Page 1 of 241
NEW NR601 FINAL EXAM PRACTICE Q&A
NEWLY MODIFIED TESTED AND APPROVED
2025/2025 LATEST
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. Start an alpha-blocker.
b. Start a 5-alpha-reductase inhibitor.
c. Start combination therapy with an alpha-blocker and a 5-alpha-reductase inhibitor.
d. Start a 4-week course of ciprofloxacin. -- ANSWER--D
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. Urinalysis
,2
b. Cystoscopy
c. Lifestyle modifications
d. Tamsulosin
e. Finasteride -- ANSWER--C
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. Start an 8-week course of ciprofloxacin.
b. Start a 5-alpha-reductase inhibitor.
c. Perform urodynamic testing.
d. Screen for depression. -- ANSWER--D
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?
Page 2 of 241
, Page 3 of 241
a. Oxybutynin
b. Doxazosin
c. Finasteride
d. Silodosin
e. Tadalafil -- ANSWER--C
A 70-year-old man has bothersome lower urinary tract syndrome (LUTS) associated with
benign prostatic hyperplasia (BPH). His symptoms are no longer well managed with lifestyle
modifications. He is interested in medication to reduce his urinary symptoms but is concerned
about possible side effects. He notes that he is recently married and sexual activity is very
important to him. Which of the following medications would be most appropriate for this
patient?
a. Alfusozin
b. Ditropan
c. Dutasteride
d. Tamsulosin
e. Tadalafil -- ANSWER--A
An 81-year-old transgender female with history of hyper lipidemia and depression. Present
for routine wellness exam. she endorses a history of smoking one pack per day and
occasional alcohol use. she reports taking atorvastatin and estrogen therapy. What is the next
important step for primary care for this patient?
A) counseling in starting ASA
B) counseling on alcohol cessation
, 4
C) counseling on smoking cessation
D) counseling on mammograms -- ANSWER--C) counseling on smoking cessation
An 84-year-old male with a history of Stroke without deficit, systolic HF and DB type 2
presents to clinic for FU. He is currently living independently and assisted-living he reports
having multiple sexual partners, both men and women with multiple areas of penetration,
including anal mouth and receiving versus entering. What sexually transmitted sexual
screening should be recommended?
A) urine testing
B) urine/blood testing
C) urine/blood/anal swab
D)urine/blood/anal swab/ oropharyngeal swab -- ANSWER--D) urine/blood/anal swab/
oropharyngeal swab
A healthy 86-year-old female presents to your office for a well check new established patient
her vitals are normal. She introduces her partner of 35 years and states she would like to have
her be her medical decision-maker in case of emergencies. What is the best advice to give to
this patient?
A) complete a POLST
B) advise them they have enough documentation
C) advise them to file an Advanced Directive
D) respond although they lack documentation her partner will be recognized as defacto --
ANSWER--C) advise then to file an Advanced Directive
Page 4 of 241
NEW NR601 FINAL EXAM PRACTICE Q&A
NEWLY MODIFIED TESTED AND APPROVED
2025/2025 LATEST
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. Start an alpha-blocker.
b. Start a 5-alpha-reductase inhibitor.
c. Start combination therapy with an alpha-blocker and a 5-alpha-reductase inhibitor.
d. Start a 4-week course of ciprofloxacin. -- ANSWER--D
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. Urinalysis
,2
b. Cystoscopy
c. Lifestyle modifications
d. Tamsulosin
e. Finasteride -- ANSWER--C
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. Start an 8-week course of ciprofloxacin.
b. Start a 5-alpha-reductase inhibitor.
c. Perform urodynamic testing.
d. Screen for depression. -- ANSWER--D
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?
Page 2 of 241
, Page 3 of 241
a. Oxybutynin
b. Doxazosin
c. Finasteride
d. Silodosin
e. Tadalafil -- ANSWER--C
A 70-year-old man has bothersome lower urinary tract syndrome (LUTS) associated with
benign prostatic hyperplasia (BPH). His symptoms are no longer well managed with lifestyle
modifications. He is interested in medication to reduce his urinary symptoms but is concerned
about possible side effects. He notes that he is recently married and sexual activity is very
important to him. Which of the following medications would be most appropriate for this
patient?
a. Alfusozin
b. Ditropan
c. Dutasteride
d. Tamsulosin
e. Tadalafil -- ANSWER--A
An 81-year-old transgender female with history of hyper lipidemia and depression. Present
for routine wellness exam. she endorses a history of smoking one pack per day and
occasional alcohol use. she reports taking atorvastatin and estrogen therapy. What is the next
important step for primary care for this patient?
A) counseling in starting ASA
B) counseling on alcohol cessation
, 4
C) counseling on smoking cessation
D) counseling on mammograms -- ANSWER--C) counseling on smoking cessation
An 84-year-old male with a history of Stroke without deficit, systolic HF and DB type 2
presents to clinic for FU. He is currently living independently and assisted-living he reports
having multiple sexual partners, both men and women with multiple areas of penetration,
including anal mouth and receiving versus entering. What sexually transmitted sexual
screening should be recommended?
A) urine testing
B) urine/blood testing
C) urine/blood/anal swab
D)urine/blood/anal swab/ oropharyngeal swab -- ANSWER--D) urine/blood/anal swab/
oropharyngeal swab
A healthy 86-year-old female presents to your office for a well check new established patient
her vitals are normal. She introduces her partner of 35 years and states she would like to have
her be her medical decision-maker in case of emergencies. What is the best advice to give to
this patient?
A) complete a POLST
B) advise them they have enough documentation
C) advise them to file an Advanced Directive
D) respond although they lack documentation her partner will be recognized as defacto --
ANSWER--C) advise then to file an Advanced Directive
Page 4 of 241
