MSN 621 EXAM SCRIPT FINAL PAPER 2026
FULL QUESTIONS AND CORRECT ANSWERS
▶ Pyelonephritis first line treatment. Answer: First line: Ciprofloxacin 500
mg BID for 7 days or extended release 1000 mg daily for 7 days
Levofloxacin 750 mg once daily for 5 to 7 days
▶ Pyelonephritis second line tratment. Answer: Bacterium DS/ Sentra DS/
TMP-SMX 160 mg and 800 mg, one tablet BID for 7-10 days. Because of
high rate of resistance to E.coli, the use of TMP-SMX should be avoided in
clients who require hospitalization
-Alternative therapy: Augmentin 500 mg/125 mg orally BID for 14 days or
Augmentin 250 mg/125 mg orally TID for 7 days
▶ Pyelonephritis education. Answer: Early recognition of UTIs, I cease
fluid intake, frequent emptying of the bladder, hand hygiene, wipe front to
back, take showers instead of baths, avoid feminine hygiene sprays and
douches, wear cotton underwear, avoid caffeine, alcohol, red wine, spicy
foods due to bladder irritation, pyridium can discolor urine orange or blue
▶ Pyelonephritis follow up. Answer: 48 hours - need to know if responsive
to treatment
Further testing and treatment change if no improvement in 72 hours
Follow up cultures not indicated
Refer to nephrology if chronic pyelonephritis
▶ urinary incontinence. Answer: Involuntary transient or persistent loss of
urine
▶ Types of urine incontinence. Answer: Stress (SUI)
Urgency (UUI)
Mixed (MUI)
Post void dribbling (PVD)
Post void incontinence (PV-UI)
▶ Risk Factors for urinary incontinence. Answer: pregnancy
vaginal delivery
, Obesity
Age
Smoking
Constipation
Genetic risk factors
▶ Risk factors for incontinence in men. Answer: Prostatic hypertrophy or
from sequels due to surgery or radiation for prostate cancer
▶ Incontinence examination. Answer: Abdominal, anal, GU, pelvic, and
neurological exam
Urinalysis/culture, urine cytology, BUN/creatinine, glucose, calcium
Stress test, PVR scan
Evaluate current medication
▶ Incontinence Management. Answer: Treatment varies according to
cause
Behavioral and pharmacological therapies are generally first-line therapies
Fluid regulation and weight loss
Voiding diaries
Reduced caffeine intake
Kegel exercises
Surgical therapy as indicated
Urology referral
▶ What are modified risk factors for urinary incontinence in women?.
Answer: Weight loss, smoking cessation, pelvic floor strengthening,
constipation management, and reducing bladder irritants
▶ What are non-modifiable risk factors for urinary incontinence?. Answer:
Age, genetics, and prior pelvic surgery
▶ prostate cancer. Answer: Second leading cancer in males in the United
States; adenocarcinoma is the prevalent type of cancer
▶ Gleason scoring system. Answer: high score=more aggressive=worse
prognosis
the grading system is based on how bad or good the prognosis is
▶ Prostate cancer symptoms. Answer: - Early: asymptomatic
FULL QUESTIONS AND CORRECT ANSWERS
▶ Pyelonephritis first line treatment. Answer: First line: Ciprofloxacin 500
mg BID for 7 days or extended release 1000 mg daily for 7 days
Levofloxacin 750 mg once daily for 5 to 7 days
▶ Pyelonephritis second line tratment. Answer: Bacterium DS/ Sentra DS/
TMP-SMX 160 mg and 800 mg, one tablet BID for 7-10 days. Because of
high rate of resistance to E.coli, the use of TMP-SMX should be avoided in
clients who require hospitalization
-Alternative therapy: Augmentin 500 mg/125 mg orally BID for 14 days or
Augmentin 250 mg/125 mg orally TID for 7 days
▶ Pyelonephritis education. Answer: Early recognition of UTIs, I cease
fluid intake, frequent emptying of the bladder, hand hygiene, wipe front to
back, take showers instead of baths, avoid feminine hygiene sprays and
douches, wear cotton underwear, avoid caffeine, alcohol, red wine, spicy
foods due to bladder irritation, pyridium can discolor urine orange or blue
▶ Pyelonephritis follow up. Answer: 48 hours - need to know if responsive
to treatment
Further testing and treatment change if no improvement in 72 hours
Follow up cultures not indicated
Refer to nephrology if chronic pyelonephritis
▶ urinary incontinence. Answer: Involuntary transient or persistent loss of
urine
▶ Types of urine incontinence. Answer: Stress (SUI)
Urgency (UUI)
Mixed (MUI)
Post void dribbling (PVD)
Post void incontinence (PV-UI)
▶ Risk Factors for urinary incontinence. Answer: pregnancy
vaginal delivery
, Obesity
Age
Smoking
Constipation
Genetic risk factors
▶ Risk factors for incontinence in men. Answer: Prostatic hypertrophy or
from sequels due to surgery or radiation for prostate cancer
▶ Incontinence examination. Answer: Abdominal, anal, GU, pelvic, and
neurological exam
Urinalysis/culture, urine cytology, BUN/creatinine, glucose, calcium
Stress test, PVR scan
Evaluate current medication
▶ Incontinence Management. Answer: Treatment varies according to
cause
Behavioral and pharmacological therapies are generally first-line therapies
Fluid regulation and weight loss
Voiding diaries
Reduced caffeine intake
Kegel exercises
Surgical therapy as indicated
Urology referral
▶ What are modified risk factors for urinary incontinence in women?.
Answer: Weight loss, smoking cessation, pelvic floor strengthening,
constipation management, and reducing bladder irritants
▶ What are non-modifiable risk factors for urinary incontinence?. Answer:
Age, genetics, and prior pelvic surgery
▶ prostate cancer. Answer: Second leading cancer in males in the United
States; adenocarcinoma is the prevalent type of cancer
▶ Gleason scoring system. Answer: high score=more aggressive=worse
prognosis
the grading system is based on how bad or good the prognosis is
▶ Prostate cancer symptoms. Answer: - Early: asymptomatic
