NR-507 Final Exam (latest update 2025 /
2026) Advanced Pathophysiology Questions
and Answers 100% Correct [Grade A] -
Chamberlain
Blood Culture - correct answer If sepsis is suspected, a blood culture may be drawn to
identify the causative organism or rule it out.
Urine Culture & Sensitivity - correct answer Patient with cystitis will have a white
blood cell (WBC) count of greater than 5000 high power field (hpf) and hematuria.
Patient with pyelonephritis, the urine will present with WBC casts. The presence of
casts in the urine indicates that the protein in the lumen of the kidney tubules has
solidified, especially in the nephron. This indicates kidney disease rather than a lower
UTI.
Urine can also be examined microscopically to determine the presence of a lower or
upper UTI. The following may be seen in urine examined under microscopy:
- RBCs (red blood cells): greater than 3 RBCs/hpf is considered abnormal. Abnormal
morphology of the RBC strongly suggests glomerular disease. RBCs are often present
with a UTI (hematuria).
-WBCs: greater than 5 WBCs/hpf is considered abnormal. These will be present in a
UTI.
-Bacteria: will be present
-Crystals: these are microscopic solids composed of a small number of different ions
and molecules. These are common in the urine and if they remain small, are not
pathologic.
-Casts: are long cylindrical structures formed in the renal tubules due to the
precipitation of Tamm-Horsfall mucoprotein. It is the most abundant protein excreted
by the urine. Casts form in concentrated and/or acidic urine. The most common casts
are hyaline casts that only consist of Tamm-Horsfall protein without other
constituents. They are non-specific and may be seen in dehydration. Muddy brown
casts suggest acute tubular necrosis. Waxy casts are suggestive of acute and chronic
renal failure. Fatty casts are suggestive of nephrotic syndrome; RBC casts suggest
glomerulonephritis and WBC casts suggest interstitial inflammation.
Complicate vs. Uncomplicated UTI - correct answer UTI may be classified as
complicated or uncomplicated in terms of its severity:
,NR-507 Final Exam (latest update 2025 /
2026) Advanced Pathophysiology Questions
and Answers 100% Correct [Grade A] -
Chamberlain
Complicated UTI, there is decreased renal function and an abnormal urinary tract
-The more intervention required, the more complicated the infection
-Exception would be during pregnancy due to the ureteral dilation that occurs that
increases the risk for pyelonephritis. Even though she may be asymptomatic,
treatment would be initiated to prevent damage to the fetus in utero.
-Complicated UTI (pyelonephritis) will require intravenous (IV antibiotics) until the
patient is afebrile, followed by a course of oral antibiotics. Overall, the course of
antibiotics for a complicated infection is longer than in an individual that has an
uncomplicated infection.
Uncomplicated UTI indicates that the urinary tract and renal function is normal
-An uncomplicated, symptomatic UTI (cystitis) will typically require a 3-7 days course
of appropriate antibiotic therapy.
Complicate vs. Uncomplicated UTI - correct answer Complicated
-A UTI that extends beyond the bladder
-Caused by structural or functional urinary tract abnormalities or untreated UTI
-Infants and older adults affected
-Associated with:
indwelling catheters
renal calculi
Diabetes
Pregnancy
Uncomplicated
-Occurs in the normal urinary tract
-Responds well to a short course of antibiotic therapy
-Simple cystitis in non-pregnant women without any urologic abnormalities
Urologist - correct answer -Referral to a urologist is necessary if the individual does
not respond to antibiotic treatment or if there are recurrent UTIs, specifically 3 or more
in one year
-Because upper UTI is uncommon in males, they should be referred to a urologist.
-The presence of hematuria would warrant a referral to the urologist to determine the
presence of significant renal disease
, NR-507 Final Exam (latest update 2025 /
2026) Advanced Pathophysiology Questions
and Answers 100% Correct [Grade A] -
Chamberlain
When there is vaginal discharge or itching involved, the NP may need to include -
correct answer A genital exam as well to rule out or diagnose a sexually transmitted
infection (STI).
Organisms that Cause Urinary Tract Infections - correct answer The most common
organisms that cause a UTI is Escherichia coli (E. Coli), Staphylococcus saprophyticus,
Proteus Mirabilis, and Klebsiella.
-E. coli causes approximately 80% of the cases of UTI because it is the most common
organism contained in the fecal matter that is easily accessible from the anus to the
urethra.
-If nitrites are present, this indicates that the causative organism is gram negative.
-A urine culture may also be performed to determine infection. A positive culture
indicates that there are greater than 100,000 colony forming units/ml.
- Dip Stick Test: Nitrites detect the presence of the Enterobacteriaceae (gram-negative
bacteria) family that converts nitrates into nitrites.
-Enterococcus are unable to produce nitrites.
-The presence of nitrites is the most specific finding and has the highest positive
predictive value.
Leukocyte esterase, WBCs and even bacteria on microscopic exam are not specific and
therefore, do not necessarily indicate infection.
Uncomplicated UTI - correct answer Protein +/_
Leukocyte Esterase +
Nitrites +/_
RBCs +/_
WBCs +/> 5000/hpf
Casts - None
Complicated UTI - correct answer Protein +/_
Leukocyte Esterase +
Nitrites +/_
RBCs +
WBCs +/> 100,000/hpf
Casts +
2026) Advanced Pathophysiology Questions
and Answers 100% Correct [Grade A] -
Chamberlain
Blood Culture - correct answer If sepsis is suspected, a blood culture may be drawn to
identify the causative organism or rule it out.
