ESTUDYR
NURS 5433 FAMILY II: UROLOGIC AND RENAL DISORDERS 2025 MULTICHOICE
ANSWERED EXAM QUESTIONS WITH DETAILED RATIONALES
1. Which organism is the most common cause of uncomplicated community urinary tract
infections?
A. Pseudomonas aeruginosa
B. Escherichia coli
C. Staphylococcus aureus
D. Candida albicans
Rationale: E. coli (a gram-negative Enterobacteriaceae) is responsible for the majority of
uncomplicated UTIs due to its virulence factors and proximity to the urethra.
2. Which of the following lists includes common bacterial causes of UTIs?
A. Staph aureus, Bacillus, Clostridium
B. E. coli, Proteus mirabilis, Klebsiella pneumoniae, Enterobacter spp., Staphylococcus
saprophyticus
C. Streptococcus pyogenes, Listeria, Corynebacterium
D. Mycobacterium tuberculosis, Nocardia, Legionella
Rationale: The listed Enterobacteriaceae plus S. saprophyticus (gram-positive) are classic
uropathogens.
3. A urine dipstick that is positive for both nitrite and leukocyte esterase most likely
indicates:
A. Viral cystitis
B. Bacterial UTI (especially gram-negative enteric organisms)
C. Interstitial nephritis only
D. Nephrolithiasis without infection
Rationale: Leukocyte esterase indicates pyuria; nitrite indicates bacterial nitrate
reduction to nitrite — together they strongly suggest bacterial UTI.
4. Which dipstick result can be present even if bacteriuria is absent (false positive for
infection)?
A. Positive nitrite only always indicates infection
B. Positive leukocyte esterase may occur with contamination or inflammation not
from infection
C. Positive blood only rules in UTI always
D. Negative leukocyte esterase rules out all infection
Rationale: Leukocyte esterase indicates WBCs in urine, which can reflect inflammation,
contamination, or infection — clinical correlation is required.
, ESTUDYR
5. Which organisms are commonly less likely to produce a positive nitrite on dipstick?
A. All Enterobacteriaceae always produce nitrite
B. Enterococcus and Staphylococcus saprophyticus (Gram-positives) and some strains
of other bacteria
C. E. coli only produces nitrite in all cases
D. Organisms that always produce nitrite are the rule; none fail to produce nitrite
Rationale: Nitrite positivity depends on bacterial nitrate-reductase activity; many gram-
positive uropathogens (Enterococcus, Staph saprophyticus) and some strains of other
bacteria may not convert nitrate to nitrite, producing false-negative nitrite tests.
6. A patient has recurrent UTI episodes caused by the same pathogen (relapse). What is
the usual management approach?
A. No antibiotics — observe only
B. Prolonged antibiotic course (often 2–3 weeks) and investigate for underlying cause
C. Single-dose therapy only each time
D. Immediate nephrectomy
Rationale: Recurrence with the same organism (relapse) suggests incomplete
eradication or anatomic/functional problem; prolonged therapy and evaluation for
source control are indicated.
7. Which imaging test is the first-line choice for evaluating genitourinary (GU) structural
symptoms in many patients?
A. Non-contrast CT always first
B. Renal/bladder ultrasound (sonogram)
C. IV pyelogram only
D. PET scan only
Rationale: Ultrasound is noninvasive, radiation-free, and useful to detect obstruction,
hydronephrosis, and many anatomic causes of GU complaints.
8. In children, which two imaging studies are commonly used to evaluate recurrent UTIs or
suspected anatomic abnormalities?
A. CT abdomen and PET scan
B. Renal ultrasound (to detect obstruction) and voiding cystourethrogram (VCUG) to
assess vesicoureteral reflux
C. MRI brain and echocardiogram
D. Bone scan and DEXA
Rationale: Renal ultrasound evaluates renal structure and obstruction; VCUG assesses
for VUR, which is important in pediatric recurrent UTIs.
