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Exam : CBUNA Certified Urologic Registered Nurse (CURN)
Number of Questions: 150
Question Type : multiple-choice questions.
Note: Some older sources mention 175 or 200 questions, but the most consistent and recent information confirms 150 questions for the CURN exam.
Passing Marks: The passing score for the CURN test is 70%

1. Anatomy and Physiology of the Urologic System (10-15%)
- Kidneys, ureters, bladder, urethra, and male reproductive organs (prostate, testes, penis).
- Nephron structure and function.
- Pelvic floor muscles and their role in continence.

- Urine formation (filtration, reabsorption, secretion, excretion).
- Hormonal regulation (e.g., antidiuretic hormone, aldosterone).
- Micturition reflex and bladder control.

- Glomerular filtration rate (GFR)
- Hydronephrosis
- Detrusor muscle
- Sphincter mechanisms
- Renal perfusion

2. Common Urologic Conditions and Pathophysiology (25-30%)
- Urinary Tract Infections (UTIs):
- Causes (e.g., Escherichia coli), risk factors, and complications (e.g., pyelonephritis).
- Types: Cystitis, urethritis, prostatitis.

- Urolithiasis (Kidney Stones):
- Types (calcium oxalate, uric acid, struvite).
- Risk factors, symptoms (renal colic), and complications (obstruction).

- Benign Prostatic Hyperplasia (BPH):
- Pathophysiology, symptoms (lower urinary tract symptoms - LUTS), and complications (e.g., bladder outlet obstruction).

- Urologic Cancers:
- Bladder cancer, prostate cancer, renal cell carcinoma, testicular cancer.
- Risk factors, staging, and metastatic patterns.

- Voiding Dysfunction:
- Overactive bladder (OAB), urinary incontinence (stress, urge, mixed, overflow).
- Neurogenic bladder (e.g., due to spinal cord injury, multiple sclerosis).

- Congenital and Pediatric Conditions:
- Vesicoureteral reflux (VUR), hypospadias, cryptorchidism.

- Interstitial cystitis/painful bladder syndrome.
- Erectile dysfunction (ED) and male infertility.
- Acute and chronic kidney injury (AKI, CKD).

- Hematuria
- Dysuria
- Nocturia
- Post-void residual (PVR)
- Azotemia
- Oliguria/Anuria

3. Diagnostic Procedures and Assessments (15-20%)
- Laboratory Tests:
- Urinalysis (specific gravity, pH, protein, blood, nitrites).
- Urine culture and sensitivity.
- Serum creatinine, blood urea nitrogen (BUN), and estimated GFR.
- Prostate-specific antigen (PSA) for prostate cancer screening.

- Imaging Studies:
- Ultrasound (renal, bladder, prostate).
- CT scan for stones or masses.
- Intravenous pyelogram (IVP) and voiding cystourethrogram (VCUG).

- Urodynamic Testing:
- Cystometry, uroflowmetry, and pressure-flow studies.
- Assessing bladder capacity, compliance, and detrusor activity.

- Endoscopic Procedures:
- Cystoscopy and ureteroscopy.
- Biopsy techniques for cancer diagnosis.

- Physical Assessments:
- Digital rectal test (DRE) for prostate evaluation.
- Pelvic floor test for incontinence.

- Cystometrogram (CMG)
- KUB (kidneys, ureters, bladder) X-ray
- Urethral pressure profile
- Retrograde pyelography
- Creatinine clearance

4. Treatments and Interventions (20-25%)
- Pharmacologic Management:
- Antibiotics for UTIs (e.g., nitrofurantoin, ciprofloxacin).
- Alpha-blockers (e.g., tamsulosin) and 5-alpha-reductase inhibitors (e.g., finasteride) for BPH.
- Anticholinergics (e.g., oxybutynin) for overactive bladder.
- Chemotherapy, immunotherapy (e.g., BCG for bladder cancer), and hormone therapy for cancers.

- Surgical Interventions:
- Transurethral resection of the prostate (TURP).
- Nephrectomy, cystectomy, and prostatectomy.
- Ureteral stent placement and lithotripsy for stones.

- Non-Surgical Procedures:
- Catheterization (indwelling, intermittent, suprapubic).
- Bladder irrigation and instillation therapies (e.g., for bladder cancer).
- Pelvic floor therapy and biofeedback for incontinence.

- Lifestyle and Behavioral Interventions:
- Bladder training, timed voiding, and fluid management.
- Dietary modifications for stone prevention (e.g., low-oxalate diet).

- Extracorporeal shock wave lithotripsy (ESWL)
- Clean intermittent catheterization (CIC)
- Intravesical therapy
- Kegel exercises
- Nephrostomy tube

5. Patient Care and Education (15-20%)
- Pre- and Post-Procedure Care:
- Preparing patients for surgery (e.g., bowel prep, fasting).
- Post-operative monitoring for complications (e.g., infection, bleeding).
- Catheter care and prevention of catheter-associated UTIs (CAUTIs).

- Patient Education:
- Teaching self-catheterization and catheter maintenance.
- Educating on medication adherence and side effects.
- Counseling on lifestyle changes to manage incontinence or prevent stones.

- Psychosocial Support:
- Addressing sensitive issues (e.g., sexual dysfunction, incontinence).
- Supporting patients with cancer diagnoses or chronic conditions.

- Stoma care
- Bladder diary
- Patient compliance
- Health literacy
- Shared decision-making

6. Professional Practice and Ethical Considerations (5-10%)
- Scope of Practice:
- Understanding RN responsibilities in urologic care.
- Collaboration with urologists, nurse practitioners, and other healthcare providers.

- Ethical Issues:
- Patient confidentiality, especially with sensitive urologic conditions.
- Informed consent for procedures and treatments.

- Quality Improvement:
- Implementing evidence-based practices to reduce CAUTIs or Excellerate outcomes.
- Participating in urologic research or quality audits.

- Evidence-based practice
- Informed consent
- HIPAA compliance
- Clinical practice guidelines
- Continuing competence

- Anatomy/Physiology:
- Renal pelvis, calyces, trigone, seminal vesicles.
- Peristalsis (ureteral), micturition, continence.
- Pathophysiology:
- Pyuria, bacteriuria, glycosuria.
- Vesicoureteral reflux (VUR), bladder diverticulum.
- Priapism, phimosis, varicocele.
- Diagnostics:
- Uroflowmetry, post-void residual (PVR).
- Renal scintigraphy, magnetic resonance urography (MRU).
- Treatments:
- Percutaneous nephrolithotomy (PCNL).
- Botulinum toxin (Botox) for overactive bladder.
- Penile prosthesis, vasectomy.
- Patient Care:
- Symptom management, care coordination.
- Patient advocacy, cultural competence.