Urine Culture & Sensitivity - correct answer Patient with cystitis will have a white
blood cell (WBC) count of greater than 5000 high power field (hpf) and hematuria.
Patient with pyelonephritis, the urine will present with WBC casts. The presence of
casts in the urine indicates that the protein in the lumen of the kidney tubules has
solidified, especially in the nephron. This indicates kidney disease rather than a lower
UTI.
Urine can also be examined microscopically to determine the presence of a lower or
upper UTI. The following may be seen in urine examined under microscopy:
- RBCs (red blood cells): greater than 3 RBCs/hpf is considered abnormal. Abnormal
morphology of the RBC strongly suggests glomerular disease. RBCs are often present
with a UTI (hematuria).
-WBCs: greater than 5 WBCs/hpf is considered abnormal. These will be present in a
UTI.
-Bacteria: will be present
-Crystals: these are microscopic solids composed of a small number of different ions
and molecules. These are common in the urine and if they remain small, are not
pathologic.
-Casts: are long cylindrical structures formed in the renal tubules due to the
precipitation of Tamm-Horsfall mucoprotein. It is the most abundant protein excreted
by the urine. Casts form in concentrated and/or acidic urine. The most common casts
are hyaline casts that only consist of Tamm-Horsfall protein without other
constituents. They are non-specific and may be seen in dehydration. Muddy brown
casts suggest acute tubular necrosis. Waxy casts are suggestive of acute and chronic
renal failure. Fatty casts are suggestive of nephrotic syndrome; RBC casts suggest
glomerulonephritis and WBC casts suggest interstitial inflammation.
Complicate vs. Uncomplicated UTI - correct answer UTI may be classified as
complicated or uncomplicated in terms of its severity:
,NR-507 Final Exam (latest update 2025 /
2026) Advanced Pathophysiology Questions
and Answers 100% Correct [Grade A] -
Chamberlain
Complicated UTI, there is decreased renal function and an abnormal urinary tract
-The more intervention required, the more complicated the infection
-Exception would be during pregnancy due to the ureteral dilation that occurs that
increases the risk for pyelonephritis. Even though she may be asymptomatic,
treatment would be initiated to prevent damage to the fetus in utero.
-Complicated UTI (pyelonephritis) will require intravenous (IV antibiotics) until the
patient is afebrile, followed by a course of oral antibiotics. Overall, the course of
antibiotics for a complicated infection is longer than in an individual that has an
uncomplicated infection.
Uncomplicated UTI indicates that the urinary tract and renal function is normal
-An uncomplicated, symptomatic UTI (cystitis) will typically require a 3-7 days course
of appropriate antibiotic therapy.
Complicate vs. Uncomplicated UTI - correct answer Complicated
-A UTI that extends beyond the bladder
-Caused by structural or functional urinary tract abnormalities or untreated UTI
-Infants and older adults affected
-Associated with:
indwelling catheters
renal calculi
Diabetes
Pregnancy
Uncomplicated
-Occurs in the normal urinary tract
-Responds well to a short course of antibiotic therapy
-Simple cystitis in non-pregnant women without any urologic abnormalities
Urologist - correct answer -Referral to a urologist is necessary if the individual does
not respond to antibiotic treatment or if there are recurrent UTIs, specifically 3 or more
in one year
-Because upper UTI is uncommon in males, they should be referred to a urologist.
-The presence of hematuria would warrant a referral to the urologist to determine the
presence of significant renal disease
, NR-507 Final Exam (latest update 2025 /
2026) Advanced Pathophysiology Questions
and Answers 100% Correct [Grade A] -
Chamberlain
When there is vaginal discharge or itching involved, the NP may need to include -
correct answer A genital exam as well to rule out or diagnose a sexually transmitted
infection (STI).
Organisms that Cause Urinary Tract Infections - correct answer The most common
organisms that cause a UTI is Escherichia coli (E. Coli), Staphylococcus saprophyticus,
Proteus Mirabilis, and Klebsiella.
-E. coli causes approximately 80% of the cases of UTI because it is the most common
organism contained in the fecal matter that is easily accessible from the anus to the
urethra.
-If nitrites are present, this indicates that the causative organism is gram negative.
-A urine culture may also be performed to determine infection. A positive culture
indicates that there are greater than 100,000 colony forming units/ml.
- Dip Stick Test: Nitrites detect the presence of the Enterobacteriaceae (gram-negative
bacteria) family that converts nitrates into nitrites.
-Enterococcus are unable to produce nitrites.
-The presence of nitrites is the most specific finding and has the highest positive
predictive value.
Leukocyte esterase, WBCs and even bacteria on microscopic exam are not specific and
therefore, do not necessarily indicate infection.
Uncomplicated UTI - correct answer Protein +/_
Leukocyte Esterase +
Nitrites +/_
RBCs +/_
WBCs +/> 5000/hpf
Casts - None
Complicated UTI - correct answer Protein +/_
Leukocyte Esterase +
Nitrites +/_
RBCs +
WBCs +/> 100,000/hpf
Casts +
