Comprehensive NP Renal & GU Disorders
Review Exam for Certification Prep (150
Items, Answers And Rationale )
2025/2026
1. A 34-year-old male presents with flank pain radiating to the groin
and gross hematuria. Which imaging test is preferred for suspected
nephrolithiasis?
A. Renal ultrasound
B. KUB X-ray
C. Non-contrast CT scan of abdomen/pelvis
D. Contrast-enhanced CT
Rationale: A non-contrast CT is the most sensitive and specific test for
kidney stones.
2. The most common cause of acute kidney injury in hospitalized
patients is:
A. Post-renal obstruction
B. Acute tubular necrosis
C. Glomerulonephritis
D. Prerenal volume depletion
Rationale: Ischemic or nephrotoxic ATN is the most frequent etiology
of AKI in hospitalized patients.
3. A 55-year-old woman with diabetes presents with
microalbuminuria. What is the best initial management?
,A. Increase protein intake
B. Start an ACE inhibitor or ARB
C. Begin loop diuretics
D. Avoid antihypertensive therapy
Rationale: ACEIs/ARBs reduce intraglomerular pressure and slow
diabetic nephropathy progression.
4. Which electrolyte abnormality is most associated with ECG changes
such as peaked T waves?
A. Hyponatremia
B. Hypocalcemia
C. Hyperkalemia
D. Hypomagnesemia
Rationale: Elevated potassium causes characteristic peaked T waves
and can lead to arrhythmias.
5. A patient with chronic kidney disease stage 4 has a GFR of:
A. 60–89 mL/min
B. 45–59 mL/min
C. 30–44 mL/min
D. 15–29 mL/min
Rationale: CKD stage 4 is defined as GFR between 15 and 29.
6. First-line treatment for uncomplicated cystitis in women includes:
A. Amoxicillin
B. Nitrofurantoin
C. Ciprofloxacin
,D. Azithromycin
Rationale: Nitrofurantoin is recommended due to high efficacy and
low resistance.
7. A palpable, nontender mass in the scrotum that transilluminates is
most likely:
A. Varicocele
B. Testicular torsion
C. Hydrocele
D. Epididymitis
Rationale: Hydroceles transilluminate and are usually painless.
8. A patient with renal artery stenosis is most likely to show which
clinical feature?
A. Hyperkalemia
B. Low renin
C. Refractory hypertension
D. Nephrotic syndrome
Rationale: RAS often presents as severe or resistant hypertension due
to renin-angiotensin activation.
9. In a patient with suspected prostatitis, the NP should avoid:
A. Urinalysis
B. Prostatic massage
C. PSA testing
D. Empiric antibiotics
, Rationale: Prostatic massage can precipitate bacteremia in acute
prostatitis.
10. Which condition presents with RBC casts on urinalysis?
A. Pyelonephritis
B. Nephrotic syndrome
C. Glomerulonephritis
D. Cystitis
Rationale: RBC casts are hallmark findings in glomerular
inflammation.
11. A 19-year-old male with sudden severe testicular pain and absent
cremasteric reflex likely has:
A. Epididymitis
B. Testicular torsion
C. Hydrocele
D. Hernia
Rationale: Torsion is characterized by acute pain and absent
cremasteric reflex—surgical emergency.
12. The best marker for assessing renal function is:
A. BUN
B. Serum creatinine
C. Urine protein
D. PSA
Rationale: Creatinine reflects GFR and is the most reliable common
marker for kidney function.
Review Exam for Certification Prep (150
Items, Answers And Rationale )
2025/2026
1. A 34-year-old male presents with flank pain radiating to the groin
and gross hematuria. Which imaging test is preferred for suspected
nephrolithiasis?
A. Renal ultrasound
B. KUB X-ray
C. Non-contrast CT scan of abdomen/pelvis
D. Contrast-enhanced CT
Rationale: A non-contrast CT is the most sensitive and specific test for
kidney stones.
2. The most common cause of acute kidney injury in hospitalized
patients is:
A. Post-renal obstruction
B. Acute tubular necrosis
C. Glomerulonephritis
D. Prerenal volume depletion
Rationale: Ischemic or nephrotoxic ATN is the most frequent etiology
of AKI in hospitalized patients.
3. A 55-year-old woman with diabetes presents with
microalbuminuria. What is the best initial management?
,A. Increase protein intake
B. Start an ACE inhibitor or ARB
C. Begin loop diuretics
D. Avoid antihypertensive therapy
Rationale: ACEIs/ARBs reduce intraglomerular pressure and slow
diabetic nephropathy progression.
4. Which electrolyte abnormality is most associated with ECG changes
such as peaked T waves?
A. Hyponatremia
B. Hypocalcemia
C. Hyperkalemia
D. Hypomagnesemia
Rationale: Elevated potassium causes characteristic peaked T waves
and can lead to arrhythmias.
5. A patient with chronic kidney disease stage 4 has a GFR of:
A. 60–89 mL/min
B. 45–59 mL/min
C. 30–44 mL/min
D. 15–29 mL/min
Rationale: CKD stage 4 is defined as GFR between 15 and 29.
6. First-line treatment for uncomplicated cystitis in women includes:
A. Amoxicillin
B. Nitrofurantoin
C. Ciprofloxacin
,D. Azithromycin
Rationale: Nitrofurantoin is recommended due to high efficacy and
low resistance.
7. A palpable, nontender mass in the scrotum that transilluminates is
most likely:
A. Varicocele
B. Testicular torsion
C. Hydrocele
D. Epididymitis
Rationale: Hydroceles transilluminate and are usually painless.
8. A patient with renal artery stenosis is most likely to show which
clinical feature?
A. Hyperkalemia
B. Low renin
C. Refractory hypertension
D. Nephrotic syndrome
Rationale: RAS often presents as severe or resistant hypertension due
to renin-angiotensin activation.
9. In a patient with suspected prostatitis, the NP should avoid:
A. Urinalysis
B. Prostatic massage
C. PSA testing
D. Empiric antibiotics
, Rationale: Prostatic massage can precipitate bacteremia in acute
prostatitis.
10. Which condition presents with RBC casts on urinalysis?
A. Pyelonephritis
B. Nephrotic syndrome
C. Glomerulonephritis
D. Cystitis
Rationale: RBC casts are hallmark findings in glomerular
inflammation.
11. A 19-year-old male with sudden severe testicular pain and absent
cremasteric reflex likely has:
A. Epididymitis
B. Testicular torsion
C. Hydrocele
D. Hernia
Rationale: Torsion is characterized by acute pain and absent
cremasteric reflex—surgical emergency.
12. The best marker for assessing renal function is:
A. BUN
B. Serum creatinine
C. Urine protein
D. PSA
Rationale: Creatinine reflects GFR and is the most reliable common
marker for kidney function.
