Renal & GU Disorders for Nurse
Practitioners – Full Practice Test Bank | 150
Verified Questions + Answers (2025/2026)
1. A 55-year-old male presents with sudden onset flank pain
radiating to the groin. Urinalysis reveals hematuria. What is the
most likely diagnosis?
a) Pyelonephritis
b) Urinary tract infection
c) Nephrolithiasis
d) Hydronephrosis
Rationale: Flank pain radiating to the groin with hematuria is classic for
kidney stones (nephrolithiasis).
2. Which of the following is the first-line treatment for
uncomplicated cystitis in an adult female?
a) Ciprofloxacin
b) Nitrofurantoin
c) Amoxicillin
d) Vancomycin
Rationale: Nitrofurantoin is recommended as first-line therapy for
uncomplicated cystitis due to efficacy and low resistance rates.
3. A patient with chronic kidney disease (CKD) stage 3 has a GFR of
45 mL/min. Which medication requires dose adjustment?
a) Metformin
b) Lisinopril
c) Furosemide
d) Acetaminophen
,Rationale: Metformin is contraindicated in patients with GFR < 45
mL/min due to risk of lactic acidosis.
4. A 60-year-old male presents with nocturia, weak urine stream,
and incomplete bladder emptying. What is the most likely cause?
a) UTI
b) Benign prostatic hyperplasia (BPH)
c) Prostate cancer
d) Neurogenic bladder
Rationale: Obstructive urinary symptoms in older males are most
commonly caused by BPH.
5. Which laboratory test is most sensitive for detecting early diabetic
nephropathy?
a) Serum creatinine
b) Urine albumin-to-creatinine ratio
c) BUN
d) Urinalysis for hematuria
Rationale: Microalbuminuria is the earliest marker for diabetic
nephropathy before creatinine rises.
6. Which of the following medications is nephrotoxic and should be
monitored closely in patients with CKD?
a) Metoprolol
b) Furosemide
c) Aminoglycosides
d) Amlodipine
Rationale: Aminoglycosides can cause acute tubular necrosis and
nephrotoxicity, especially in CKD.
7. A patient with nephrotic syndrome is at increased risk for which
complication?
, a) Hyperthyroidism
b) Thromboembolism
c) Hypoglycemia
d) Pulmonary hypertension
Rationale: Loss of antithrombotic proteins in urine increases risk of
thromboembolic events in nephrotic syndrome.
8. Which of the following is a hallmark feature of acute
glomerulonephritis?
a) Proteinuria > 3.5 g/day
b) No hematuria
c) Hematuria with red blood cell casts
d) Polyuria
Rationale: Red blood cell casts in urine indicate glomerular injury, a
hallmark of acute glomerulonephritis.
9. Which electrolyte abnormality is most commonly associated with
CKD?
a) Hypokalemia
b) Hypocalcemia
c) Hyperphosphatemia
d) Hypernatremia
Rationale: CKD impairs phosphate excretion leading to
hyperphosphatemia, and often hypocalcemia due to secondary
hyperparathyroidism.
10. A patient presents with recurrent UTIs. Which imaging
modality is preferred to assess for structural abnormalities?
a) X-ray
b) MRI
, c) Renal ultrasound
d) PET scan
Rationale: Renal ultrasound is non-invasive and effective for detecting
structural abnormalities in patients with recurrent UTIs.
11. Which type of kidney stone is most commonly associated
with a urinary tract infection?
a) Calcium oxalate
b) Struvite
c) Uric acid
d) Cystine
Rationale: Struvite stones are associated with urease-producing
bacteria and recurrent UTIs.
12. A 35-year-old female presents with dysuria and frequency.
UA shows >10 WBCs/HPF but no bacteria. What is the likely
diagnosis?
a) Interstitial cystitis
b) Pyelonephritis
c) Acute bacterial cystitis
d) Urethritis
Rationale: Interstitial cystitis presents with urinary frequency and
dysuria without bacterial infection on urinalysis.
