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CBUNA-CUNP


CBUNA Certified Urologic Nurse Practitioner


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Question: 1000


A 29-year-old male presents with penile discharge. Nucleic acid amplification testing reveals Chlamydia trachomatis. Which of the following should be included in his treatment regimen?


  1. Azithromycin

  2. Ceftriaxone

  3. Doxycycline

  4. Metronidazole

    Answer: A

Explanation: Azithromycin is effective for treating uncomplicated Chlamydia infections.




Question: 1001


A 65-year-old male presents with difficulty urinating and a history of recurrent urinary tract infections. A CT scan reveals a 2 cm prostate mass. What is the most appropriate next step in management?


  1. Watchful waiting

  2. Referral for radiation therapy

  3. Initiation of 5-alpha reductase inhibitors

  4. Prostate biopsy

    Answer: D

Explanation: Given the prostate mass and urinary symptoms, a biopsy is necessary to determine if the mass is malignant, guiding further management.




Question: 1002


During a case discussion regarding a patient with prostate cancer, what is the most effective way for a urologic nurse practitioner to present their findings?


  1. By solely focusing on their diagnostic conclusions

  2. By avoiding discussion of the patient's psychosocial aspects

  3. By presenting data in a disorganized manner

  4. By integrating clinical findings with patient-reported outcomes and preferences

    Answer: D

Explanation: Integrating clinical findings with patient-reported outcomes and preferences allows for a more patient-centered approach that can influence treatment decisions.




Question: 1003


A 60-year-old male presents with erectile dysfunction and has a history of coronary artery disease. Which of the following medications is contraindicated for him?


  1. Nitrates

  2. Tadalafil

  3. Sildenafil

  4. Vardenafil

    Answer: A

Explanation: Nitrates are contraindicated in patients taking phosphodiesterase inhibitors due to the risk of severe hypotension.




Question: 1004


A 4-year-old girl presents with enuresis and abdominal pain. Upon further evaluation, a renal ultrasound shows hydronephrosis. What is the most likely cause of her enuresis?


  1. Bladder overactivity due to pain

  2. Obstructive uropathy due to a structural anomaly

  3. Psychosocial factors due to pain

  4. Neurological cause related to hydronephrosis

    Answer: B

Explanation: Hydronephrosis suggests an obstructive uropathy, which can lead to urinary retention and subsequently cause enuresis.




Question: 1005


A 42-year-old male presents with sudden onset flank pain and hematuria after lifting heavy weights. A CT scan shows a renal hematoma but no laceration. What is the most appropriate management for this patient?


  1. Bed rest and observation

  2. Immediate nephrectomy

  3. Angiographic embolization

  4. Open surgical intervention

    Answer: A

Explanation: In cases of renal hematoma without laceration and with stable vital signs, bed rest and observation are typically sufficient for management.




Question: 1006


In discussions about palliative care options for a patient with advanced urological disease, what should a urologic nurse practitioner prioritize?


  1. Focusing only on curative options

  2. Deferring to oncologists without input from the patient

  3. Ensuring that all team members are aware of the treatment options

  4. Understanding the patient???s values and preferences for end-of-life care

    Answer: D

Explanation: Understanding the patient???s values and preferences is crucial in guiding palliative care discussions and ensuring that their needs are met during treatment.




Question: 1007


Which of the following factors is a significant prognostic indicator for patients with non-muscle invasive bladder cancer following TURBT?


  1. Tumor grade and number of lesions

  2. Patient age at diagnosis

  3. Presence of hematuria at presentation

  4. History of smoking

    Answer: A

Explanation: Tumor grade and the number of lesions are significant prognostic factors that help predict recurrence and progression in non-muscle invasive bladder cancer.




Question: 1008


A 62-year-old female patient presents with urinary urgency, frequency, and pelvic pain. She reports that symptoms worsen during her menstrual cycle. What diagnosis should be considered?


  1. Radiation-induced cystitis

  2. Acute cystitis

  3. Interstitial cystitis

  4. Chronic pyelonephritis



Answer: C


Explanation: The cyclical nature of symptoms in relation to the menstrual cycle is suggestive of interstitial cystitis, often exacerbated by hormonal changes.




Question: 1009


A patient presents to the clinic with prolonged erections and is diagnosed with ischemic priapism. What is the most appropriate immediate treatment?


