NR 601 Verified Multiple Choice and Conceptual
Actual Emended Exam Questions With
Reviewed 100% Correct Detailed Answers
Guaranteed Pass!!Current Update
1. A 66-year-old man complains of nocturia (three to four times a night),
hesitancy, and incomplete emptying of the bladder. Physical examination
reveals an enlarged, nontender prostate, about 40 g in size without discrete
nodules. Urinalysis reveals hematuria without leukocyte esterase. Upon
further evaluation, the hematuria is attributed to his BPH. The patient
declines surgical options at this time. Which of the following medications
would be most appropriate?
a) Tamsulosin
b) Finasteride
c) Oxybutynin
d) Ciprofloxacin
Answer: b) Finasteride
Rationale: Finasteride, a 5-alpha reductase inhibitor, reduces prostate size and
symptoms in patients with moderate BPH who decline surgery. Alpha-blockers
like tamsulosin relieve symptoms but don’t address hematuria risk due to
prostate enlargement.
2. Mr. Quince is a 68-year-old patient who describes several months of urinary
frequency and a sensation of incomplete emptying with no associated
dysuria, hematuria, or fever. Physical examination reveals a slightly
enlarged but nontender prostate, a postvoid residual urine volume of 20 mL,
and a urinalysis with 15 white blood cells (WBCs) and 5 red blood cells
(RBCs). Urine culture reveals 30,000 colony-forming units of Escherichia
coli. You see a report from last year that shows urinalysis with 10 WBCs
and 4 RBCs that was obtained as part of a routine evaluation. What is the
most appropriate next step in the management of Mr. Quince’s symptoms?
,a) Repeat urinalysis in 3 months
b) Begin tamsulosin therapy
c) Start a 4-week course of ciprofloxacin
d) Refer immediately for prostate biopsy
Answer: c) Start a 4-week course of ciprofloxacin
Rationale: The findings are consistent with chronic bacterial prostatitis.
Long-term antibiotic therapy (4–6 weeks, often with fluoroquinolones) is the
treatment of choice.
3. Mr. Roberts, a 72-year-old patient who has sought medical care on an
intermittent basis in the past, complains of aching discomfort in his perineal
area, urinary urgency, and frequency for the past few years. He also
complains of insomnia and intermittent anxiety that he attributes to
loneliness after his wife’s death about a year ago. Digital rectal examination
(DRE) reveals a slightly enlarged, nontender prostate with no palpable
nodules. Perineal examination is normal. Bladder scan is unremarkable and
postvoid residual urine volume is 50 mL. Urinalysis shows no WBCs or
RBCs. Urine culture is negative. Previous treatment has included dietary
modification and alpha-blocker medication. What is the most appropriate
next step?
a) Increase the alpha-blocker dose
b) Refer for TURP
c) Screen for depression
d) Start a 5-alpha reductase inhibitor
Answer: c) Screen for depression
Rationale: With a normal exam and no evidence of infection, his symptoms
may be exacerbated by untreated depression. Addressing mental health is
critical in geriatric care.
4. Mr. Hunter, a 69-year-old man, complains of urinary frequency and urgency
that have increased over the past several months. There is no dysuria,
hematuria, or sensation of incomplete voiding. He drinks 2 cups of coffee
daily and diet cola multiple times a day. His International Prostate Symptom
Score (IPSS) is 6, with a bother score of 1 indicating mild voiding symptoms
with low impact on his quality of life. His medical history includes
hypertension, coronary artery disease, and benign prostatic hyperplasia.
Current medications are aspirin, metoprolol, and hydrochlorothiazide.
, Physical examination reveals normal-sized prostate. Which of the following
is the best next step?
a) Start tamsulosin therapy
b) Lifestyle modifications
c) Begin finasteride
d) Refer for surgical evaluation
Answer: b) Lifestyle modifications
Rationale: With mild symptoms and minimal bother, conservative management
such as reducing caffeine intake and fluid management is first-line.
