NU-650 Week 12 GU Focused SOAP Note Acute
Simple Cystitis Case Study | 2026 Update
Questions with Answers & Detailed Rationales
Instructions
This comprehensive examination consists of multiple-choice
questions based on the acute simple cystitis case study presented in the
Week 12 GU Focused SOAP Note. The assessment covers clinical presentation,
pathophysiology, diagnostic reasoning, differential diagnosis, treatment
protocols, and patient education for uncomplicated urinary tract infections.
CASE STUDY
Patient: ER, 27-year-old female
Chief Complaint: "I feel like I have to pee constantly and it hurts when I pee."
HPI: 3-day history of urinary urgency and frequency (every 1-2 hours during
the day, 4-5 times nightly), constant suprapubic pressure, mild burning after
urination. Denies hematuria, fever, chills, nausea, vomiting, flank pain, or
vaginal discharge. Increased water intake without improvement. Denies new
sexual partners, travel, or new hygiene products.
PMH: No significant past medical history
ROS: General: Well-appearing. Denies fevers, weight loss, night sweats. GU:
Reports urinary frequency, urgency, mild dysuria, suprapubic discomfort.
SECTION A: CASE STUDY ASSESSMENT AND CLINICAL REASONING
(Questions 1–20)
Question 1
Which of the following symptoms reported by the patient is consistent with
the diagnosis of acute simple cystitis?
• A) Fever and chills
, • B) Flank pain
• C) Urinary urgency and frequency
• D) Vaginal discharge
• E) Nausea and vomiting
Answer: C) Urinary urgency and frequency
Rationale: Acute simple cystitis typically presents with dysuria, urinary
urgency, frequency, and suprapubic discomfort. Fever, chills, and flank pain
suggest pyelonephritis. Vaginal discharge suggests vaginitis or a sexually
transmitted infection. Nausea and vomiting are not typical of uncomplicated
cystitis.
Question 2
The patient reports nocturia (waking 4-5 times nightly to urinate). This is
consistent with:
• A) Overhydration
• B) Bladder irritation from infection
• C) Diabetes mellitus
• D) Pregnancy
• E) Caffeine consumption
Answer: B) Bladder irritation from infection
Rationale: Nocturia (waking at night to urinate) is a symptom of cystitis
caused by bladder irritation and inflammation from infection. While diabetes,
pregnancy, and caffeine can cause nocturia, the context of other urinary
symptoms (urgency, frequency, dysuria) points to cystitis.
Question 3
Which of the following is a classic triad of symptoms for acute cystitis?
• A) Fever, flank pain, nausea
, • B) Dysuria, frequency, urgency
• C) Hematuria, fever, chills
• D) Dysuria, vaginal discharge, itching
• E) Frequency, fever, hematuria
Answer: B) Dysuria, frequency, urgency
Rationale: The classic triad for acute cystitis is dysuria (painful urination),
urinary frequency, and urgency. These symptoms reflect bladder irritation
and inflammation. Fever, flank pain, and chills are more consistent with
pyelonephritis.
Question 4
The patient denies visible blood in her urine. This finding is documented as:
• A) Hematuria
• B) Gross hematuria absent
• C) Microscopic hematuria
• D) Dysuria
• E) Pyuria
Answer: B) Gross hematuria absent
Rationale: Gross hematuria (visible blood in urine) is reported as
"hematuria" when present. The patient denies visible blood, which is
documented as "gross hematuria absent." Microscopic hematuria can only be
detected by urinalysis and is not a patient-reported symptom.
Question 5
Which of the following risk factors for cystitis is NOT present in this patient?
• A) Female gender
• B) New sexual partner
• C) Age 27
, • D) Increased water intake (without improvement)
• E) None of the above
Answer: B) New sexual partner
Rationale: The patient denies new sexual partners. Female gender and age
are risk factors for cystitis due to anatomical and physiological factors.
Increased water intake without improvement is a clinical clue that supports
the diagnosis.
Question 6
The patient's description of "constant pressure in her lower abdomen" is best
described as:
• A) Flank pain
• B) Suprapubic discomfort
• C) Pelvic pain
• D) Abdominal cramping
• E) Costovertebral angle tenderness
Answer: B) Suprapubic discomfort
Rationale: Suprapubic discomfort is pain or pressure felt in the lower
abdomen, above the pubic bone. It is a classic symptom of cystitis due to
bladder irritation. Flank pain suggests renal involvement (pyelonephritis).
Costovertebral angle tenderness is also associated with pyelonephritis.
