NR 570 Final Exam: (Latest 2026/2027 Update) Nephrolithiasis, BPH,
Prostatitis, Pyelonephritis, Fluid & Electrolytes | Q&A | Grade A | 100%
Correct (Verified Answers) – Nursing Program
Subject: NR 570 Final Exam – Nephrolithiasis (Kidney Stones), Benign Prostatic Hyperplasia (BPH),
Prostatitis, Pyelonephritis, Total Body Water, Fluid & Electrolyte Disorders (Sodium, Potassium, Calcium,
Magnesium)
Source: NR 570 Course Materials / Latest 2026/2027 NCLEX/HESI Blueprint
Format: Q&A Guide with Rationale
1: What is nephrolithiasis?
Correct Answer: Renal calculi (kidney stones).
1. Nephrolithiasis refers to the formation of stones within the kidney parenchyma or collecting
system.
2. These stones can cause obstruction, pain, hematuria, and potential renal damage.
3. Stone composition varies; calcium oxalate stones are most common (75-80%).
2: How do renal calculi form?
Correct Answer: Formed due to elevated levels of minerals in the body.
1. Supersaturation of urine with stone-forming minerals leads to crystallization.
2. Decreased urine volume (dehydration) and lack of inhibitors (citrate, magnesium) promote
stone formation.
3. Risk factors include hypercalciuria, hyperoxaluria, hyperuricosuria, and hypocitraturia.
3: What minerals in excess can cause renal calculi?
Correct Answer: Calcium oxalate (most common), phosphate, uric acid, struvite, cystine.
1. Calcium oxalate and calcium phosphate stones account for approximately 80% of all kidney
stones.
2. Uric acid stones (5-10%) are radiolucent and associated with gout and high purine intake.
3. Struvite stones (magnesium ammonium phosphate) are associated with urease-producing
bacteria (Proteus).
4: What is urolithiasis?
Correct Answer: Stone in the bladder.
1. Urolithiasis refers to stones anywhere in the urinary tract, but specifically bladder stones.
2. Bladder stones often develop from urinary stasis, neurogenic bladder, or BPH.
3. Symptoms include suprapubic pain, hematuria, and interrupted urinary stream.
,5: What is ureterolithiasis?
Correct Answer: Condition of stones in the ureter.
1. Ureterolithiasis occurs when a kidney stone passes into and obstructs the ureter.
2. This causes classic renal colic: severe, intermittent flank pain radiating to groin.
3. Obstruction can lead to hydronephrosis, infection, and renal impairment.
6: What are risk factors and complications of renal calculi?
Correct Answer: Male, age 20-50 years, previous stones, obesity, hypertension, diabetes, low fluid
intake. Complications: obstructions, pyelonephritis (kidney infection), chronic kidney disease (CKD).
1. Men have 2-3x higher stone risk than women, peaking in the 4th-5th decade.
2. Low fluid intake reduces urine volume and increases stone risk; target 2-3 L/day urine output.
3. Obstructing stones cause hydronephrosis and increase pyelonephritis risk, leading to potential
CKD.
7: What is the classic presentation of a kidney stone?
Correct Answer: Acute onset of severe, colicky flank pain that waxes and wanes in intensity. Severe
pain is associated with movement of the stone and can cause nausea/vomiting. Patient may seem
anxious and unable to sit still.
1. Renal colic is described as "the worst pain of my life" with pain intensity out of proportion to
physical findings.
2. Patients are often restless and cannot find a comfortable position (unlike peritonitis patients
who lie still).
3. Pain radiates to groin as stone moves distally; nausea/vomiting from shared nerve innervation
(celiac and renal nerves).
8: What history and physical findings are expected in nephrolithiasis?
Correct Answer: Irritative bladder symptoms (dysuria, urgency, frequency), vague flank pain or acute
colicky pain with increasing intensity, radiation of pain into the groin, costovertebral angle (CVA)
tenderness, hematuria, diaphoretic, tachycardic, appearing extremely uncomfortable.
1. CVA tenderness suggests obstruction in the ureteropelvic junction or proximal ureter.
2. Hematuria (gross or microscopic) is present in 80-90% of patients with stones.
3. Tachycardia and diaphoresis reflect severe pain and sympathetic activation.
9: Where is the stone located if the patient has costovertebral angle (CVA) tenderness?
Correct Answer: Caused by passing of the stone through the ureter with obstruction and spasm. CVA
tenderness indicates the stone is in the upper ureter near the kidney.
1. CVA tenderness localizes pain to the kidney or proximal ureter.
2. This is distinct from flank tenderness from musculoskeletal causes.
3. Percussion of CVA reproduces the typical colicky pain.
, 10: Where is the stone located if the patient has pain radiating to the groin region?
