NSG 554 Exam 4 (Latest
Update) Nurse Practitioners in Primary
Care I Questions and Verified Answers
100% Correct {Grade A} – Wilkes
Acute bacterial prostatitis - Correct answer -caused by gram negative rods esp e.coli
and psuedomas species, less common by gram positive organisms ex. Enterococci
-likely routes include ascent up the urethra and reflux of infected urine into the
prostatic ducts
-lymphatic and hematogenous routes rare
Acute bacterial prostatitis: clinical findings - Correct answer -perineal, sacral or
suprapubic pain
-fever
-irritative voiding complaints
-varying degree of obstructive symptoms
-urinary retention
-tender prostate on exam
-prostatic massage contraindicated
,Acute bacterial prostatitis: laboratory findings - Correct answer -CBC with
leukocytosis with left shift
-UA: pyuria, bacteriuria, varying degrees of hematuria -cultures: pathogen
Acute bacterial prostatitis: imaging - Correct answer -transrectal US, pelvic CT if no
response to therapy within 24-48 hours
Acute bacterial prostatitis: treatment - Correct answer -hospitalization may be
required and parental abx (ampicillin & amioglycoside) should be initiated until
organisms are available
-after being afebrile for 24-48 hours PO abx are used to complete 4-6 weeks of
therapy
-if UR develop in and out catheterization can be used
-outpatient: trimethoprim-sulfamethoxazole 160/800 mg every 12 hours for 3 weeks or
ciprofloxacin 250-500mg every 12 hours for 3 weeks
, Chronic bacterial prostatits - Correct answer -can evolve from acute bacterial
prostatitis or from recurrent UTI over 1/2 of men have no hx of acute infection
-gram negative rods most common etiology agents but only 1 gram positive organism
(enterococcus) is associated with chronic infection
Chronic bacterial prostatits: S&S - Correct answer -varying degrees of irritative
voiding symptoms: urethral pain, obstructive urinary symptoms
-low back and perineal pain common
-unremarkable physical examination although prostate may feel normal, indurated or
boggy
-post void residual volume should be measured for retention
Chronic bacterial prostatitis: laboratory findings - Correct answer -urinalysis normal
unless secondary cystitis is present
-expressed prostatic secretions or post prostatic massage increased numbers of
leukocytes >5-10 per high powered field
-bacterial growth when cultured
-cultures of secretions/massage/urine necessary for diagnosis
Update) Nurse Practitioners in Primary
Care I Questions and Verified Answers
100% Correct {Grade A} – Wilkes
Acute bacterial prostatitis - Correct answer -caused by gram negative rods esp e.coli
and psuedomas species, less common by gram positive organisms ex. Enterococci
-likely routes include ascent up the urethra and reflux of infected urine into the
prostatic ducts
-lymphatic and hematogenous routes rare
Acute bacterial prostatitis: clinical findings - Correct answer -perineal, sacral or
suprapubic pain
-fever
-irritative voiding complaints
-varying degree of obstructive symptoms
-urinary retention
-tender prostate on exam
-prostatic massage contraindicated
,Acute bacterial prostatitis: laboratory findings - Correct answer -CBC with
leukocytosis with left shift
-UA: pyuria, bacteriuria, varying degrees of hematuria -cultures: pathogen
Acute bacterial prostatitis: imaging - Correct answer -transrectal US, pelvic CT if no
response to therapy within 24-48 hours
Acute bacterial prostatitis: treatment - Correct answer -hospitalization may be
required and parental abx (ampicillin & amioglycoside) should be initiated until
organisms are available
-after being afebrile for 24-48 hours PO abx are used to complete 4-6 weeks of
therapy
-if UR develop in and out catheterization can be used
-outpatient: trimethoprim-sulfamethoxazole 160/800 mg every 12 hours for 3 weeks or
ciprofloxacin 250-500mg every 12 hours for 3 weeks
, Chronic bacterial prostatits - Correct answer -can evolve from acute bacterial
prostatitis or from recurrent UTI over 1/2 of men have no hx of acute infection
-gram negative rods most common etiology agents but only 1 gram positive organism
(enterococcus) is associated with chronic infection
Chronic bacterial prostatits: S&S - Correct answer -varying degrees of irritative
voiding symptoms: urethral pain, obstructive urinary symptoms
-low back and perineal pain common
-unremarkable physical examination although prostate may feel normal, indurated or
boggy
-post void residual volume should be measured for retention
Chronic bacterial prostatitis: laboratory findings - Correct answer -urinalysis normal
unless secondary cystitis is present
-expressed prostatic secretions or post prostatic massage increased numbers of
leukocytes >5-10 per high powered field
-bacterial growth when cultured
-cultures of secretions/massage/urine necessary for diagnosis
