Urinary Disorders NCLEX Exam (Quiz
#1: 50 Questions) 2025 Questions and
Rationales (All Answered) and
Categories Covered
1. 1. Question
1 point(s)
Which of the following symptoms do you expect to see in a patient diagnosed
with acute pyelonephritis?
o A. Jaundice and flank pain
o B. Costovertebral angle tenderness and chills
o C. Burning sensation on urination
o D. Polyuria and nocturia
Correct Answer: B. Costovertebral angle tenderness and chills
Costovertebral angle tenderness, flank pain, and chills are symptoms of acute
pyelonephritis. Acute pyelonephritis is a bacterial infection causing
inflammation of the kidneys. Pyelonephritis occurs as a complication of an
ascending urinary tract infection which spreads from the bladder to the
kidneys. Symptoms usually include fever, flank pain, nausea, vomiting, burning
with urination, increased frequency, and urgency.
• Option A: Jaundice indicates gallbladder or liver obstruction. Dysfunction in
prehepatic phase results in elevated serum levels of unconjugated bilirubin
while insult in post hepatic phase marks elevated conjugated bilirubin.
Hepatic phase impairment can elevate both unconjugated and conjugated
bilirubin.
• Option C: A burning sensation on urination is a sign of lower urinary tract
infection. Symptoms of uncomplicated UTI are pain on urination (dysuria),
frequent urination (frequency), inability to start the urine stream
(hesitation), sudden onset of the need to urinate (urgency), and blood in
the urine (hematuria). Usually, patients with uncomplicated UTI do not have
, fever, chills, nausea, vomiting, or back pain, which are signs of kidney
involvement or upper tract disease/pyelonephritis.
• Option D: Nocturnal polyuria as a cause of nocturia is more prevalent in
older patients, while in younger patients, a decreased nocturnal bladder
capacity is the more common etiology. Caffeine and excessive oral fluid
intake in the evenings, as well as alcoholism, can contribute significantly to
this disorder. It is also associated with congestive heart failure, obstructive
sleep apnea, evening use of diuretics, peripheral edema, high dietary salt
intake, and chronic venous insufficiency of the lower extremities.
2. 2. Question
1 point(s)
You have a patient that might have a urinary tract infection (UTI). Which
statement by the patient suggests that a UTI is likely?
• A. “I pee a lot.”
• B. “It burns when I pee.”
• C. “I go hours without the urge to pee.”
• D. “My pee smells sweet.”
Correct Answer: B. “It burns when I pee.”
A common symptom of a UTI is dysuria. A patient with a UTI often reports
frequent voiding of small amounts and the urgency to void. Symptoms of
uncomplicated UTI are pain on urination (dysuria), frequent urination
(frequency), inability to start the urine stream (hesitation), sudden onset of the
need to urinate (urgency), and blood in the urine (hematuria). Usually, patients
with uncomplicated UTI do not have fever, chills, nausea, vomiting, or back
pain, which are signs of kidney involvement or upper tract
disease/pyelonephritis.
• Option A: High amounts of solutes within the renal tubules cause a passive
osmotic diuresis (solute diuresis) and thus an increase in urine volume. The
classic example of this process is the glucose-induced osmotic diuresis in
uncontrolled diabetes mellitus, when high urinary glucose levels (> 250
mg/dL [13.88 mmol/L]) exceed tubular reabsorption capacity, leading to
high glucose levels in the renal tubules; water follows passively, resulting in
glucosuria and increased urine volume.
• Option C: Oliguria can be the result of various causes that can be apparent
or subclinical. Oliguria can arise as a result of the normal physiological
, response of the body or due to an underlying pathology affecting the
kidney or urinary tract. The most common prerenal cause is reduced blood
flow to the kidney secondary to intravascular volume depletion, heart
failure, sepsis, or as a side effect of medication.
• Option D: Urine that smells sweet is often associated with diabetic
ketoacidosis. Commonly accepted criteria for diabetic ketoacidosis are
blood glucose greater than 250 mg/dl, arterial pH less than 7.3, serum
bicarbonate less than 15 mEq/l, and the presence of ketonemia or
ketonuria.
3. 3. Question
1 point(s)
Which instructions do you include in the teaching care plan for a patient with
cystitis receiving phenazopyridine (Pyridium)?
• A. If the urine turns orange-red, call the doctor.
• B. Take phenazopyridine just before urination to relieve pain.
• C. Once painful urination is relieved, discontinue prescribed
antibiotics.
• D. After painful urination is relieved, stop taking phenazopyridine.
Correct Answer: D. After painful urination is relieved, stop taking
phenazopyridine.
Pyridium is taken to relieve dysuria because it provides an analgesic and
anesthetic effect on the urinary tract mucosa. The patient can stop taking it
after the dysuria is relieved. Symptomatic treatment with analgesics may be
used in patients who present with severe dysuria. Phenazopyridine is a urinary
analgesic used in short-term treatment of urinary dysuria or discomfort.
