MSN 621 FINAL TEST PAPER 2026 COMPLETE
QUESTIONS AND ANSWERS VERIFIED
▶ UTI management in pregnancy. Answer: Do not use Fluoroquinolones
(auditory and vestibular toxicity)
Do not use tetracycline (tooth staining)
Nitrofurantoin is contraindicated in pregnancy clients at term, during labor,
and during delivery
▶ UTI local antibiotic resistance. Answer: Use antiviral to check for local
resistance, these can be found at your local hospital
▶ pyelonephritis. Answer: Acute infection and inflammatory disease of the
upper urinary tract of one or both kidneys
▶ Acute pyelonephritis characterized by. Answer: Scarring to the kidneys
and may lead to significant damage, kidney failure, abscess formation, and
sepsis
▶ Upper UTI (pyelonephritis). Answer: Are less common, but more serious
than lower UTIs, may require hospitalization
▶ Pyelonephritis symptoms. Answer: 1) urinary frequency
2) urgency
3) fevers, chills, shaking
4) CVA tenderness
5) flank pain and tenderness.
6) nausea and vomiting
7) hematuria
8) abdominal pain or suprapubic heaviness
9) elderly may present with mental status change
**Pyelonephritis is also a more severe disease, so there is a higher fever
and the patient is much more ill.
, ▶ Pylonephritis diagnostic test. Answer: Urinalysis, urine cx and
sensitivity, blood cxs if indicated, CT/MRI, renal ultrasound, STI testing
▶ Pyelonephritis management. Answer: broad-spec antibiotics, pain
management (NSAIDS + anti-pyretic), adequate oral fluid
▶ 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
QUESTIONS AND ANSWERS VERIFIED
▶ UTI management in pregnancy. Answer: Do not use Fluoroquinolones
(auditory and vestibular toxicity)
Do not use tetracycline (tooth staining)
Nitrofurantoin is contraindicated in pregnancy clients at term, during labor,
and during delivery
▶ UTI local antibiotic resistance. Answer: Use antiviral to check for local
resistance, these can be found at your local hospital
▶ pyelonephritis. Answer: Acute infection and inflammatory disease of the
upper urinary tract of one or both kidneys
▶ Acute pyelonephritis characterized by. Answer: Scarring to the kidneys
and may lead to significant damage, kidney failure, abscess formation, and
sepsis
▶ Upper UTI (pyelonephritis). Answer: Are less common, but more serious
than lower UTIs, may require hospitalization
▶ Pyelonephritis symptoms. Answer: 1) urinary frequency
2) urgency
3) fevers, chills, shaking
4) CVA tenderness
5) flank pain and tenderness.
6) nausea and vomiting
7) hematuria
8) abdominal pain or suprapubic heaviness
9) elderly may present with mental status change
**Pyelonephritis is also a more severe disease, so there is a higher fever
and the patient is much more ill.
, ▶ Pylonephritis diagnostic test. Answer: Urinalysis, urine cx and
sensitivity, blood cxs if indicated, CT/MRI, renal ultrasound, STI testing
▶ Pyelonephritis management. Answer: broad-spec antibiotics, pain
management (NSAIDS + anti-pyretic), adequate oral fluid
▶ 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