NURS 5433 FAMILY II: UROLOGIC AND RENAL DISORDERS 2025 MULTICHOICE
ANSWERED EXAM QUESTIONS WITH DETAILED RATIONALES
1. Which organism is the most common cause of uncomplicated community urinary tract
infections?
A. Pseudomonas aeruginosa
B. Escherichia coli
C. Staphylococcus aureus
D. Candida albicans
Rationale: E. coli (a gram-negative Enterobacteriaceae) is responsible for the majority of
uncomplicated UTIs due to its virulence factors and proximity to the urethra.
2. Which of the following lists includes common bacterial causes of UTIs?
A. Staph aureus, Bacillus, Clostridium
B. E. coli, Proteus mirabilis, Klebsiella pneumoniae, Enterobacter spp., Staphylococcus
saprophyticus
C. Streptococcus pyogenes, Listeria, Corynebacterium
D. Mycobacterium tuberculosis, Nocardia, Legionella
Rationale: The listed Enterobacteriaceae plus S. saprophyticus (gram-positive) are classic
uropathogens.
3. A urine dipstick that is positive for both nitrite and leukocyte esterase most likely
indicates:
A. Viral cystitis
B. Bacterial UTI (especially gram-negative enteric organisms)
C. Interstitial nephritis only
D. Nephrolithiasis without infection
Rationale: Leukocyte esterase indicates pyuria; nitrite indicates bacterial nitrate
reduction to nitrite — together they strongly suggest bacterial UTI.
4. Which dipstick result can be present even if bacteriuria is absent (false positive for
infection)?
A. Positive nitrite only always indicates infection
B. Positive leukocyte esterase may occur with contamination or inflammation not
from infection
C. Positive blood only rules in UTI always
D. Negative leukocyte esterase rules out all infection
Rationale: Leukocyte esterase indicates WBCs in urine, which can reflect inflammation,
contamination, or infection — clinical correlation is required.
, ESTUDYR
5. Which organisms are commonly less likely to produce a positive nitrite on dipstick?
A. All Enterobacteriaceae always produce nitrite
B. Enterococcus and Staphylococcus saprophyticus (Gram-positives) and some strains
of other bacteria
C. E. coli only produces nitrite in all cases
D. Organisms that always produce nitrite are the rule; none fail to produce nitrite
Rationale: Nitrite positivity depends on bacterial nitrate-reductase activity; many gram-
positive uropathogens (Enterococcus, Staph saprophyticus) and some strains of other
bacteria may not convert nitrate to nitrite, producing false-negative nitrite tests.
6. A patient has recurrent UTI episodes caused by the same pathogen (relapse). What is
the usual management approach?
A. No antibiotics — observe only
B. Prolonged antibiotic course (often 2–3 weeks) and investigate for underlying cause
C. Single-dose therapy only each time
D. Immediate nephrectomy
Rationale: Recurrence with the same organism (relapse) suggests incomplete
eradication or anatomic/functional problem; prolonged therapy and evaluation for
source control are indicated.
7. Which imaging test is the first-line choice for evaluating genitourinary (GU) structural
symptoms in many patients?
A. Non-contrast CT always first
B. Renal/bladder ultrasound (sonogram)
C. IV pyelogram only
D. PET scan only
Rationale: Ultrasound is noninvasive, radiation-free, and useful to detect obstruction,
hydronephrosis, and many anatomic causes of GU complaints.
8. In children, which two imaging studies are commonly used to evaluate recurrent UTIs or
suspected anatomic abnormalities?
A. CT abdomen and PET scan
B. Renal ultrasound (to detect obstruction) and voiding cystourethrogram (VCUG) to
assess vesicoureteral reflux
C. MRI brain and echocardiogram
D. Bone scan and DEXA
Rationale: Renal ultrasound evaluates renal structure and obstruction; VCUG assesses
for VUR, which is important in pediatric recurrent UTIs.
