NR 570 EXAM 300 ACTUAL QUESTIONS AND CORRECT ANSWERS WITH RATIONALE ALREADY GRADED A+

NR 570 EXAM 300 ACTUAL QUESTIONS AND
CORRECT ANSWERS WITH RATIONALE
ALREADY GRADED A+



The NR 570 exam is a comprehensive advanced practice nursing assessment
covering acute and chronic conditions across multiple organ systems. This
rigorous examination evaluates clinical reasoning in nephrology, cardiology,
pulmonology, gastroenterology, endocrinology, infectious diseases, neurology,
and hematology/oncology. Key topics include nephrolithiasis, acute and
chronic kidney disease, fluid and electrolyte imbalances, acid-base disorders,
heart failure, arrhythmias, COPD, pneumonia, liver disease, diabetes, thyroid
disorders, sepsis, stroke, meningitis, anemia, and common malignancies. The
exam emphasizes accurate diagnosis, appropriate diagnostic testing, evidence-
based pharmacologic and non-pharmacologic management, and recognition
of life-threatening emergencies requiring urgent intervention. It tests the
provider's ability to prioritize care based on clinical presentations.




BLOCK 1: NEPHROLITHIASIS AND UROLOGIC DISORDERS
Question 1
What is nephrolithiasis?
A) Inflammation of the bladder
B) Kidney stones (renal calculi)
C) Infection of the urethra
D) Enlargement of the prostate
Correct Answer: B
Rationale: Nephrolithiasis refers to renal calculi, or kidney stones, which are hard
mineral deposits that form in the urine. Urolithiasis is the term for stones in the
bladder.

Question 2
Which mineral type is the most common component of kidney stones?
A) Uric acid

,B) Struvite
C) Calcium oxalate
D) Cystine
Correct Answer: C
Rationale: Calcium oxalate is the most common type of kidney stone, accounting
for approximately 80% of all stones. Other types include calcium phosphate, uric
acid, struvite, and cystine stones.

Question 3
A patient presents with acute onset severe colicky flank pain that waxes and wanes
in intensity. This presentation is classic for which condition?
A) Pyelonephritis
B) Nephrolithiasis
C) Diverticulitis
D) Aortic aneurysm
Correct Answer: B
Rationale: Nephrolithiasis typically presents with acute, severe, colicky flank pain
that radiates to the groin. The pain is often described as waxing and waning as the
stone moves through the urinary tract.

Question 4
Which medication is a first-line treatment for acute pain management in a patient
with suspected renal colic?
A) Morphine
B) Ibuprofen
C) Acetaminophen
D) Ketorolac
Correct Answer: D
Rationale: Ketorolac, a nonsteroidal anti-inflammatory drug (NSAID), is a first-
line agent for renal colic because it reduces prostaglandin-mediated ureteral spasm
and inflammation. Opioids like morphine are second-line options.

Question 5
What is the most appropriate initial imaging study for a patient with suspected
nephrolithiasis?
A) Abdominal X-ray (KUB)
B) Ultrasound
C) Non-contrast computed tomography (CT) scan
D) Intravenous pyelogram (IVP)
Correct Answer: C

,Rationale: Non-contrast CT scan is the gold standard for diagnosing nephrolithiasis
because it has high sensitivity and specificity for detecting stones of all types,
regardless of radiopacity.

Question 6
A patient with a kidney stone smaller than 5 mm is most likely to be managed with
which approach?
A) Surgical removal
B) Extracorporeal shock wave lithotripsy (ESWL)
C) Conservative management with hydration and pain control
D) Ureteroscopy with laser lithotripsy
Correct Answer: C
Rationale: Stones smaller than 5 mm typically pass spontaneously with
conservative management including increased oral hydration, pain control, and
medical expulsive therapy such as tamsulosin. Surgical intervention is reserved for
larger or obstructing stones.

Question 7
Which medication is commonly used as a medical expulsive therapy to facilitate
passage of ureteral stones?
A) Furosemide
B) Tamsulosin
C) Metformin
D) Lisinopril
Correct Answer: B
Rationale: Tamsulosin, an alpha-blocker, relaxes the smooth muscle of the ureter,
facilitating stone passage and reducing pain. It is commonly used for stones less
than 10 mm in diameter.

Question 8
What is a major risk factor for the formation of calcium oxalate kidney stones?
A) Low calcium diet
B) High fluid intake
C) Hyperuricosuria
D) Recurrent urinary tract infections
Correct Answer: A
Rationale: Paradoxically, a low calcium diet increases the risk of calcium oxalate
stones because calcium binds to oxalate in the gut, preventing its absorption. High
fluid intake is protective, hyperuricosuria is a risk for uric acid stones, and
recurrent UTIs are a risk for struvite stones.

, Question 9
Which type of kidney stone is associated with recurrent urinary tract infections
caused by urease-producing bacteria such as Proteus?
A) Calcium oxalate
B) Uric acid
C) Struvite
D) Cystine
Correct Answer: C
Rationale: Struvite stones (magnesium ammonium phosphate) are associated with
UTIs caused by urease-producing bacteria such as Proteus, Klebsiella, and
Pseudomonas. The urease enzyme splits urea into ammonia, making urine more
alkaline and promoting stone formation.

Question 10
Which inherited disorder leads to cystine stones?
A) Cystinuria
B) Hyperoxaluria
C) Gout
D) Hyperparathyroidism
Correct Answer: A
Rationale: Cystinuria is an autosomal recessive disorder resulting in defective renal
tubular reabsorption of cystine, leading to cystine stone formation. Hyperoxaluria
leads to calcium oxalate stones, gout leads to uric acid stones, and
hyperparathyroidism leads to calcium phosphate stones.

Question 11
A patient with nephrolithiasis develops fever and chills. What is the most
concerning complication to consider?
A) Renal colic recurrence
B) Hydronephrosis
C) Obstructive pyelonephritis with sepsis
D) Gastrointestinal obstruction
Correct Answer: C
Rationale: Fever and chills in a patient with nephrolithiasis suggest a superimposed
urinary tract infection with obstruction, which can rapidly progress to urosepsis.
This is a medical emergency requiring urgent decompression and antibiotics.

Question 12