◉ Possible complications: Fibromyalgia. Answer: -Chronic pain
-Chronic work loss
-Marked functional impairment
-Severe depression/anxiety
◉ Etiology: BPH. Answer: -Exact cause unknown
-Age-related hormone changes, androgen/estrogen imbalance,
increased growth-factor signaling
-Age-related epithelial ratio changes increase the number of
prostatic stem cells and decrease cell death
-The presence of testosterone and DHT is necessary for the
development of BPH
◉ Risk factors: BPH. Answer: -Elevated PSA
,-Increasing age
-Family genetics
-Black men more likely to be affected
-Asian men less likely to be affected
-Cigarette smoking, male-pattern baldness, and metabolic syndrome
-DM II
-Obesity
-Increased alcohol consumption
-Physical inactivity
◉ Assessment findings: BPH. Answer: -Obstructive: incomplete
bladder emptying, hesitancy and post-void dribbling, straining to
void, weak urine stream
-Irritative: nocturia, frequency, urgency, dysuria
-Urinary incontinence
-Urinary retention
-Hematuria: gross or microscopic
-Firm, smooth, symmetrically enlarged prostate
◉ Differential diagnosis: BPH. Answer: -Prostatitis
-Prostate cancer
-Urethral stricture
,-Neurogenic bladder
-Side effect of meds (sympathomimetic, opiates, antihistamines,
anticholinergics)
-UTI
-Malignancy (bladder or prostate)
◉ Final diagnosis: BPH. Answer: -Initial evaluation: urological
association symptom index; self-administered tool that asks about
BPH symptoms (incomplete emptying, frequency, intermittency,
urgency, weak stream, hesitancy, and nocturia)
-Mild: 0-7; mod: 8-19; severe: 20-35
-UA: pyuria if residual urine present
-Renal panel to assess function
-PSA: may be elevated, but < 10
-Obstruction: ultrasound and assess renal function
-Needle biopsy
-US, CT, MRI
◉ Non-pharm management: BPH. Answer: -Lifestyle modification:
limit fluids 1-2 hours before bed; frequent voiding; avoid
sympathomimetic (decongestants) or anticholinergic medications
d/t increased risk of urinary retention
-Avoid caffeine, alcohol
-Sitting vs standing may reduce symptoms
, -Limit salt intake (water retention)
◉ Pharmacological management: BPH. Answer: -Assess for infection,
prostate cancer, stricture disease, hypotonic bladder, or other
neurogenic disorders that could mimic BPH
-Indicated in mild-mod disease
-Mild-mod warrant tx with an alpha-1 as monotherapy; provides
immediate therapeutic benefits
-5-alpha-reductase inhibitors should be used long-term for
maximum efficacy: 6-12 months of treatment may be required for
symptom improvement
-Severe disease: initiate treatment with both alpha-1 and 5-alpha-
reductase
◉ Follow-up: BPH. Answer: -Annual digital rectal exam
-PSA annually
-Review possible side effects of medications
-Screen for ED
-Encourage patient to keep log of symptoms and voiding patterns,
including volume of urination
◉ Expected course: BPH. Answer: -Symptoms improve or stabilize in
70-80% of patients
-20-30% of patients require treatment due to worsening symptoms
STUDY GUIDE 2026 PRACTICE QUESTIONS
AND ACCURATE ANSWERS GRADED A+
◉ Expected course: Fibromyalgia. Answer: -Fluctuating, chronic
course
-Consider dual diagnosis of autoimmune disease
◉ Possible complications: Fibromyalgia. Answer: -Chronic pain
-Chronic work loss
-Marked functional impairment
-Severe depression/anxiety
◉ Etiology: BPH. Answer: -Exact cause unknown
-Age-related hormone changes, androgen/estrogen imbalance,
increased growth-factor signaling
-Age-related epithelial ratio changes increase the number of
prostatic stem cells and decrease cell death
-The presence of testosterone and DHT is necessary for the
development of BPH
◉ Risk factors: BPH. Answer: -Elevated PSA
,-Increasing age
-Family genetics
-Black men more likely to be affected
-Asian men less likely to be affected
-Cigarette smoking, male-pattern baldness, and metabolic syndrome
-DM II
-Obesity
-Increased alcohol consumption
-Physical inactivity
◉ Assessment findings: BPH. Answer: -Obstructive: incomplete
bladder emptying, hesitancy and post-void dribbling, straining to
void, weak urine stream
-Irritative: nocturia, frequency, urgency, dysuria
-Urinary incontinence
-Urinary retention
-Hematuria: gross or microscopic
-Firm, smooth, symmetrically enlarged prostate
◉ Differential diagnosis: BPH. Answer: -Prostatitis
-Prostate cancer
-Urethral stricture
,-Neurogenic bladder
-Side effect of meds (sympathomimetic, opiates, antihistamines,
anticholinergics)
-UTI
-Malignancy (bladder or prostate)
◉ Final diagnosis: BPH. Answer: -Initial evaluation: urological
association symptom index; self-administered tool that asks about
BPH symptoms (incomplete emptying, frequency, intermittency,
urgency, weak stream, hesitancy, and nocturia)
-Mild: 0-7; mod: 8-19; severe: 20-35
-UA: pyuria if residual urine present
-Renal panel to assess function
-PSA: may be elevated, but < 10
-Obstruction: ultrasound and assess renal function
-Needle biopsy
-US, CT, MRI
◉ Non-pharm management: BPH. Answer: -Lifestyle modification:
limit fluids 1-2 hours before bed; frequent voiding; avoid
sympathomimetic (decongestants) or anticholinergic medications
d/t increased risk of urinary retention
-Avoid caffeine, alcohol
-Sitting vs standing may reduce symptoms
, -Limit salt intake (water retention)
◉ Pharmacological management: BPH. Answer: -Assess for infection,
prostate cancer, stricture disease, hypotonic bladder, or other
neurogenic disorders that could mimic BPH
-Indicated in mild-mod disease
-Mild-mod warrant tx with an alpha-1 as monotherapy; provides
immediate therapeutic benefits
-5-alpha-reductase inhibitors should be used long-term for
maximum efficacy: 6-12 months of treatment may be required for
symptom improvement
-Severe disease: initiate treatment with both alpha-1 and 5-alpha-
reductase
◉ Follow-up: BPH. Answer: -Annual digital rectal exam
-PSA annually
-Review possible side effects of medications
-Screen for ED
-Encourage patient to keep log of symptoms and voiding patterns,
including volume of urination
◉ Expected course: BPH. Answer: -Symptoms improve or stabilize in
70-80% of patients
-20-30% of patients require treatment due to worsening symptoms
