CUA Urology Nurse Exam Prep Exam Questions & Answers 2026 (21–30)

Question 1

A 9-month-old infant is scheduled for hypospadias repair. What is the primary rationale for performing this surgery between 6 and 18 months of age rather than delaying until later childhood?

TheoryPractice · Accepted Answer

Minimize psychosocial stress impact. Surgery between 6 and 18 months minimizes psychosocial stress by avoiding the separation anxiety and body image awareness seen in older children. This window also balances anesthetic safety. Delaying surgery increases psychosocial risks. Penile size rarely requires delay to puberty. Anesthetic risks are manageable in this age group.

Question 2

A newborn with a history of prenatal hydronephrosis requires a postnatal renal ultrasound. To minimize the risk of a false-negative result due to transient physiological dehydration, when is the earliest recommended time to perform this study?

TheoryPractice · Accepted Answer

After 48 hours of life. The correct answer is after 48 hours of life. Newborns experience physiological oliguria and relative dehydration during the first 2 days of life, which can underestimate the degree of hydronephrosis (dilation) on ultrasound. Performing the scan after 48 hours allows for fluid shifts that provide a more accurate anatomical assessment. Distractor 1 is incorrect because immediate scanning often yields false negatives. Distractor 2 and Distractor 3 fall within the window of physiological dehydration artifact.

Question 3

When counseling parents of a 9-month-old with an undescended testicle, what is a primary medical rationale for recommending orchiopexy rather than continued observation?

TheoryPractice · Accepted Answer

Improve future fertility potential. Early orchiopexy preserves germ cell development, improving future fertility potential. It also facilitates future testicular self-examination for malignancy. Surgery facilitates surveillance but does not eliminate cancer risk. Cosmetic symmetry is secondary. Spontaneous descent after 6 months is rare, making continued observation ineffective.

Question 4

A 12-month-old female presents with her first febrile urinary tract infection (UTI). According to the American Academy of Pediatrics guidelines, which initial imaging study is the most appropriate next step?

TheoryPractice · Accepted Answer

Renal and bladder ultrasound. Renal and bladder ultrasound (RBUS) is the recommended first-line screening for anatomical abnormalities (e.g., hydronephrosis) in young children with a first febrile UTI. It avoids radiation exposure. Voiding cystourethrogram (VCUG) is invasive and indicated for recurrent UTIs or abnormal ultrasound findings. DMSA and CT involve radiation and are not first-line.

Question 5

A pediatric patient is being evaluated for an abdominal malignancy. Which clinical finding is part of the classic presentation triad specifically associated with Wilms tumor?

TheoryPractice · Accepted Answer

Painless palpable abdominal mass. Wilms tumor (nephroblastoma) classically presents as a painless, palpable abdominal mass. The triad often includes hypertension and hematuria. Painful voiding suggests cystitis, while scrotal swelling indicates testicular pathology. Fever and flank pain are more typical of pyelonephritis.

Question 6

An infant with prenatal hydronephrosis shows worsening dilation on follow-up ultrasound. A MAG-3 diuretic renogram is ordered primarily to evaluate which parameter?

TheoryPractice · Accepted Answer

Renal drainage and function. The correct answer is renal drainage and function. A MAG-3 scan provides functional data, specifically the split differential function (percentage of function in each kidney) and drainage time (washout), to distinguish between obstruction and non-obstructive dilation. Distractor 1 is evaluated by VCUG. Distractor 2 is evaluated by ultrasound. Distractor 3 refers to structural detail, which is better seen on anatomical imaging.

Question 7

During the physical assessment of a male infant diagnosed with hypospadias, which associated anatomical anomaly is most commonly identified and requires surgical correction?

TheoryPractice · Accepted Answer

Ventral curvature (chordee). Ventral curvature (chordee), a downward penile curvature caused by fibrous bands, is frequently associated with hypospadias and requires surgical correction. A dorsal hooded foreskin is also characteristic. Conditions like posterior urethral valves or hernias are distinct and not universally present with the hypospadias defect.

Question 8

A 7-year-old child presents with monosymptomatic nocturnal enuresis. According to standard clinical treatment guidelines, which intervention should be implemented first?

TheoryPractice · Accepted Answer

Fluid restriction and timed voiding. Behavioral modifications, such as fluid restriction and timed voiding, are first-line therapy. If these fail, bedwetting alarms are used. Pharmacological agents like desmopressin or anticholinergics are second-line treatments reserved for refractory cases.

Question 9

Which advice given to the parents of a 10-month-old infant with a persistent undescended testicle represents a significant error in standard management?

TheoryPractice · Accepted Answer

Wait until school age to refer. Spontaneous descent is rare after 6 months. Referral is required if the testis remains undescended by this age to facilitate orchidopexy between 6 and 18 months, optimizing fertility. Waiting until school age delays necessary surgery and negatively impacts outcomes.

Question 10

A 4-year-old child is found to have a large abdominal mass suspicious for Wilms tumor. Which immediate management step is most appropriate for the urologic associate to facilitate?

TheoryPractice · Accepted Answer

Expedite pediatric oncology referral. The correct answer is to expedite pediatric oncology referral. Management of Wilms tumor requires a multidisciplinary approach involving pediatric urology and oncology. Biopsy is generally contraindicated (Distractor 1) due to the risk of tumor spillage and upstaging the disease; the diagnosis is often confirmed by imaging and then surgical resection. Distractors 2 and 3 are inappropriate as they delay necessary multidisciplinary evaluation or involve procedures that should only be decided by the specialist team.

CUA Urology Nurse Exam Prep Exam Questions & Answers 2026 (21–30)

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