NSG 6320 AGNP Board Exam – Urology Assessment Exam

NSG 6320 AGNP Board Exam – Urology Assessment Exam 1. Question: In renal adaptation of the newborn, which one of the following statements is correct? The kidneys have an inability to concentrate urine and adapt to fluid and electrolyte stress. Correct In the nephrons of the kidneys long tubules enhance the effectiveness of tubular reabsorption. The kidneys are fully capable of concentrating urine and maintaining fluid and electrolyte balance. The kidneys have the ability to increase the production of antidiuretic hormone (ADH) effectively. Explanation: In the neonate the kidneys are structurally complete but physiologically immature. The glomeruli have an inability to filter and concentrate urine, therefore glucose and amino acids escape and there is decreased ability to remove uric acid crystals which give the reddish appearance to the urine. There is an inability to adapt to fluid and electrolyte stress leading to loss of bicarbonate and poor reabsorption. This puts the neonate at increased risk of metabolic acidosis. The tubules are short/narrow which causes a problem with reabsorption. The nephrons function well within a month. ADH inhibits diuresis and the immature kidney causes an increased risk for dehydration. 2. Question: What is the most common non-skin cancer in America? Uterine cancer Bladder cancer Cervical cancer Prostate cancer Correct Explanation: Prostate cancer is the most common non-skin cancer in America; 1 in 8 men will be diagnosed with it at some point in their lives. In fact, nearly 60% of all prostate cancers are diagnosed in men older than 65. 3. Question: Patients with prior hypospadias surgery who develop slow and painful urination as well as prostatitis are experiencing symptoms of: neurogenic bladder. urethral stricture. Correct benign prostatic hyperplasia (BPH). prostate cancer. Explanation: A urethral stricture may occur in patients who have undergone hypospadias surgery and experience voiding symptoms such as urinary retention and straining to void. Neurogenic bladder symptoms include urinary retention and/or incontinence associated with other underlying chronic neurologic conditions (e.g., multiple sclerosis) or after spinal cord injury. Patients with BPH experience an increase in daytime frequency, nocturia, urinary incontinence, and terminal dribbling. Prostate cancer is usually asymptomatic but can sometimes present with storage, voiding, or irritative symptoms. 4. Question: What is the average urine pH level? 4.5 6 Correct 7 8 Explanation: The average urine pH level is 5-6, acid pH is 4.5-5.5, and alkaline pH is 6.5-8. 5. Question: Symptoms of proctitis may include all of the following except: left-sided abdominal pain. rectal pain. suprapubic pain. Correct tenesmus. Explanation: Proctitis is inflammation of the lining of the rectum leading to rectal pain, bleeding, and a continuous sensation to defecate (tenesmus). Additional symptoms may also include left-sided abdominal pain, diarrhea, pain with bowel movements, and a feeling of fullness in the rectum. Suprapubic pain is not generally associated with proctitis. 6. Question: A useful mnemonic for elucidating causes of incontinence in the older adult is: STOOL. DIAPERS. Correct DRIP. URINE. Explanation: For elucidating causes of incontinence, two mnemonics may be helpful: DIAPERS, (Delirium, Infection, Atrophic urethritis/vaginitis, Pharmaceuticals, Excess urine output from conditions like hyperglycemia or heart failure, Restricted mobility, and Stool impaction) and DDRRIIPP (Delirium, Drug side effects, Retention of feces, Restricted mobility, Infection of urine, Inflammation, Polyuria, and Psychogenic). 7. Question: Which of the following symptoms is NOT associated with nephrotic syndrome? Proteinuria Hyperlipidemia Lower leg edema Hyperalbuminosa Correct Explanation: Nephrotic syndrome is diagnosed by the presence of proteinuria, hyperlipidemia, edema, or swelling (usually in the legs, feet, or ankles and less often in the hands or face), and hypoalbuminemia. 8. Question: In afebrile patients who experience intermittent sharp flank pain in addition to gross hematuria, further testing would be indicated for: pelvic inflammatory disease (PID). pyelonephritis. nephrolithiasis. Correct urethritis. Explanation: The majority of patients with symptomatic nephrolithiasis have intermittent flank