NRNP 6635 Week 11 Final Exam Premium Study Pack with
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Page 1
, 1. A patient with a history of recurrent urinary tract infections presents with
dysuria, frequency, and suprapubic discomfort. Urinalysis shows pyuria and
bacteriuria, but urine culture is negative. Which of the following best explains this
discrepancy?
A. Contamination of the urine specimen with vaginal flora
B. Infection with a fastidious organism such as Ureaplasma urealyticum
C. Recent antibiotic use suppressing bacterial growth but not inflammation
D. Presence of a biofilm-producing organism that does not grow on standard media
Answer: B. Infection with a fastidious organism such as Ureaplasma urealyticum
Negative culture with pyuria and symptoms suggests an infection with fastidious
organisms like Ureaplasma or Mycoplasma, which require specialized media. Option A
would show mixed flora; C is less likely without recent antibiotic history; D is rare in
UTIs.
2. In managing a patient with newly diagnosed type 2 diabetes and an estimated
glomerular filtration rate (eGFR) of 45 mL/min/1.73 m², which antihyperglycemic
agent requires dose adjustment or avoidance?
A. Metformin
B. Liraglutide
C. Empagliflozin
D. Sitagliptin
Answer: A. Metformin
Metformin is contraindicated when eGFR <30 and should be used with caution at 30-45
due to lactic acidosis risk. Liraglutide and empagliflozin can be used with dose
adjustment; sitagliptin requires dose reduction but is not contraindicated.
Page 2
Verified A+ Graded Questions and Answers, Detailed Rationales,
Clinical Guidelines, and Complete 2026 Updated Family Practice
Review Guide — 100 Questions and Answers Already Graded A+
Premium Exam Tested And Verified
Page 1
, 1. A patient with a history of recurrent urinary tract infections presents with
dysuria, frequency, and suprapubic discomfort. Urinalysis shows pyuria and
bacteriuria, but urine culture is negative. Which of the following best explains this
discrepancy?
A. Contamination of the urine specimen with vaginal flora
B. Infection with a fastidious organism such as Ureaplasma urealyticum
C. Recent antibiotic use suppressing bacterial growth but not inflammation
D. Presence of a biofilm-producing organism that does not grow on standard media
Answer: B. Infection with a fastidious organism such as Ureaplasma urealyticum
Negative culture with pyuria and symptoms suggests an infection with fastidious
organisms like Ureaplasma or Mycoplasma, which require specialized media. Option A
would show mixed flora; C is less likely without recent antibiotic history; D is rare in
UTIs.
2. In managing a patient with newly diagnosed type 2 diabetes and an estimated
glomerular filtration rate (eGFR) of 45 mL/min/1.73 m², which antihyperglycemic
agent requires dose adjustment or avoidance?
A. Metformin
B. Liraglutide
C. Empagliflozin
D. Sitagliptin
Answer: A. Metformin
Metformin is contraindicated when eGFR <30 and should be used with caution at 30-45
due to lactic acidosis risk. Liraglutide and empagliflozin can be used with dose
adjustment; sitagliptin requires dose reduction but is not contraindicated.
Page 2
