NU-650 Week 12 GU Focused SOAP
Note: Acute Simple Cystitis Case Study
2026 Update with complete solutions.
Question 1
A 28-year-old female presents with complaints of burning with urination. Which of the
following is the most appropriate way to document this symptom in the SOAP note?
A) "Patient complains of dysuria" under Objective Data
B) "Patient reports burning sensation when voiding" under Subjective Data
C) "Dysuria noted on examination" under Assessment
D) "Urinary discomfort" under Plan
Answer: B
Rationale: Subjective data includes information reported by the patient, such as
symptoms, history, and chief complaints. "Patient reports burning sensation when
voiding" is a direct patient-reported symptom and belongs in the Subjective section.
Objective data consists of measurable findings from examination or testing.
Question 2
Which element of the History of Presenting Illness (HPI) is most critical when evaluating
a patient with suspected acute cystitis?
A) Family history of UTIs
B) Onset, duration, and severity of urinary symptoms
C) Social history including alcohol use
D) Review of systems for cardiac symptoms
Answer: B
Rationale: The HPI should include the onset, duration, severity, and character of
,symptoms. For acute cystitis, understanding when symptoms began and their severity
helps determine if the presentation is acute uncomplicated cystitis versus a more
complicated infection requiring different management.
Question 3
A patient with acute cystitis reports urinary frequency and urgency. Which associated
symptom, if present, would most strongly suggest an alternative diagnosis requiring
pelvic examination?
A) Suprapubic discomfort
B) Hematuria
C) Vaginal discharge
D) Nocturia
Answer: C
Rationale: The presence of vaginal discharge or significant change in vaginal discharge
suggests vaginitis or cervicitis rather than uncomplicated cystitis. This distinction is
important because the differential diagnosis for acute dysuria in women includes cystitis,
vaginitis, and urethritis. Pelvic examination is indicated when vaginal symptoms are
present.
Question 4
Which question is most important to ask a female patient presenting with dysuria to
differentiate uncomplicated cystitis from urethritis?
A) "Have you had any fever or chills?"
B) "Do you have any vaginal discharge or irritation?"
C) "Have you experienced any flank pain?"
D) "Do you have a history of kidney stones?"
Answer: B
Rationale: Uncomplicated cystitis is characterized by the absence of vaginal discharge
or irritation. The presence of vaginal discharge suggests vaginitis or cervicitis (often
sexually transmitted), whereas urethritis may present with urethral discharge. Fever,
chills, and flank pain suggest pyelonephritis or complicated UTI.
, Question 5
A 32-year-old woman reports dysuria, frequency, and urgency for 2 days. She denies
fever, chills, flank pain, or vaginal discharge. She is sexually active with one male partner
and uses condoms for contraception. What additional history is most relevant?
A) Recent antibiotic use
B) Number of sexual partners in the past year
C) History of diabetes mellitus
D) All of the above
Answer: D
Rationale: All of these factors are important in evaluating acute cystitis. Recent
antibiotic use may indicate drug resistance or recent infection. Number of sexual
partners and sexual activity are risk factors for UTI and STIs. Diabetes is a complicating
factor that reclassifies a UTI as complicated and may require different management.
Question 6
A patient's history reveals she developed her first UTI at age 14 and has had two UTIs in
the past 6 months. How should this history be documented and classified?
A) As a first-time uncomplicated UTI
B) As recurrent UTI (2 or more in 6 months)
C) As complicated UTI due to age of onset
D) As asymptomatic bacteriuria
Answer: B
Rationale: Recurrent UTIs are defined as 2 or more culture-confirmed UTIs within 6
months or 3 or more within 12 months. Early age of first UTI (before age 15) is a risk
factor for recurrent infection but does not by itself define recurrence.
Question 7
A patient reports that she developed a UTI 10 days after completing a 5-day course of
nitrofurantoin for a prior infection. This presentation is best described as:
Note: Acute Simple Cystitis Case Study
2026 Update with complete solutions.
Question 1
A 28-year-old female presents with complaints of burning with urination. Which of the
following is the most appropriate way to document this symptom in the SOAP note?
A) "Patient complains of dysuria" under Objective Data
B) "Patient reports burning sensation when voiding" under Subjective Data
C) "Dysuria noted on examination" under Assessment
D) "Urinary discomfort" under Plan
Answer: B
Rationale: Subjective data includes information reported by the patient, such as
symptoms, history, and chief complaints. "Patient reports burning sensation when
voiding" is a direct patient-reported symptom and belongs in the Subjective section.
Objective data consists of measurable findings from examination or testing.
Question 2
Which element of the History of Presenting Illness (HPI) is most critical when evaluating
a patient with suspected acute cystitis?
A) Family history of UTIs
B) Onset, duration, and severity of urinary symptoms
C) Social history including alcohol use
D) Review of systems for cardiac symptoms
Answer: B
Rationale: The HPI should include the onset, duration, severity, and character of
,symptoms. For acute cystitis, understanding when symptoms began and their severity
helps determine if the presentation is acute uncomplicated cystitis versus a more
complicated infection requiring different management.
Question 3
A patient with acute cystitis reports urinary frequency and urgency. Which associated
symptom, if present, would most strongly suggest an alternative diagnosis requiring
pelvic examination?
A) Suprapubic discomfort
B) Hematuria
C) Vaginal discharge
D) Nocturia
Answer: C
Rationale: The presence of vaginal discharge or significant change in vaginal discharge
suggests vaginitis or cervicitis rather than uncomplicated cystitis. This distinction is
important because the differential diagnosis for acute dysuria in women includes cystitis,
vaginitis, and urethritis. Pelvic examination is indicated when vaginal symptoms are
present.
Question 4
Which question is most important to ask a female patient presenting with dysuria to
differentiate uncomplicated cystitis from urethritis?
A) "Have you had any fever or chills?"
B) "Do you have any vaginal discharge or irritation?"
C) "Have you experienced any flank pain?"
D) "Do you have a history of kidney stones?"
Answer: B
Rationale: Uncomplicated cystitis is characterized by the absence of vaginal discharge
or irritation. The presence of vaginal discharge suggests vaginitis or cervicitis (often
sexually transmitted), whereas urethritis may present with urethral discharge. Fever,
chills, and flank pain suggest pyelonephritis or complicated UTI.
, Question 5
A 32-year-old woman reports dysuria, frequency, and urgency for 2 days. She denies
fever, chills, flank pain, or vaginal discharge. She is sexually active with one male partner
and uses condoms for contraception. What additional history is most relevant?
A) Recent antibiotic use
B) Number of sexual partners in the past year
C) History of diabetes mellitus
D) All of the above
Answer: D
Rationale: All of these factors are important in evaluating acute cystitis. Recent
antibiotic use may indicate drug resistance or recent infection. Number of sexual
partners and sexual activity are risk factors for UTI and STIs. Diabetes is a complicating
factor that reclassifies a UTI as complicated and may require different management.
Question 6
A patient's history reveals she developed her first UTI at age 14 and has had two UTIs in
the past 6 months. How should this history be documented and classified?
A) As a first-time uncomplicated UTI
B) As recurrent UTI (2 or more in 6 months)
C) As complicated UTI due to age of onset
D) As asymptomatic bacteriuria
Answer: B
Rationale: Recurrent UTIs are defined as 2 or more culture-confirmed UTIs within 6
months or 3 or more within 12 months. Early age of first UTI (before age 15) is a risk
factor for recurrent infection but does not by itself define recurrence.
Question 7
A patient reports that she developed a UTI 10 days after completing a 5-day course of
nitrofurantoin for a prior infection. This presentation is best described as:
