WALDEN UNIVERSITY 2026 NURS 6531
FINAL EXAM LATEST SPRING SUMMER
ACTUAL EXAM SOLVED
A 70-year-old male reports urinary hesitancy, postvoid dribbling, and a
diminished urine stream. A digital rectal exam (DRE) reveals an enlarged prostate
gland that feels rubbery and smooth. Which tests will the primary care provider
order based on these findings?
a. Bladder scan for postvoid residual
b. Prostate-specific antigen (PSA) and bladder imaging
c. Urinalysis and serum creatinine
d. Urine culture and CBC with differential
ANS: C
The DRE reveals a prostate gland consistent with benign prostatic hyperplasia (BPH).
The primary provider should order a urinalysis and creatinine to evaluate possible
infection and renal function. A bladder scan is ordered at the discretion of the urologist.
The prostate exam isn't consistent with prostate cancer, so PSA and bladder imaging
are not necessary. Symptoms of prostatitis would indicate a need for evaluation of
possible infection.
The provider is evaluating a patient for potential causes of urinary incontinence
and performs a postvoid residual (PVR) test which yields 30 mL of urine. What is
the interpretation of this
result?
,a. The patient may have overflow incontinence.
b. The patient probably has a urinary tract infection (UTI).
c. This is a normal result.
d. This represents incomplete emptying.
ANS: C
A PVR less than 50 mL is considered normal and this result does not indicate any
abnormality.
The provider is counseling a patient who has stress incontinence about ways to
minimize accidents. What will the provider suggest initially?
a. Increasing fluid intake to dilute the urine
b. Referral to a physical therapist
c. Taking pseudoephedrine daily
d. Voiding every 2 hours during the day
ANS: D
Timed voiding is useful to help minimize stress incontinence and is used initially.
Increasing fluid intake will increase symptoms. PT referral may be done if other
measures fail to help with exercises to strengthen the pelvic floor muscles.
Pseudoephedrine is useful, but not an initial therapy.
An older male patient reports urinary frequency, back pain, and nocturia. A
dipstick urinalysis reveals hematuria. What will the provider do next to evaluate
this condition?
a. Order a PSA and perform a digital rectal exam (DRE)
b. Refer for a biopsy
,c. Refer the patient to a urologist
d. Schedule a transurethral ultrasound (TRUS)
ANS: A
Patients with symptoms of potential prostate cancer should be screened with PSA and
DRE. Referral to a urologist is the next step even with normal findings, since PSA is
occasionally normal. The urologist may order TRUS or biopsy.
An older male patient has a screening prostate-specific antigen (PSA) which is 12
ng/mL. What does this value indicate?
a. A normal result
b. Benign prostatic hypertrophy
c. Early prostate cancer
d. Prostate cancer
ANS: D
A PSA greater than 10 ng/mL suggests prostate cancer. A level between 4 and 10
ng/mL may be early prostate cancer or a benign condition. A level less than 4 ng/mL is
normal.
A patient is diagnosed with prostate cancer and diagnostic testing reveals
disease that has gone past the prostatic capsule without evidence of metastasis.
The patient does not wish to undergo treatment. What will the provider tell this
patient?
a. Chemotherapy is indicated to provide cure for this cancer.
b. Monitoring prostate-specific antigen (PSA) with regular digital rectal
examination (DRE) is an acceptable option.
, c. Palliative radiation therapy is necessary to improve quality of life.
d. This level of disease requires intervention with hormonal therapy.
ANS: B
This patient has stage T2 prostate cancer which may be managed with watchful waiting
which includes PSA and DRE evaluation. Chemotherapy, palliative radiation therapy,
and hormonal therapy are not required.
A male patient reports nocturia and daytime urinary frequency and urgency
without changes in the force of the urine stream. What is the likely cause of this?
a. Bladder outlet obstruction
b. Lower urinary tract symptoms (LUTS)
c. Prostate cancer
d. Urinary tract infection (UTI)
ANS: B
Lower urinary tract symptoms (LUTS) result from irritative changes in the lower tract.
Bladder outlet obstruction causes hesitancy, decreased caliber and force of the urine
stream, and postvoid dribbling. Diagnosis of prostate cancer and UTI require further
testing and are less likely causes.
