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Exam 3: NUR 6111 (2026 Update) Advanced Practice Nursing Guide| Questions & Answers Grade A 100% Correct Verified Solutions

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This document provides a comprehensive clinical overview of urinary incontinence (types, risk factors, diagnosis, and management including behavioral, pharmacologic, and surgical therapies), kidney disease (AKI staging, CKD evaluation and treatment), nephrolithiasis (stone diagnosis and passage rates), urinary tract infections (UTI, pyelonephritis, recurrent UTI, and epididymitis), prostatitis (categories and UPOINT system), benign prostatic hyperplasia (BPH), prostate cancer (Gleason score), and male sexual dysfunction/erectile dysfunction (causes, evaluation, and PDE5 inhibitors). Key clinical pearls include first-line behavioral therapy for incontinence, urine culture thresholds, antibiotic selection, and contraindication of nitrates with PDE5 inhibitors.

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Exam 3: NUR 6111 (2026 Update) Advanced Practice
Nursing Guide| Questions & Answers Grade A 100%
Correct Verified Solutions

1. Definition: Urinary incontinence

Answer: Involuntary loss of urine (in an adult patient) from the urethra. Major inconvenience. More
common in females than males.



2. Effects of urinary incontinence

Answer: Increased risk of skin infections: incontinence dermatitis (diaper rash), bacterial/fungal
infections. Activities such as running or other high impact exercises are often avoided or stopped.
Avoiding social activities, isolation, depression and anxiety. Financial: 23% of women take time off work.



3. Risk factors (RF) for incontinence

Answer: Increasing age, declining estrogen levels, multiparity, dementia, DM, spinal cord injury/lesion,
prostatic hypertrophy, stroke, medications (e.g., diuretics), immobility.



4. Stress urinary incontinence

Answer: Predictable loss of urine with activities that increase intra-abdominal pressure (sneezing,
laughing, exercising).



5. Urge urinary incontinence

Answer: Urgency as well as increased urinary frequency or nocturia. Patients typically lose urine on
the way to the toilet.



6. Mixed urinary incontinence

Answer: Has both components of stress and urge incontinence.



7. Overflow urinary incontinence

Answer: Urinary retention and subsequent leakage. Patients may strain to pass urine or have a
sensation of incomplete emptying.

,8. Functional urinary incontinence

Answer: Occurs when there are barriers to toileting such as cognitive impairment, physical frailty or
immobility.



19. Assessment findings for urinary incontinence

Answer: Involuntary loss of urine, urinary urgency, perineal irritation. Pelvic exam: may detect GU
pathology. Rectal exam: may demonstrate prostatic pathology, fecal impaction. Abdomen: may palpate
distended bladder.



10. Urinalysis for urinary incontinence

Answer: Abnormal: hematuria, pyuria, bacteriuria, glycosuria, proteinuria. Order urine culture if
bacteria is detected.



11. Cystometry for urinary incontinence

Answer: Severe urgency or bladder contractions when <300ml of bladder volume = urge incontinence.



12. BUN, creatinine for urinary incontinence

Answer: Suspected obstruction, noncompliant bladder, urinary retention.



13. FBS and Ca levels for urinary incontinence

Answer: Polyuria and lack of diuretic drugs.



14. Diagnosis (DX) of urinary incontinence

Answer: Urinalysis, cystometry, BUN, creatinine, FBS and Ca levels, voiding diary (203 days indicating
when incontinent episodes occur), post voiding residual volume measurement (200-300ml).



15. Prevention of urinary incontinence

Answer: Kegel exercises or pelvic floor therapy, treatment of BPH, maintain healthy weight, adequate
oral hydration, avoidance of bladder irritants (caffeine, alcohol), smoking cessation.

, 17. Non-pharm management of stress urinary incontinence

Answer: Behavioral therapies: timed or double voiding, smoking cessation, weight loss, pelvic muscle
exercises with or without a physical therapist, pessary, bowel management. Surgical: injectables,
bladder neck suspensions, slings, artificial sphincters.



18. Pharm management of stress UI

Answer: Not FDA approved. Alpha adrenergic agonist: pseudoephedrine (Sudafed) - increase urethral
pressure and outlet resistance, may improve s/s without significant side effects. Tricyclic antidepressant:
Imipramine 10-25mg PO up to TID - may be useful in younger patients who have failed other therapies,
alpha agonist and anticholinergic effects. Estrogen - topical cream (may help improve urethral closure).



19. Urge UI non-pharm management
Answer: Behavioral therapies: same as stress UI with bladder training, scheduled voiding, bladder
irritants minimization, and urge suppression. Surgical therapy: neurosacral modulation, bladder
augmentation, botulinum toxin injection.



20. Urge UI pharm management

Answer: Anticholinergic/antimuscarinics: oxybutynin 2.5-5mg PO BID-TID, tolterodine 2mg BID
(caution with bladder outflow obstruction, caution in OA, sedation, confusion, delirium). Beta adrenergic
agonists: mirabegron 25mg PO daily (may increase BP in patients with HTN, not recommended in severe
hepatic or renal impairment).



21. Mixed UI management

Answer: Combination of therapies for stress and urge incontinence.



22. Overflow UI non-pharm management

Answer: Behavioral therapies: timed or double voiding, clean intermittent catheterization, pessary.
Surgery: to relieve urethral obstruction or stricture or to reduce prolapse.



23. Overflow UI pharm management

Answer: Alpha blockers: tamsulosin 0.4mg PO daily, doxazosin 1mg PO daily (may cause orthostatic
hypotension, dizziness, HA). 5-alpha reductase inhibitors: Finasteride 5mg PO daily, dutasteride 0.5mg
PO daily (may cause HA, GI discomfort, decreased libido).

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