5. A 66-year-old male presents with nocturia, hesitancy, and incomplete
bladder emptying. On exam, the prostate is enlarged but smooth and
nontender. UA shows hematuria without infection. He declines surgery.
Which medication is most appropriate?
a) Tamsulosin
b) Finasteride
c) Oxybutynin
d) Ciprofloxacin
Answer: b) Finasteride
Rationale: 5-alpha-reductase inhibitors reduce prostate volume and are
effective in men with BPH and prostate enlargement.
6. Which medication for BPH should be avoided in a patient planning cataract
surgery due to risk of intraoperative floppy iris syndrome?
a) Tadalafil
b) Finasteride
c) Tamsulosin
d) Alfuzosin
Answer: c) Tamsulosin
Rationale: Alpha-blockers like tamsulosin may complicate cataract surgery.
, 7. A 72-year-old man with mild BPH (IPSS 6) and minimal bother asks about
management. What is the best initial step?
a) Start finasteride
b) Lifestyle modifications
c) Begin antibiotics
d) Refer for TURP
Answer: b) Lifestyle modifications
Rationale: Mild, low-impact symptoms can be managed with fluid
restriction at night, caffeine avoidance, and timed voiding.
8. Which finding would prompt urgent referral to urology in a patient with
BPH?
a) Mild nocturia
b) Urinary urgency
c) Recurrent gross hematuria
d) Post-void residual of 50 mL
Answer: c) Recurrent gross hematuria
Rationale: Hematuria, recurrent UTIs, or obstructive symptoms suggest
complications requiring specialty evaluation.
9. A patient with BPH develops recurrent UTIs, hematuria, and severe
obstruction despite finasteride and tamsulosin. What is the next best step?
a) Add oxybutynin
b) Surgical resection of the prostate
c) Increase fluid intake
d) Watchful waiting
Answer: b) Surgical resection of the prostate
Rationale: TURP is indicated for refractory, severe cases with complications.
10.Which symptom best distinguishes delirium from dementia in an older
adult?
a) Memory impairment
b) Wandering at night
c) Inattentiveness with waxing and waning alertness
Actual Emended Exam Questions With
Reviewed 100% Correct Detailed Answers
Guaranteed Pass!!Current Update
1. A 66-year-old man complains of nocturia (three to four times a night),
hesitancy, and incomplete emptying of the bladder. Physical examination
reveals an enlarged, nontender prostate, about 40 g in size without discrete
nodules. Urinalysis reveals hematuria without leukocyte esterase. Upon
further evaluation, the hematuria is attributed to his BPH. The patient
declines surgical options at this time. Which of the following medications
would be most appropriate?
a) Tamsulosin
b) Finasteride
c) Oxybutynin
d) Ciprofloxacin
Answer: b) Finasteride
Rationale: Finasteride, a 5-alpha reductase inhibitor, reduces prostate size and
symptoms in patients with moderate BPH who decline surgery. Alpha-blockers
like tamsulosin relieve symptoms but don’t address hematuria risk due to
prostate enlargement.
2. Mr. Quince is a 68-year-old patient who describes several months of urinary
frequency and a sensation of incomplete emptying with no associated
dysuria, hematuria, or fever. Physical examination reveals a slightly
enlarged but nontender prostate, a postvoid residual urine volume of 20 mL,
and a urinalysis with 15 white blood cells (WBCs) and 5 red blood cells
(RBCs). Urine culture reveals 30,000 colony-forming units of Escherichia
coli. You see a report from last year that shows urinalysis with 10 WBCs
and 4 RBCs that was obtained as part of a routine evaluation. What is the
most appropriate next step in the management of Mr. Quince’s symptoms?
,a) Repeat urinalysis in 3 months
b) Begin tamsulosin therapy
c) Start a 4-week course of ciprofloxacin
d) Refer immediately for prostate biopsy
Answer: c) Start a 4-week course of ciprofloxacin
Rationale: The findings are consistent with chronic bacterial prostatitis.
Long-term antibiotic therapy (4–6 weeks, often with fluoroquinolones) is the
treatment of choice.