• Option A: The urine may temporarily turn red or orange due to the dye in
the drug. Patients should be informed that Phenazopyridine HCl produces a
reddish-orange discoloration of the urine and may stain fabric. Staining of
contact lenses has been reported.
• Option B: The drug isn’t taken before voiding, and is usually taken 3 times
a day for 2 days. Treatment of a urinary tract infection with Phenazopyridine
HCl should not exceed two days because there is a lack of evidence that the
combined administration of Phenazopyridine HCl and an antibacterial
provides greater benefit than administration of the antibacterial alone after
two days.
, • Option C: Antibiotics should not be discontinued without indication from
the physician. The analgesic action may reduce or eliminate the need for
systemic analgesics or narcotics. It is, however, compatible with antibacterial
therapy and can help to relieve pain and discomfort during the interval
before antibacterial therapy controls the infection.
4. 4. Question
1 point(s)
Which patient is at greatest risk for developing a urinary tract infection (UTI)?
• A. A 35 y.o. woman with a fractured wrist
• B. A 20 y.o. woman with asthma
• C. A 50 y.o. postmenopausal woman
• D. A 28 y.o. with angina
Correct Answer: C. A 50 y.o. postmenopausal woman
Women are more prone to UTIs after menopause due to reduced estrogen
levels. Reduced estrogen levels lead to reduced levels of vaginal Lactobacilli
bacteria, which protect against infection. Premenopausal women have large
concentrations of lactobacilli in the vagina and prevent the colonization of
uropathogens. However, the use of antibiotics can erase this protective effect.
• Option A: An uncomplicated UTI usually only involves the bladder. When
the bacteria invade the bladder mucosal wall, cystitis is produced. The
majority of organisms causing a UTI are enteric coliforms that usually
inhabit the periurethral vaginal introitus. These organisms ascend into the
bladder and cause a UTI.
• Option B: Sexual intercourse is a common cause of a UTI as it promotes the
migration of bacteria into the bladder. People who frequently void and
empty the bladder have a much lower risk of a UTI. Pathogenic bacteria
ascend from the perineum, causing UTI. Women have shorter urethras than
men and therefore are more susceptible to UTI. Very few uncomplicated
UTIs are caused by blood-borne bacteria. Escherichia coli is the most
common organism in uncomplicated UTI by a large margin.
• Option D: A major risk factor for UTI is the use of a catheter. In addition,
manipulation of the urethra is also a risk factor. Sexual intercourse and the
use of spermicide and diaphragm are also risk factors for UTI. Frequent
pelvic exams and the presence of anatomical abnormalities of the urinary
tract can also predispose one to UTI.
#1: 50 Questions) 2025 Questions and
Rationales (All Answered) and
Categories Covered
1. 1. Question
1 point(s)
Which of the following symptoms do you expect to see in a patient diagnosed
with acute pyelonephritis?
o A. Jaundice and flank pain
o B. Costovertebral angle tenderness and chills
o C. Burning sensation on urination
o D. Polyuria and nocturia
Correct Answer: B. Costovertebral angle tenderness and chills
Costovertebral angle tenderness, flank pain, and chills are symptoms of acute
pyelonephritis. Acute pyelonephritis is a bacterial infection causing
inflammation of the kidneys. Pyelonephritis occurs as a complication of an
ascending urinary tract infection which spreads from the bladder to the
kidneys. Symptoms usually include fever, flank pain, nausea, vomiting, burning
with urination, increased frequency, and urgency.
• Option A: Jaundice indicates gallbladder or liver obstruction. Dysfunction in
prehepatic phase results in elevated serum levels of unconjugated bilirubin
while insult in post hepatic phase marks elevated conjugated bilirubin.
Hepatic phase impairment can elevate both unconjugated and conjugated
bilirubin.
• Option C: A burning sensation on urination is a sign of lower urinary tract
infection. Symptoms of uncomplicated UTI are pain on urination (dysuria),
frequent urination (frequency), inability to start the urine stream
(hesitation), sudden onset of the need to urinate (urgency), and blood in
the urine (hematuria). Usually, patients with uncomplicated UTI do not have
, fever, chills, nausea, vomiting, or back pain, which are signs of kidney
involvement or upper tract disease/pyelonephritis.
• Option D: Nocturnal polyuria as a cause of nocturia is more prevalent in
older patients, while in younger patients, a decreased nocturnal bladder
capacity is the more common etiology. Caffeine and excessive oral fluid
intake in the evenings, as well as alcoholism, can contribute significantly to
this disorder. It is also associated with congestive heart failure, obstructive
sleep apnea, evening use of diuretics, peripheral edema, high dietary salt
intake, and chronic venous insufficiency of the lower extremities.
2. 2. Question
1 point(s)
You have a patient that might have a urinary tract infection (UTI). Which
statement by the patient suggests that a UTI is likely?
• A. “I pee a lot.”
• B. “It burns when I pee.”
• C. “I go hours without the urge to pee.”
• D. “My pee smells sweet.”
Correct Answer: B. “It burns when I pee.”