A patient has been taking terazosin daily at bedtime to treat benign prostatic
hyperplasia (BPH) and reports persistent daytime dizziness. What will the
provider do?
a. Prescribe finasteride instead of terazosin
b. Recommend taking the medication in the morning
FINAL EXAM LATEST SPRING SUMMER
ACTUAL EXAM SOLVED
A 70-year-old male reports urinary hesitancy, postvoid dribbling, and a
diminished urine stream. A digital rectal exam (DRE) reveals an enlarged prostate
gland that feels rubbery and smooth. Which tests will the primary care provider
order based on these findings?
a. Bladder scan for postvoid residual
b. Prostate-specific antigen (PSA) and bladder imaging
c. Urinalysis and serum creatinine
d. Urine culture and CBC with differential
ANS: C
The DRE reveals a prostate gland consistent with benign prostatic hyperplasia (BPH).
The primary provider should order a urinalysis and creatinine to evaluate possible
infection and renal function. A bladder scan is ordered at the discretion of the urologist.
The prostate exam isn't consistent with prostate cancer, so PSA and bladder imaging
are not necessary. Symptoms of prostatitis would indicate a need for evaluation of
possible infection.
The provider is evaluating a patient for potential causes of urinary incontinence
and performs a postvoid residual (PVR) test which yields 30 mL of urine. What is
the interpretation of this
result?
,a. The patient may have overflow incontinence.
b. The patient probably has a urinary tract infection (UTI).
c. This is a normal result.
d. This represents incomplete emptying.
ANS: C
A PVR less than 50 mL is considered normal and this result does not indicate any
abnormality.
The provider is counseling a patient who has stress incontinence about ways to
minimize accidents. What will the provider suggest initially?
a. Increasing fluid intake to dilute the urine
b. Referral to a physical therapist
c. Taking pseudoephedrine daily
d. Voiding every 2 hours during the day
ANS: D
Timed voiding is useful to help minimize stress incontinence and is used initially.
Increasing fluid intake will increase symptoms. PT referral may be done if other
measures fail to help with exercises to strengthen the pelvic floor muscles.
Pseudoephedrine is useful, but not an initial therapy.
An older male patient reports urinary frequency, back pain, and nocturia. A
dipstick urinalysis reveals hematuria. What will the provider do next to evaluate
this condition?
a. Order a PSA and perform a digital rectal exam (DRE)
b. Refer for a biopsy
,c. Refer the patient to a urologist
d. Schedule a transurethral ultrasound (TRUS)
ANS: A
Patients with symptoms of potential prostate cancer should be screened with PSA and
DRE. Referral to a urologist is the next step even with normal findings, since PSA is
occasionally normal. The urologist may order TRUS or biopsy.
An older male patient has a screening prostate-specific antigen (PSA) which is 12
ng/mL. What does this value indicate?
a. A normal result
b. Benign prostatic hypertrophy
c. Early prostate cancer
d. Prostate cancer
ANS: D
A PSA greater than 10 ng/mL suggests prostate cancer. A level between 4 and 10
ng/mL may be early prostate cancer or a benign condition. A level less than 4 ng/mL is
normal.
A patient is diagnosed with prostate cancer and diagnostic testing reveals
disease that has gone past the prostatic capsule without evidence of metastasis.
The patient does not wish to undergo treatment. What will the provider tell this
patient?
a. Chemotherapy is indicated to provide cure for this cancer.
b. Monitoring prostate-specific antigen (PSA) with regular digital rectal
examination (DRE) is an acceptable option.
, c. Palliative radiation therapy is necessary to improve quality of life.
d. This level of disease requires intervention with hormonal therapy.
ANS: B
This patient has stage T2 prostate cancer which may be managed with watchful waiting
which includes PSA and DRE evaluation. Chemotherapy, palliative radiation therapy,
and hormonal therapy are not required.
A male patient reports nocturia and daytime urinary frequency and urgency
without changes in the force of the urine stream. What is the likely cause of this?
a. Bladder outlet obstruction
b. Lower urinary tract symptoms (LUTS)
c. Prostate cancer
d. Urinary tract infection (UTI)
ANS: B
Lower urinary tract symptoms (LUTS) result from irritative changes in the lower tract.
Bladder outlet obstruction causes hesitancy, decreased caliber and force of the urine
stream, and postvoid dribbling. Diagnosis of prostate cancer and UTI require further
testing and are less likely causes.
A patient has been taking terazosin daily at bedtime to treat benign prostatic
hyperplasia (BPH) and reports persistent daytime dizziness. What will the
provider do?
a. Prescribe finasteride instead of terazosin
b. Recommend taking the medication in the morning
