NR 511 LATEST EXAM QUESTIONS AND ANSWERS
Urinary Incontinence
•Functional incontinence: occurs due to Delirium, fecal impaction, lack of manual
dexterity, or decreased mobility and taking the following medications: diuretics,
hypnotics, alcohol, narcotics, decongestants
•Stress incontinence: occurs due to history of vaginal deliveries, urine leakage with
cough or sneezing
•Urinary incontinence work-up: A urinalysis and urine culture and sensitivity should be
done, as well as measurements of serum electrolytes, blood urea nitrogen, creatinine,
calcium (for polyuria in the absence of diuretics), and glucose. Catheterization to assess
post-void residual volume is important even on initial evaluation of the patient.
Overactive Bladder
syndrome of symptoms that include urgency, frequency, and nocturia, all of which are
associated with involuntary contractions of the detrusor muscle
urge incontinence
(the sudden intense urge to urinate and an involuntary loss of urine) may or may not be
a feature of this syndrome, as about one-third of patients with OAB have urge
incontinence, not all. OAB is most common in women
A diagnosis of a lower UTI is made based on
• the subjective complaints of the patient and a clean-catch midstream urine sample
showing the presence of bacteria, especially if more than 100,000 organisms/mL
•In elderly patients, altered mental status may be the sole manifestation of UTI and
should create a high level of suspicion.
•Although urine culture is considered the gold standard with the greatest sensitivity for
laboratory confirmation of UTI, urinalysis with microscopy is also helpful and provides
rapid results in the primary care setting.
Pyridium
• is used for relief of pain, burning, urgency, and frequency from UTI.
Priapism
•A prolonged erection of the penis, usually without sexual arousal
•Phenylephrine (Neo-Synephrine) is
, the drug of choice for first-line treatment of low-flow priapism because the drug has
almost pure alpha-agonist effects and minimal beta activity.
Phimosis
•Is an unusually long foreskin or a foreskin that cannot be retracted over the glans penis
during physical examination
•It occurs in uncircumcised males and is normal in infancy.
•In anyone older than infancy, refer to urologist
Hypospadias
•Condition where the opening of the penis is on the underside of the organ.
•Is more common in infants with a family history of hypospadias.
•A circumcision should never be done on a newborn with hypospadias because the
surgeon who ultimately corrects the hypospadias may need the prepuce to repair the
defect.
•Surgical correction should be undertaken by the time the child enters the first grade.
varicocele
•May describe testicular pain and testicles that feel like a bag of worms;
•On exam, there will be soft and movable blood vessels underneath the scrotal skin
upon palpation.
•Palpation of varicose veins, described as a "bag of worms", in the scrotum is a classic
example of a varicocele, an abnormal tortuosity and dilation of the veins of the
pampiniform plexus within the spermatic cord.
Undescended Testes
•In boys with undescended testes, less than 1% have their testes descend after the first
year.
•Orchiopexy needs to be performed before age 6 to promote normal spermatogenesis
and hormone production, prevent tumor formation, and leave the testis in a location
where it can be easily palpated.
Benign Prostatic Hypertrophy
•After 6 months of therapy with finasteride (Proscar) for benign prostatic hyperplasia,
the PSA should decrease by about 50%.
Urinary Incontinence
•Functional incontinence: occurs due to Delirium, fecal impaction, lack of manual
dexterity, or decreased mobility and taking the following medications: diuretics,
hypnotics, alcohol, narcotics, decongestants
•Stress incontinence: occurs due to history of vaginal deliveries, urine leakage with
cough or sneezing
•Urinary incontinence work-up: A urinalysis and urine culture and sensitivity should be
done, as well as measurements of serum electrolytes, blood urea nitrogen, creatinine,
calcium (for polyuria in the absence of diuretics), and glucose. Catheterization to assess
post-void residual volume is important even on initial evaluation of the patient.
Overactive Bladder
syndrome of symptoms that include urgency, frequency, and nocturia, all of which are
associated with involuntary contractions of the detrusor muscle
urge incontinence
(the sudden intense urge to urinate and an involuntary loss of urine) may or may not be
a feature of this syndrome, as about one-third of patients with OAB have urge
incontinence, not all. OAB is most common in women
A diagnosis of a lower UTI is made based on
• the subjective complaints of the patient and a clean-catch midstream urine sample
showing the presence of bacteria, especially if more than 100,000 organisms/mL
•In elderly patients, altered mental status may be the sole manifestation of UTI and
should create a high level of suspicion.
•Although urine culture is considered the gold standard with the greatest sensitivity for
laboratory confirmation of UTI, urinalysis with microscopy is also helpful and provides
rapid results in the primary care setting.
Pyridium
• is used for relief of pain, burning, urgency, and frequency from UTI.
Priapism
•A prolonged erection of the penis, usually without sexual arousal
•Phenylephrine (Neo-Synephrine) is
, the drug of choice for first-line treatment of low-flow priapism because the drug has
almost pure alpha-agonist effects and minimal beta activity.
Phimosis
•Is an unusually long foreskin or a foreskin that cannot be retracted over the glans penis
during physical examination
•It occurs in uncircumcised males and is normal in infancy.
•In anyone older than infancy, refer to urologist
Hypospadias
•Condition where the opening of the penis is on the underside of the organ.
•Is more common in infants with a family history of hypospadias.
•A circumcision should never be done on a newborn with hypospadias because the
surgeon who ultimately corrects the hypospadias may need the prepuce to repair the
defect.
•Surgical correction should be undertaken by the time the child enters the first grade.
varicocele
•May describe testicular pain and testicles that feel like a bag of worms;
•On exam, there will be soft and movable blood vessels underneath the scrotal skin
upon palpation.
•Palpation of varicose veins, described as a "bag of worms", in the scrotum is a classic
example of a varicocele, an abnormal tortuosity and dilation of the veins of the
pampiniform plexus within the spermatic cord.
Undescended Testes
•In boys with undescended testes, less than 1% have their testes descend after the first
year.
•Orchiopexy needs to be performed before age 6 to promote normal spermatogenesis
and hormone production, prevent tumor formation, and leave the testis in a location
where it can be easily palpated.
Benign Prostatic Hypertrophy
•After 6 months of therapy with finasteride (Proscar) for benign prostatic hyperplasia,
the PSA should decrease by about 50%.