13. A patient with CKD develops hyperkalemia. Which
medication is commonly used to stabilize cardiac membranes?
a) Furosemide
b) IV calcium gluconate
c) Sodium bicarbonate
d) Insulin alone
Practitioners – Full Practice Test Bank | 150
Verified Questions + Answers (2025/2026)
1. A 55-year-old male presents with sudden onset flank pain
radiating to the groin. Urinalysis reveals hematuria. What is the
most likely diagnosis?
a) Pyelonephritis
b) Urinary tract infection
c) Nephrolithiasis
d) Hydronephrosis
Rationale: Flank pain radiating to the groin with hematuria is classic for
kidney stones (nephrolithiasis).
2. Which of the following is the first-line treatment for
uncomplicated cystitis in an adult female?
a) Ciprofloxacin
b) Nitrofurantoin
c) Amoxicillin
d) Vancomycin
Rationale: Nitrofurantoin is recommended as first-line therapy for
uncomplicated cystitis due to efficacy and low resistance rates.
3. A patient with chronic kidney disease (CKD) stage 3 has a GFR of
45 mL/min. Which medication requires dose adjustment?
a) Metformin
b) Lisinopril
c) Furosemide
d) Acetaminophen
,Rationale: Metformin is contraindicated in patients with GFR < 45
mL/min due to risk of lactic acidosis.
4. A 60-year-old male presents with nocturia, weak urine stream,
and incomplete bladder emptying. What is the most likely cause?
a) UTI
b) Benign prostatic hyperplasia (BPH)
c) Prostate cancer
d) Neurogenic bladder
Rationale: Obstructive urinary symptoms in older males are most
commonly caused by BPH.
5. Which laboratory test is most sensitive for detecting early diabetic
nephropathy?
a) Serum creatinine
b) Urine albumin-to-creatinine ratio
c) BUN
d) Urinalysis for hematuria
Rationale: Microalbuminuria is the earliest marker for diabetic
nephropathy before creatinine rises.
6. Which of the following medications is nephrotoxic and should be
monitored closely in patients with CKD?
a) Metoprolol
b) Furosemide
c) Aminoglycosides
d) Amlodipine
Rationale: Aminoglycosides can cause acute tubular necrosis and
nephrotoxicity, especially in CKD.
7. A patient with nephrotic syndrome is at increased risk for which
complication?
, a) Hyperthyroidism
b) Thromboembolism
c) Hypoglycemia
d) Pulmonary hypertension
Rationale: Loss of antithrombotic proteins in urine increases risk of
thromboembolic events in nephrotic syndrome.
8. Which of the following is a hallmark feature of acute
glomerulonephritis?
a) Proteinuria > 3.5 g/day
b) No hematuria
c) Hematuria with red blood cell casts
d) Polyuria
Rationale: Red blood cell casts in urine indicate glomerular injury, a
hallmark of acute glomerulonephritis.
9. Which electrolyte abnormality is most commonly associated with
CKD?
a) Hypokalemia
b) Hypocalcemia
c) Hyperphosphatemia
d) Hypernatremia
Rationale: CKD impairs phosphate excretion leading to
hyperphosphatemia, and often hypocalcemia due to secondary
hyperparathyroidism.
10. A patient presents with recurrent UTIs. Which imaging
modality is preferred to assess for structural abnormalities?
a) X-ray
b) MRI
, c) Renal ultrasound
d) PET scan
Rationale: Renal ultrasound is non-invasive and effective for detecting
structural abnormalities in patients with recurrent UTIs.
11. Which type of kidney stone is most commonly associated
with a urinary tract infection?
a) Calcium oxalate
b) Struvite
c) Uric acid
d) Cystine
Rationale: Struvite stones are associated with urease-producing
bacteria and recurrent UTIs.
12. A 35-year-old female presents with dysuria and frequency.
UA shows >10 WBCs/HPF but no bacteria. What is the likely
diagnosis?
a) Interstitial cystitis
b) Pyelonephritis
c) Acute bacterial cystitis
d) Urethritis
Rationale: Interstitial cystitis presents with urinary frequency and
dysuria without bacterial infection on urinalysis.
13. A patient with CKD develops hyperkalemia. Which
medication is commonly used to stabilize cardiac membranes?
a) Furosemide
b) IV calcium gluconate
c) Sodium bicarbonate
d) Insulin alone