A common symptom of a UTI is dysuria. A patient with a UTI often reports
frequent voiding of small amounts and the urgency to void. Symptoms of
uncomplicated UTI are pain on urination (dysuria), frequent urination
(frequency), inability to start the urine stream (hesitation), sudden onset of the
need to urinate (urgency), and blood in the urine (hematuria). Usually, patients
with uncomplicated UTI do not have fever, chills, nausea, vomiting, or back
pain, which are signs of kidney involvement or upper tract
disease/pyelonephritis.
• Option A: High amounts of solutes within the renal tubules cause a passive
osmotic diuresis (solute diuresis) and thus an increase in urine volume. The
classic example of this process is the glucose-induced osmotic diuresis in
uncontrolled diabetes mellitus, when high urinary glucose levels (> 250
mg/dL [13.88 mmol/L]) exceed tubular reabsorption capacity, leading to
high glucose levels in the renal tubules; water follows passively, resulting in
glucosuria and increased urine volume.
• Option C: Oliguria can be the result of various causes that can be apparent
or subclinical. Oliguria can arise as a result of the normal physiological
, response of the body or due to an underlying pathology affecting the
kidney or urinary tract. The most common prerenal cause is reduced blood
flow to the kidney secondary to intravascular volume depletion, heart
failure, sepsis, or as a side effect of medication.
• Option D: Urine that smells sweet is often associated with diabetic
ketoacidosis. Commonly accepted criteria for diabetic ketoacidosis are
blood glucose greater than 250 mg/dl, arterial pH less than 7.3, serum
bicarbonate less than 15 mEq/l, and the presence of ketonemia or
ketonuria.
3. 3. Question
1 point(s)
Which instructions do you include in the teaching care plan for a patient with
cystitis receiving phenazopyridine (Pyridium)?
• A. If the urine turns orange-red, call the doctor.
• B. Take phenazopyridine just before urination to relieve pain.
• C. Once painful urination is relieved, discontinue prescribed
antibiotics.
• D. After painful urination is relieved, stop taking phenazopyridine.
Correct Answer: D. After painful urination is relieved, stop taking
phenazopyridine.
Pyridium is taken to relieve dysuria because it provides an analgesic and
anesthetic effect on the urinary tract mucosa. The patient can stop taking it
after the dysuria is relieved. Symptomatic treatment with analgesics may be
used in patients who present with severe dysuria. Phenazopyridine is a urinary
analgesic used in short-term treatment of urinary dysuria or discomfort.
• Option A: The urine may temporarily turn red or orange due to the dye in
the drug. Patients should be informed that Phenazopyridine HCl produces a
reddish-orange discoloration of the urine and may stain fabric. Staining of
contact lenses has been reported.
• Option B: The drug isn’t taken before voiding, and is usually taken 3 times
a day for 2 days. Treatment of a urinary tract infection with Phenazopyridine
HCl should not exceed two days because there is a lack of evidence that the
combined administration of Phenazopyridine HCl and an antibacterial
provides greater benefit than administration of the antibacterial alone after
two days.
, • Option C: Antibiotics should not be discontinued without indication from
the physician. The analgesic action may reduce or eliminate the need for
systemic analgesics or narcotics. It is, however, compatible with antibacterial
therapy and can help to relieve pain and discomfort during the interval
before antibacterial therapy controls the infection.
4. 4. Question
1 point(s)
Which patient is at greatest risk for developing a urinary tract infection (UTI)?
• A. A 35 y.o. woman with a fractured wrist
• B. A 20 y.o. woman with asthma
• C. A 50 y.o. postmenopausal woman
• D. A 28 y.o. with angina
Correct Answer: C. A 50 y.o. postmenopausal woman
Women are more prone to UTIs after menopause due to reduced estrogen
levels. Reduced estrogen levels lead to reduced levels of vaginal Lactobacilli
bacteria, which protect against infection. Premenopausal women have large
concentrations of lactobacilli in the vagina and prevent the colonization of
uropathogens. However, the use of antibiotics can erase this protective effect.
• Option A: An uncomplicated UTI usually only involves the bladder. When
the bacteria invade the bladder mucosal wall, cystitis is produced. The
majority of organisms causing a UTI are enteric coliforms that usually
inhabit the periurethral vaginal introitus. These organisms ascend into the
bladder and cause a UTI.
• Option B: Sexual intercourse is a common cause of a UTI as it promotes the
migration of bacteria into the bladder. People who frequently void and
empty the bladder have a much lower risk of a UTI. Pathogenic bacteria
ascend from the perineum, causing UTI. Women have shorter urethras than
men and therefore are more susceptible to UTI. Very few uncomplicated
UTIs are caused by blood-borne bacteria. Escherichia coli is the most
common organism in uncomplicated UTI by a large margin.
• Option D: A major risk factor for UTI is the use of a catheter. In addition,
manipulation of the urethra is also a risk factor. Sexual intercourse and the
use of spermicide and diaphragm are also risk factors for UTI. Frequent
pelvic exams and the presence of anatomical abnormalities of the urinary
tract can also predispose one to UTI.