  1. Apply cold compresses

  2. Perform cavernosal aspiration

  3. Initiate oral PDE5 inhibitors

  4. Administer systemic anticoagulation

    Answer: B

Explanation: Cavernosal aspiration is a critical intervention for ischemic priapism to relieve the prolonged erection and prevent complications, often leading to tissue damage.




Question: 1010


For a patient who has undergone a ureteroscopy, which of the following post-operative assessments should the nurse prioritize to identify potential complications early?


  1. Assessing urine output and color

  2. Monitoring vital signs every four hours

  3. Evaluating the surgical site for drainage

  4. Checking the patient's pain level regularly

    Answer: A

Explanation: Assessing urine output and color post-ureteroscopy is critical to detect any potential complications such as obstruction or bleeding.




Question: 1011


A 50-year-old male with persistent hematuria undergoes a workup. A renal biopsy reveals dysplasia. What does this finding suggest?


  1. Benign process

  2. Infection

  3. Increased cancer risk

  4. Inflammatory condition

Explanation: Dysplasia in a renal biopsy is indicative of a precancerous process, suggesting an increased risk for renal cell carcinoma.




Question: 1012


A 34-year-old male presents with acute flank pain and is found to have a 5 mm stone in the renal pelvis. He reports nausea and vomiting. What is the most appropriate acute management for this patient?


  1. Ureteroscopy

  2. Extracorporeal shock wave lithotripsy (ESWL)

  3. Immediate nephrectomy

  4. Pain management and hydration

    Answer: D

Explanation: In acute management, pain control and hydration are essential for facilitating stone passage; ESWL or ureteroscopy can be considered if symptoms persist or worsen.




Question: 1013


A 59-year-old male presents with urinary urgency and frequency. An ultrasound reveals a 70-gram prostate. What is the best first-line treatment option?


  1. Watchful waiting

  2. 5-alpha-reductase inhibitors

  3. Alpha-blockers

  4. Surgical intervention

    Answer: C

Explanation: Alpha-blockers are the first-line treatment for managing urinary symptoms in patients with BPH, providing quick symptom relief.




Question: 1014


In a situation where a urologic nurse practitioner is asked for a second opinion on a patient diagnosed with complex urolithiasis, which approach should they adopt?


  1. They should immediately suggest surgical intervention.

  2. They should rely solely on the previous physician's notes.

  3. They should thoroughly review imaging studies and the patient's symptoms.

  4. They should ask the patient to wait for further testing before giving an opinion.

    Answer: C

Explanation: A thorough review of imaging studies and the patient's symptoms is essential for forming an informed and accurate second opinion.




Question: 1015


During a well-child visit, a 4-year-old girl exhibits signs of urinary incontinence and recurrent UTIs. Upon further evaluation, VUR is diagnosed. Which of the following is a potential long-term consequence of untreated VUR?


  1. Acute kidney injury

  2. Development of hypertension

  3. Enuresis

  4. Progressive renal damage

    Answer: D

Explanation: Untreated VUR can lead to progressive renal damage due to recurrent infections and reflux nephropathy, potentially resulting in long-term renal impairment.




Question: 1016


During a routine follow-up, a 70-year-old male with BPH reports worsening urinary stream and increased nocturia. A post-void residual volume is measured at 600 mL. What intervention should be considered next?


  1. Observation and lifestyle modifications

  2. Initiation of combination therapy with alpha-blockers and 5-alpha reductase inhibitors

  3. Surgical intervention

  4. Urodynamic studies

    Answer: B

Explanation: Given the significant post-void residual volume, combination therapy can help manage severe symptoms and improve urinary flow.




Question: 1017


In a scenario where a patient with a complex medical history presents with urological issues, what is the best approach for the urologic nurse practitioner?


  1. To focus on the current urological symptoms without considering the medical history

  2. To immediately refer the patient to another specialist without assessment

  3. To rely on previous notes without verifying the current status

  4. To conduct a holistic assessment that integrates the patient???s entire medical history

Explanation: A holistic assessment that considers the entire medical history is vital for understanding the context of the urological issues and guiding appropriate treatment.




Question: 1018


A 52-year-old male presents with erectile dysfunction and a history of prostate cancer treated with radiation. Which of the following is the most likely cause of his erectile dysfunction?


  1. Psychological factors

  2. Vascular damage from radiation

  3. Hormonal therapy

  4. Neurogenic causes

    Answer: B

Explanation: Radiation therapy can cause vascular damage, leading to erectile dysfunction in prostate cancer survivors.


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