Nurs 640 Exam 4 Practice Test 2026-2027 NEWEST EXAM
WITH UPDATED QUESTIONS AND CORRECT DETAILED
ANSWERS \VERIFIED 100% \GRADED A+
BPH (benign prostatic hyperplasia)
noncancerous enlargement of the
prostate s/s hesitancy
DRE (digital rectal exam): enlarged prostate.
Med: alpha blockers
procedures: TURP
Acute Urinary retention
cause: BPH or medication
S/S: lower abdomen/ suprapubic
discomfort. urine output less than
300cc
Admit for urosepsis, malignancy, acute myelopathy, acute renal
failure. 400cc leave cath in place
Most common UTI organism
e. coli, pseudomonas, klebsiella, staphylococci, candida
,Urine Dipstick
Screening test for infection with some
limitations in diagnostic value
- Best paired with clinical history / findings
- Negative findings does not necessarily
rule out infection in symptomatic patient
- Lower detection of infection for some parameters
• Key Findings
- Leukocyte esterase (presence)
- Nitrates (presence)
- Blood (≥ 1+)
- Protein (≥ 3+)
,Urine Microscopy (UA)
Key findings
• Pyuria
- WBCs or pus
- Cloudy urine is not necessarily pyuria
- Supports diagnosis of UTI but can have other causes and
negative results do not rule out trial of empiric antibiotics in
clinically likely UTI
• WBCs
- > 5 WBCs per HPF suggests infection
• Alternatively 8,000-10,000 / mL or 8 -10 per uL (note different units)
- WBC casts indicate inflammation that may or may not be infectious
• Bacteria
- Bacteria in any amount suggests infection
- Bacteria without pyuria can be contamination
• RBC's
- > 5 RBC's per HPF
• Elevated epithelial cells can suggest contamination
• Low bacterial count may be associated with antibiotic
exposure, urine dilution
Uncomplicated Acute Cystitis treatment
Cephalexin, nitrofurantoin or trimethoprimsulfamethoxazole
- Sulfa allergy: Ciprofloxacin
, 2/6/26, 6:36 PM Nurs 640 Exam 4
Acute Pyelonephritis treatment
• 7-14 days therapy (non-pregnant)
- 14 for inpatient
• Empiric first line options (examples)
- Oral: Ciprofloxacin, levofloxacin or trimethoprimsulfamethoxazole
• Allergy -Bactrim or beta lactam
- Inpatient: IV ampicillin + aminoglycoside
• Consider imaging if fever persists > 48 hrs
• Follow-up culture after treatment
• Tailor to culture results, when available
Hematuria
work up: infection/anticoagulation
Urinary stone disease
most common Ca
s/s: hematuria/ severe colic, acute flank
pain, N&V Testing: Ultrasound or spiral non
contract CT.
/ 4/33
WITH UPDATED QUESTIONS AND CORRECT DETAILED
ANSWERS \VERIFIED 100% \GRADED A+
BPH (benign prostatic hyperplasia)
noncancerous enlargement of the
prostate s/s hesitancy
DRE (digital rectal exam): enlarged prostate.
Med: alpha blockers
procedures: TURP
Acute Urinary retention
cause: BPH or medication
S/S: lower abdomen/ suprapubic
discomfort. urine output less than
300cc
Admit for urosepsis, malignancy, acute myelopathy, acute renal
failure. 400cc leave cath in place
Most common UTI organism
e. coli, pseudomonas, klebsiella, staphylococci, candida
,Urine Dipstick
Screening test for infection with some
limitations in diagnostic value
- Best paired with clinical history / findings
- Negative findings does not necessarily
rule out infection in symptomatic patient
- Lower detection of infection for some parameters
• Key Findings
- Leukocyte esterase (presence)
- Nitrates (presence)
- Blood (≥ 1+)
- Protein (≥ 3+)
,Urine Microscopy (UA)
Key findings
• Pyuria
- WBCs or pus
- Cloudy urine is not necessarily pyuria
- Supports diagnosis of UTI but can have other causes and
negative results do not rule out trial of empiric antibiotics in
clinically likely UTI
• WBCs
- > 5 WBCs per HPF suggests infection
• Alternatively 8,000-10,000 / mL or 8 -10 per uL (note different units)
- WBC casts indicate inflammation that may or may not be infectious
• Bacteria
- Bacteria in any amount suggests infection
- Bacteria without pyuria can be contamination
• RBC's
- > 5 RBC's per HPF
• Elevated epithelial cells can suggest contamination
• Low bacterial count may be associated with antibiotic
exposure, urine dilution
Uncomplicated Acute Cystitis treatment
Cephalexin, nitrofurantoin or trimethoprimsulfamethoxazole
- Sulfa allergy: Ciprofloxacin
, 2/6/26, 6:36 PM Nurs 640 Exam 4
Acute Pyelonephritis treatment
• 7-14 days therapy (non-pregnant)
- 14 for inpatient
• Empiric first line options (examples)
- Oral: Ciprofloxacin, levofloxacin or trimethoprimsulfamethoxazole
• Allergy -Bactrim or beta lactam
- Inpatient: IV ampicillin + aminoglycoside
• Consider imaging if fever persists > 48 hrs
• Follow-up culture after treatment
• Tailor to culture results, when available
Hematuria
work up: infection/anticoagulation
Urinary stone disease
most common Ca
s/s: hematuria/ severe colic, acute flank
pain, N&V Testing: Ultrasound or spiral non
contract CT.
/ 4/33