Question 7
The patient's history of increasing water intake without symptom
improvement suggests:
• A) The infection is not being flushed out by hydration alone
• B) The patient has diabetes insipidus
• C) The patient is drinking too much water
Simple Cystitis Case Study | 2026 Update
Questions with Answers & Detailed Rationales
Instructions
This comprehensive examination consists of multiple-choice
questions based on the acute simple cystitis case study presented in the
Week 12 GU Focused SOAP Note. The assessment covers clinical presentation,
pathophysiology, diagnostic reasoning, differential diagnosis, treatment
protocols, and patient education for uncomplicated urinary tract infections.
CASE STUDY
Patient: ER, 27-year-old female
Chief Complaint: "I feel like I have to pee constantly and it hurts when I pee."
HPI: 3-day history of urinary urgency and frequency (every 1-2 hours during
the day, 4-5 times nightly), constant suprapubic pressure, mild burning after
urination. Denies hematuria, fever, chills, nausea, vomiting, flank pain, or
vaginal discharge. Increased water intake without improvement. Denies new
sexual partners, travel, or new hygiene products.
PMH: No significant past medical history
ROS: General: Well-appearing. Denies fevers, weight loss, night sweats. GU:
Reports urinary frequency, urgency, mild dysuria, suprapubic discomfort.
SECTION A: CASE STUDY ASSESSMENT AND CLINICAL REASONING
(Questions 1–20)
Question 1
Which of the following symptoms reported by the patient is consistent with
the diagnosis of acute simple cystitis?
• A) Fever and chills
, • B) Flank pain
• C) Urinary urgency and frequency
• D) Vaginal discharge
• E) Nausea and vomiting
Answer: C) Urinary urgency and frequency
Rationale: Acute simple cystitis typically presents with dysuria, urinary
urgency, frequency, and suprapubic discomfort. Fever, chills, and flank pain
suggest pyelonephritis. Vaginal discharge suggests vaginitis or a sexually
transmitted infection. Nausea and vomiting are not typical of uncomplicated
cystitis.
Question 2
The patient reports nocturia (waking 4-5 times nightly to urinate). This is
consistent with:
• A) Overhydration
• B) Bladder irritation from infection
• C) Diabetes mellitus
• D) Pregnancy
• E) Caffeine consumption
Answer: B) Bladder irritation from infection
Rationale: Nocturia (waking at night to urinate) is a symptom of cystitis
caused by bladder irritation and inflammation from infection. While diabetes,
pregnancy, and caffeine can cause nocturia, the context of other urinary
symptoms (urgency, frequency, dysuria) points to cystitis.
Question 3
Which of the following is a classic triad of symptoms for acute cystitis?
• A) Fever, flank pain, nausea
, • B) Dysuria, frequency, urgency
• C) Hematuria, fever, chills
• D) Dysuria, vaginal discharge, itching
• E) Frequency, fever, hematuria
Answer: B) Dysuria, frequency, urgency
Rationale: The classic triad for acute cystitis is dysuria (painful urination),
urinary frequency, and urgency. These symptoms reflect bladder irritation
and inflammation. Fever, flank pain, and chills are more consistent with
pyelonephritis.
Question 4
The patient denies visible blood in her urine. This finding is documented as:
• A) Hematuria
• B) Gross hematuria absent
• C) Microscopic hematuria
• D) Dysuria
• E) Pyuria
Answer: B) Gross hematuria absent
Rationale: Gross hematuria (visible blood in urine) is reported as
"hematuria" when present. The patient denies visible blood, which is
documented as "gross hematuria absent." Microscopic hematuria can only be
detected by urinalysis and is not a patient-reported symptom.
Question 5
Which of the following risk factors for cystitis is NOT present in this patient?
• A) Female gender
• B) New sexual partner
• C) Age 27
, • D) Increased water intake (without improvement)
• E) None of the above
Answer: B) New sexual partner
Rationale: The patient denies new sexual partners. Female gender and age
are risk factors for cystitis due to anatomical and physiological factors.
Increased water intake without improvement is a clinical clue that supports
the diagnosis.
Question 6
The patient's description of "constant pressure in her lower abdomen" is best
described as:
• A) Flank pain
• B) Suprapubic discomfort
• C) Pelvic pain
• D) Abdominal cramping
• E) Costovertebral angle tenderness
Answer: B) Suprapubic discomfort
Rationale: Suprapubic discomfort is pain or pressure felt in the lower
abdomen, above the pubic bone. It is a classic symptom of cystitis due to
bladder irritation. Flank pain suggests renal involvement (pyelonephritis).
Costovertebral angle tenderness is also associated with pyelonephritis.
Question 7
The patient's history of increasing water intake without symptom
improvement suggests:
• A) The infection is not being flushed out by hydration alone
• B) The patient has diabetes insipidus
• C) The patient is drinking too much water