Correct Answer: Pain that radiates downward into the groin indicates the stone has passed into the
lower third of the ureter.
1. As the stone descends, pain radiation follows the dermatomes along the ureter to the
testicles/labia.
2. Stones at the ureterovesical junction cause urinary frequency and urgency (bladder irritation).
3. Groin radiation suggests the stone is approaching the bladder and may pass soon.
11: Where is the stone located if the patient has vague flank pain or acute colicky pain with
increasing intensity?
Correct Answer: Stones located in the renal pelvis.
1. Stones in the renal pelvis cause dull, aching pain rather than classic colic.
2. When the stone moves into the ureter, pain becomes acute and colicky.
3. Staghorn calculi (large stones filling the renal pelvis) may be asymptomatic or cause chronic
dull pain.
12: What are differential diagnoses for abdominal and/or flank pain?
Correct Answer: Nephrolithiasis (kidney stones), pyelonephritis (kidney infection), ectopic pregnancy,
ovarian or testicular torsion, appendicitis, bowel obstruction, diverticulitis, rupture of abdominal aortic
aneurysm.
1. The presentation of kidney stones often mimics other emergent surgical and obstetrical
conditions.
2. Pregnancy test should be performed in all women of childbearing age with abdominal pain.
3. CT scan is the gold standard to differentiate these diagnoses.
13: Right lower quadrant abdominal tenderness with a positive Blumberg sign suggests what
condition?
Correct Answer: Blumberg sign: rebound tenderness in the RLQ caused by acute peritonitis – suspect
appendicitis.
1. Rebound tenderness indicates peritoneal irritation from inflammation.
2. Appendicitis pain typically starts periumbilical and migrates to RLQ (McBurney's point).
3. Kidney stones rarely cause peritoneal signs; pain is colicky without rebound.
14: What laboratory tests are used to diagnose a kidney stone?
Correct Answer: Urinalysis dipstick, urine microscopy and urine culture & sensitivity (C&S). Serum
blood urea nitrogen (BUN) and creatinine (Cr) to assess renal function.
1. UA shows hematuria (gross or microscopic) in most stone patients; absence does not rule out
stones.
2. Urine pH can suggest stone type: acidic (<5.5) for uric acid; alkaline (>7) for struvite.
3. Elevated BUN/Cr indicates obstruction or pre-renal azotemia from dehydration.
Prostatitis, Pyelonephritis, Fluid & Electrolytes | Q&A | Grade A | 100%
Correct (Verified Answers) – Nursing Program
Subject: NR 570 Final Exam – Nephrolithiasis (Kidney Stones), Benign Prostatic Hyperplasia (BPH),
Prostatitis, Pyelonephritis, Total Body Water, Fluid & Electrolyte Disorders (Sodium, Potassium, Calcium,
Magnesium)
Source: NR 570 Course Materials / Latest 2026/2027 NCLEX/HESI Blueprint
Format: Q&A Guide with Rationale
1: What is nephrolithiasis?
Correct Answer: Renal calculi (kidney stones).
1. Nephrolithiasis refers to the formation of stones within the kidney parenchyma or collecting
system.
2. These stones can cause obstruction, pain, hematuria, and potential renal damage.
3. Stone composition varies; calcium oxalate stones are most common (75-80%).
2: How do renal calculi form?
Correct Answer: Formed due to elevated levels of minerals in the body.
1. Supersaturation of urine with stone-forming minerals leads to crystallization.
2. Decreased urine volume (dehydration) and lack of inhibitors (citrate, magnesium) promote
stone formation.
3. Risk factors include hypercalciuria, hyperoxaluria, hyperuricosuria, and hypocitraturia.
3: What minerals in excess can cause renal calculi?
Correct Answer: Calcium oxalate (most common), phosphate, uric acid, struvite, cystine.
1. Calcium oxalate and calcium phosphate stones account for approximately 80% of all kidney
stones.
2. Uric acid stones (5-10%) are radiolucent and associated with gout and high purine intake.
3. Struvite stones (magnesium ammonium phosphate) are associated with urease-producing
bacteria (Proteus).
4: What is urolithiasis?
Correct Answer: Stone in the bladder.
1. Urolithiasis refers to stones anywhere in the urinary tract, but specifically bladder stones.
2. Bladder stones often develop from urinary stasis, neurogenic bladder, or BPH.
3. Symptoms include suprapubic pain, hematuria, and interrupted urinary stream.
,5: What is ureterolithiasis?
Correct Answer: Condition of stones in the ureter.
