NRNP 6550 FINAL EXAM QUESTIONS AND
ANSWERS 2025 100% CORRECT
https://www.stuvia.com/user/LUCIDWISE
,Risk factors for UTI
(ANS-
Female
critically ill
elderly
catheter (caused by biofilm)
DM
calculi, tumor, stricture
neurogenic bladder
Women:
sexual intercourse or new sex partner
pregnancy
previous UTI
Men:
prostate enlargement
prostatitis
lack of circumcision
gay
HIV
Findings UTI
(ANS-
Lower:
Dysuria/ urgency/ frequency/ incontinence
suprapubic pain
hematuria
fever/ chills uncommon
No flank pain
Upper:
flank pain
fever and chills
hematuria
n/v
ams (in elderly)
https://www.stuvia.com/user/LUCIDWISE
,malaise
tachycardia/ tachypnea
Testing and results for UTI
(ANS-
Gold standard: urine culture and sensitivity: detection of bacteria. Start with POC:
urine analysis.
UA: pos for nitrite or leukocyte or blood
CBC: leukocyte with left shift in pyelonephritis
For recurrent UTI in women or UTI in men rule out obstruction, calculi, or
necrosis with:
xr voiding
CT abdomen
US pelvis
MRI pelvis
Management acute cystitis
(ANS-
First line:
- Single dose Fosfomycin (monurol)
- 3 day: sulfa: trimethoprim/ sulfa (bactrim) (do not give near delivery of baby,
give cephalexin instead) or sulfa
- 5 days: nitrofurantoin, caution in elderly
Second line:
- qiunolones: ciprofloxain or levofloxacin for 3 days (not for pregnant women!)
- B-lactams: amoxi-clav, cefdinir for 3 - 7 days
Management uncomplicated upper UTI
(ANS-
Outpt:
quinolone: ciprofloxacin for 7 days or levofloxacin for 5 days
Sulfa: trimethoprim/ sulfa (bactrim) for 14 days
Inpt:
https://www.stuvia.com/user/LUCIDWISE
, Ceftriaxone or cefotaxime
Ampicillin
CAUTION:
bacterial: treat with AB for 7 days
Candiduria: fluconazole for 14 days
Discomfort: Pyridium
Management acute complicated bacterial pyelonephritis
(ANS-
- Admit
- Aminoglycosides: gentamicin/ tobramycin (not for monotherapy), based on renal
function (trough less than 2 and peak level 5-10mg/L) and do not give for CKD
- Ampicillin
- Cefazolin
- Cefotaxime and Ceftriaxon based on obesity and pulm disease
Urine analysis: glucose and ketones
(ANS- Serum glucose at least 180mg/dl for glucose to appear in urine
Glucose in ua caused by:
- Fancone Syndrome (bad wall: caused by ahminoglycosides for example)
- DM
- Cushing's
- Vit C can give false negative
Ketones in urine:
- Alcohol
- Diabetic
- Starvation
Acute Kidney Injury
(ANS-
https://www.stuvia.com/user/LUCIDWISE
ANSWERS 2025 100% CORRECT
https://www.stuvia.com/user/LUCIDWISE
,Risk factors for UTI
(ANS-
Female
critically ill
elderly
catheter (caused by biofilm)
DM
calculi, tumor, stricture
neurogenic bladder
Women:
sexual intercourse or new sex partner
pregnancy
previous UTI
Men:
prostate enlargement
prostatitis
lack of circumcision
gay
HIV
Findings UTI
(ANS-
Lower:
Dysuria/ urgency/ frequency/ incontinence
suprapubic pain
hematuria
fever/ chills uncommon
No flank pain
Upper:
flank pain
fever and chills
hematuria
n/v
ams (in elderly)
https://www.stuvia.com/user/LUCIDWISE
,malaise
tachycardia/ tachypnea
Testing and results for UTI
(ANS-
Gold standard: urine culture and sensitivity: detection of bacteria. Start with POC:
urine analysis.
UA: pos for nitrite or leukocyte or blood
CBC: leukocyte with left shift in pyelonephritis
For recurrent UTI in women or UTI in men rule out obstruction, calculi, or
necrosis with:
xr voiding
CT abdomen
US pelvis
MRI pelvis
Management acute cystitis
(ANS-
First line:
- Single dose Fosfomycin (monurol)
- 3 day: sulfa: trimethoprim/ sulfa (bactrim) (do not give near delivery of baby,
give cephalexin instead) or sulfa
- 5 days: nitrofurantoin, caution in elderly
Second line:
- qiunolones: ciprofloxain or levofloxacin for 3 days (not for pregnant women!)
- B-lactams: amoxi-clav, cefdinir for 3 - 7 days
Management uncomplicated upper UTI
(ANS-
Outpt:
quinolone: ciprofloxacin for 7 days or levofloxacin for 5 days
Sulfa: trimethoprim/ sulfa (bactrim) for 14 days
Inpt:
https://www.stuvia.com/user/LUCIDWISE
, Ceftriaxone or cefotaxime
Ampicillin
CAUTION:
bacterial: treat with AB for 7 days
Candiduria: fluconazole for 14 days
Discomfort: Pyridium
Management acute complicated bacterial pyelonephritis
(ANS-
- Admit
- Aminoglycosides: gentamicin/ tobramycin (not for monotherapy), based on renal
function (trough less than 2 and peak level 5-10mg/L) and do not give for CKD
- Ampicillin
- Cefazolin
- Cefotaxime and Ceftriaxon based on obesity and pulm disease
Urine analysis: glucose and ketones
(ANS- Serum glucose at least 180mg/dl for glucose to appear in urine
Glucose in ua caused by:
- Fancone Syndrome (bad wall: caused by ahminoglycosides for example)
- DM
- Cushing's
- Vit C can give false negative
Ketones in urine:
- Alcohol
- Diabetic
- Starvation
Acute Kidney Injury
(ANS-
https://www.stuvia.com/user/LUCIDWISE