3. Mr. Roberts, a 72-year-old patient who has sought medical care on an
intermittent basis in the past, complains of aching discomfort in his perineal
area, urinary urgency, and frequency for the past few years. He also
complains of insomnia and intermittent anxiety that he attributes to
loneliness after his wife’s death about a year ago. Digital rectal examination
(DRE) reveals a slightly enlarged, nontender prostate with no palpable
nodules. Perineal examination is normal. Bladder scan is unremarkable and
postvoid residual urine volume is 50 mL. Urinalysis shows no WBCs or
RBCs. Urine culture is negative. Previous treatment has included dietary
modification and alpha-blocker medication. What is the most appropriate
next step?
a) Increase the alpha-blocker dose
b) Refer for TURP
c) Screen for depression
d) Start a 5-alpha reductase inhibitor
Answer: c) Screen for depression
Rationale: With a normal exam and no evidence of infection, his symptoms
may be exacerbated by untreated depression. Addressing mental health is
critical in geriatric care.
4. Mr. Hunter, a 69-year-old man, complains of urinary frequency and urgency
that have increased over the past several months. There is no dysuria,
hematuria, or sensation of incomplete voiding. He drinks 2 cups of coffee
daily and diet cola multiple times a day. His International Prostate Symptom
Score (IPSS) is 6, with a bother score of 1 indicating mild voiding symptoms
with low impact on his quality of life. His medical history includes
hypertension, coronary artery disease, and benign prostatic hyperplasia.
Current medications are aspirin, metoprolol, and hydrochlorothiazide.
, Physical examination reveals normal-sized prostate. Which of the following
is the best next step?
a) Start tamsulosin therapy
b) Lifestyle modifications
c) Begin finasteride
d) Refer for surgical evaluation
Answer: b) Lifestyle modifications
Rationale: With mild symptoms and minimal bother, conservative management
such as reducing caffeine intake and fluid management is first-line.
5. A 66-year-old male presents with nocturia, hesitancy, and incomplete
bladder emptying. On exam, the prostate is enlarged but smooth and
nontender. UA shows hematuria without infection. He declines surgery.
Which medication is most appropriate?
a) Tamsulosin
b) Finasteride
c) Oxybutynin
d) Ciprofloxacin
Answer: b) Finasteride
Rationale: 5-alpha-reductase inhibitors reduce prostate volume and are
effective in men with BPH and prostate enlargement.
6. Which medication for BPH should be avoided in a patient planning cataract
surgery due to risk of intraoperative floppy iris syndrome?
a) Tadalafil
b) Finasteride
c) Tamsulosin
d) Alfuzosin
Answer: c) Tamsulosin
Rationale: Alpha-blockers like tamsulosin may complicate cataract surgery.
, 7. A 72-year-old man with mild BPH (IPSS 6) and minimal bother asks about
management. What is the best initial step?
a) Start finasteride
b) Lifestyle modifications
c) Begin antibiotics
d) Refer for TURP
Answer: b) Lifestyle modifications
Rationale: Mild, low-impact symptoms can be managed with fluid
restriction at night, caffeine avoidance, and timed voiding.
8. Which finding would prompt urgent referral to urology in a patient with
BPH?
a) Mild nocturia
b) Urinary urgency
c) Recurrent gross hematuria
d) Post-void residual of 50 mL
Answer: c) Recurrent gross hematuria
Rationale: Hematuria, recurrent UTIs, or obstructive symptoms suggest
complications requiring specialty evaluation.
9. A patient with BPH develops recurrent UTIs, hematuria, and severe
obstruction despite finasteride and tamsulosin. What is the next best step?
a) Add oxybutynin
b) Surgical resection of the prostate
c) Increase fluid intake
d) Watchful waiting
Answer: b) Surgical resection of the prostate
Rationale: TURP is indicated for refractory, severe cases with complications.
10.Which symptom best distinguishes delirium from dementia in an older
adult?
a) Memory impairment
b) Wandering at night
c) Inattentiveness with waxing and waning alertness
