CCCN
Final Test Review
(Questions & Solutions)
2025
1
,1. MCQ
Case: A 75-year-old woman in a skilled-nursing facility reports urgency
urinary incontinence and voiding six times nightly. Post-void residual
(PVR) by bladder scan is 50 mL. Which next step best refines your
assessment?
A. Refer for urodynamic study
B. Start timed voiding every 2 hours
C. Prescribe nightly desmopressin
D. Teach pelvic-floor muscle exercises
ANS: B
Rationale: With low PVR and frequency/urgency, bladder training (timed
voiding) is the least invasive first step prior to urodynamics or
pharmacotherapy.
2. MCQ
Case: A 45-year-old woman post-vaginal delivery complains of small urine
leaks when coughing. Which diagnostic test most accurately confirms
stress urinary incontinence?
A. Pad weight test
B. Post-void residual measurement
C. Cystoscopy
D. Urethral pressure profilometry
ANS: A
Rationale: A standardized pad weight test objectively quantifies leakage
with physical stress, confirming stress UI.
3. MCQ
Case: A spinal-cord-injured male uses an indwelling catheter and
develops chronic bacteriuria. Which intervention most effectively
reduces infection risk?
A. Change catheter every week
B. Switch to clean intermittent self-catheterization (CISC)
C. Flush catheter with antiseptic daily
2
,D. Increase fluid intake to 3 L/day
ANS: B
Rationale: Transitioning to CISC lowers bacteriuria risk compared with
long-term indwelling catheters.
4. MCQ
In home care, a frail elder with fecal incontinence has perianal skin
breakdown. Which product selection best prevents incontinence-
associated dermatitis (IAD)?
A. Standard adult brief changed q4h
B. Cloth underpad with zinc oxide ointment
C. Super-absorbent underpad with skin sealant
D. Petroleum-based cream and gauze
ANS: C
Rationale: Super-absorbent pads wick moisture away, and skin sealant
provides a moisture barrier to prevent IAD.
5. MCQ
An older man with benign prostatic hyperplasia (BPH) reports nocturia
4×/night. His bladder diary shows small voided volumes. Which
pharmacologic agent do you anticipate initiating?
A. Oxybutynin
B. Tamsulosin
C. Mirabegron
D. Bethanechol
ANS: B
Rationale: Tamsulosin relieves bladder outlet obstruction, increasing
voided volumes and reducing nocturia.
6. MCQ
Case: A patient with multiple sclerosis has urinary retention; PVR is 350
mL repeatedly. Which assessment tool best determines detrusor
function?
A. Uroflowmetry
B. Bladder diary
3
, C. Abdominal ultrasound
D. Urinalysis
ANS: A
Rationale: Uroflowmetry measures flow rate and pattern, distinguishing
detrusor underactivity from outlet obstruction.
7. MCQ
For a woman with mixed urinary incontinence, which pelvic-floor
rehabilitation parameter is most predictive of successful long-term
improvement?
A. Ability to perform 3 fast contractions
B. Resting vaginal pressure ≥20 cmH₂O
C. Volitional squeeze duration ≥10 seconds
D. Onset of contraction within 1 second
ANS: C
Rationale: Sustained contractions ≥10 seconds correlate with improved
support and leak reduction.
8. MCQ
A hospitalized patient with fecal impaction develops overflow diarrhea.
What is your priority intervention?
A. Begin stimulant laxative regimen
B. Implement scheduled toileting program
C. Perform manual disimpaction
D. Start high-fiber diet
ANS: C
Rationale: Manual disimpaction relieves the obstruction causing
overflow, allowing subsequent bowel regimen.
9. MCQ
A pelvic-floor physical therapist refers a patient for biofeedback. Which
finding most indicates candidacy?
A. Inability to feel pelvic-floor contraction
B. Stage III uterine prolapse
C. Refractory urge incontinence
4
Final Test Review
(Questions & Solutions)
2025
1
,1. MCQ
Case: A 75-year-old woman in a skilled-nursing facility reports urgency
urinary incontinence and voiding six times nightly. Post-void residual
(PVR) by bladder scan is 50 mL. Which next step best refines your
assessment?
A. Refer for urodynamic study
B. Start timed voiding every 2 hours
C. Prescribe nightly desmopressin
D. Teach pelvic-floor muscle exercises
ANS: B
Rationale: With low PVR and frequency/urgency, bladder training (timed
voiding) is the least invasive first step prior to urodynamics or
pharmacotherapy.
2. MCQ
Case: A 45-year-old woman post-vaginal delivery complains of small urine
leaks when coughing. Which diagnostic test most accurately confirms
stress urinary incontinence?
A. Pad weight test
B. Post-void residual measurement
C. Cystoscopy
D. Urethral pressure profilometry
ANS: A
Rationale: A standardized pad weight test objectively quantifies leakage
with physical stress, confirming stress UI.
3. MCQ
Case: A spinal-cord-injured male uses an indwelling catheter and
develops chronic bacteriuria. Which intervention most effectively
reduces infection risk?
A. Change catheter every week
B. Switch to clean intermittent self-catheterization (CISC)
C. Flush catheter with antiseptic daily
2
,D. Increase fluid intake to 3 L/day
ANS: B
Rationale: Transitioning to CISC lowers bacteriuria risk compared with
long-term indwelling catheters.
4. MCQ
In home care, a frail elder with fecal incontinence has perianal skin
breakdown. Which product selection best prevents incontinence-
associated dermatitis (IAD)?
A. Standard adult brief changed q4h
B. Cloth underpad with zinc oxide ointment
C. Super-absorbent underpad with skin sealant
D. Petroleum-based cream and gauze
ANS: C
Rationale: Super-absorbent pads wick moisture away, and skin sealant
provides a moisture barrier to prevent IAD.
5. MCQ
An older man with benign prostatic hyperplasia (BPH) reports nocturia
4×/night. His bladder diary shows small voided volumes. Which
pharmacologic agent do you anticipate initiating?
A. Oxybutynin
B. Tamsulosin
C. Mirabegron
D. Bethanechol
ANS: B
Rationale: Tamsulosin relieves bladder outlet obstruction, increasing
voided volumes and reducing nocturia.
6. MCQ
Case: A patient with multiple sclerosis has urinary retention; PVR is 350
mL repeatedly. Which assessment tool best determines detrusor
function?
A. Uroflowmetry
B. Bladder diary
3
, C. Abdominal ultrasound
D. Urinalysis
ANS: A
Rationale: Uroflowmetry measures flow rate and pattern, distinguishing
detrusor underactivity from outlet obstruction.
7. MCQ
For a woman with mixed urinary incontinence, which pelvic-floor
rehabilitation parameter is most predictive of successful long-term
improvement?
A. Ability to perform 3 fast contractions
B. Resting vaginal pressure ≥20 cmH₂O
C. Volitional squeeze duration ≥10 seconds
D. Onset of contraction within 1 second
ANS: C
Rationale: Sustained contractions ≥10 seconds correlate with improved
support and leak reduction.
8. MCQ
A hospitalized patient with fecal impaction develops overflow diarrhea.
What is your priority intervention?
A. Begin stimulant laxative regimen
B. Implement scheduled toileting program
C. Perform manual disimpaction
D. Start high-fiber diet
ANS: C
Rationale: Manual disimpaction relieves the obstruction causing
overflow, allowing subsequent bowel regimen.
9. MCQ
A pelvic-floor physical therapist refers a patient for biofeedback. Which
finding most indicates candidacy?
A. Inability to feel pelvic-floor contraction
B. Stage III uterine prolapse
C. Refractory urge incontinence
4