1. Ureterolithiasis occurs when a kidney stone passes into and obstructs the ureter.
2. This causes classic renal colic: severe, intermittent flank pain radiating to groin.
3. Obstruction can lead to hydronephrosis, infection, and renal impairment.
6: What are risk factors and complications of renal calculi?
Correct Answer: Male, age 20-50 years, previous stones, obesity, hypertension, diabetes, low fluid
intake. Complications: obstructions, pyelonephritis (kidney infection), chronic kidney disease (CKD).
1. Men have 2-3x higher stone risk than women, peaking in the 4th-5th decade.
2. Low fluid intake reduces urine volume and increases stone risk; target 2-3 L/day urine output.
3. Obstructing stones cause hydronephrosis and increase pyelonephritis risk, leading to potential
CKD.
7: What is the classic presentation of a kidney stone?
Correct Answer: Acute onset of severe, colicky flank pain that waxes and wanes in intensity. Severe
pain is associated with movement of the stone and can cause nausea/vomiting. Patient may seem
anxious and unable to sit still.
1. Renal colic is described as "the worst pain of my life" with pain intensity out of proportion to
physical findings.
2. Patients are often restless and cannot find a comfortable position (unlike peritonitis patients
who lie still).
3. Pain radiates to groin as stone moves distally; nausea/vomiting from shared nerve innervation
(celiac and renal nerves).
8: What history and physical findings are expected in nephrolithiasis?
Correct Answer: Irritative bladder symptoms (dysuria, urgency, frequency), vague flank pain or acute
colicky pain with increasing intensity, radiation of pain into the groin, costovertebral angle (CVA)
tenderness, hematuria, diaphoretic, tachycardic, appearing extremely uncomfortable.
1. CVA tenderness suggests obstruction in the ureteropelvic junction or proximal ureter.
2. Hematuria (gross or microscopic) is present in 80-90% of patients with stones.
3. Tachycardia and diaphoresis reflect severe pain and sympathetic activation.
9: Where is the stone located if the patient has costovertebral angle (CVA) tenderness?
Correct Answer: Caused by passing of the stone through the ureter with obstruction and spasm. CVA
tenderness indicates the stone is in the upper ureter near the kidney.
1. CVA tenderness localizes pain to the kidney or proximal ureter.
2. This is distinct from flank tenderness from musculoskeletal causes.
3. Percussion of CVA reproduces the typical colicky pain.
, 10: Where is the stone located if the patient has pain radiating to the groin region?
Correct Answer: Pain that radiates downward into the groin indicates the stone has passed into the
lower third of the ureter.
1. As the stone descends, pain radiation follows the dermatomes along the ureter to the
testicles/labia.
2. Stones at the ureterovesical junction cause urinary frequency and urgency (bladder irritation).
3. Groin radiation suggests the stone is approaching the bladder and may pass soon.
11: Where is the stone located if the patient has vague flank pain or acute colicky pain with
increasing intensity?
Correct Answer: Stones located in the renal pelvis.
1. Stones in the renal pelvis cause dull, aching pain rather than classic colic.
2. When the stone moves into the ureter, pain becomes acute and colicky.
3. Staghorn calculi (large stones filling the renal pelvis) may be asymptomatic or cause chronic
dull pain.
12: What are differential diagnoses for abdominal and/or flank pain?
Correct Answer: Nephrolithiasis (kidney stones), pyelonephritis (kidney infection), ectopic pregnancy,
ovarian or testicular torsion, appendicitis, bowel obstruction, diverticulitis, rupture of abdominal aortic
aneurysm.
1. The presentation of kidney stones often mimics other emergent surgical and obstetrical
conditions.
2. Pregnancy test should be performed in all women of childbearing age with abdominal pain.
3. CT scan is the gold standard to differentiate these diagnoses.
13: Right lower quadrant abdominal tenderness with a positive Blumberg sign suggests what
condition?
Correct Answer: Blumberg sign: rebound tenderness in the RLQ caused by acute peritonitis – suspect
appendicitis.
1. Rebound tenderness indicates peritoneal irritation from inflammation.
2. Appendicitis pain typically starts periumbilical and migrates to RLQ (McBurney's point).
3. Kidney stones rarely cause peritoneal signs; pain is colicky without rebound.
14: What laboratory tests are used to diagnose a kidney stone?
Correct Answer: Urinalysis dipstick, urine microscopy and urine culture & sensitivity (C&S). Serum
blood urea nitrogen (BUN) and creatinine (Cr) to assess renal function.
1. UA shows hematuria (gross or microscopic) in most stone patients; absence does not rule out
stones.
2. Urine pH can suggest stone type: acidic (<5.5) for uric acid; alkaline (>7) for struvite.
3. Elevated BUN/Cr indicates obstruction or pre-renal azotemia from dehydration.
