100+ Free CUNP Practice Questions

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Question 1

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A patient on finasteride for 12 months has PSA of 1.8 ng/mL. How should this value be interpreted?

Double the PSA to estimate true level

Normal; no adjustment needed

Repeat PSA in 3 months

Order prostate biopsy immediately

to track

2026 Statistics

Key Facts: CUNP Exam

175

Exam Questions

CBUNA

72%

Passing Score

Angoff Procedure 2017

3 years

Certification Valid

Recertification cycle

800 hrs

Clinical Hours Required

CBUNA eligibility

$350-445

Exam Fee

CBUNA 2026

25%

Largest Blueprint Domain

Infertility/Sexual Dysfunction

The CUNP exam contains 175 questions with a 72% passing score. Content spans seven blueprint domains with infertility/sexual dysfunction (25%) and obstructive uropathies/stones (24%) as the largest areas. Eligibility requires an NP license, master's/DNP, national NP certification, and 800 urology practice hours in the past 3 years. Certification is valid for 3 years.

Sample CUNP Practice Questions

Try these sample questions to test your CUNP exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A patient presents with IPSS score of 22. Which medication class is FIRST-line treatment for his BPH-related LUTS?

A.Alpha-1 adrenergic blocker

B.5-alpha reductase inhibitor

C.Anticholinergic agent

D.PDE5 inhibitor

Explanation: Alpha-1 blockers (tamsulosin, alfuzosin) relax prostatic smooth muscle and provide rapid symptom relief. They are first-line for moderate-to-severe LUTS (IPSS ≥8). 5-ARIs are added for large prostates (>30 mL) but have delayed onset.

2Tamsulosin 0.4 mg daily is prescribed. Which counseling point is MOST important?

A.Take on an empty stomach 30 minutes before meals

B.Expect orthostatic hypotension, especially after first dose

C.Discontinue if retrograde ejaculation occurs

D.Avoid grapefruit juice

Explanation: Tamsulosin is uro-selective but still causes orthostatic hypotension, particularly the first-dose effect. Patients should rise slowly. Retrograde ejaculation is common but not a reason to stop if tolerated.

3A 68-year-old male has a prostate volume of 55 mL and IPSS of 19. Finasteride is added to tamsulosin. The primary goal of combination therapy is to:

A.Provide faster symptom relief than monotherapy

B.Reduce prostate volume and prevent clinical progression

C.Prevent acute urinary retention and need for surgery

D.Improve erectile function

Explanation: The MTOPS trial showed combination therapy with a 5-ARI plus alpha-blocker reduces prostate volume, lowers risk of AUR, and delays BPH progression better than either agent alone in men with large prostates.

4Which 5-alpha reductase inhibitor inhibits BOTH type 1 and type 2 isoenzymes?

A.Finasteride

B.Dutasteride

C.Alfuzosin

D.Doxazosin

Explanation: Dutasteride inhibits both 5-AR type 1 and type 2, producing greater DHT suppression (~95%) compared to finasteride (~70%), which inhibits only type 2.

5A patient on finasteride for 12 months has PSA of 1.8 ng/mL. How should this value be interpreted?

A.Normal; no adjustment needed

B.Double the PSA to estimate true level

C.Repeat PSA in 3 months

D.Order prostate biopsy immediately

Explanation: Finasteride reduces PSA by approximately 50% after 6-12 months. Doubling the measured PSA approximates the baseline equivalent, maintaining screening validity for prostate cancer detection.

6The IPSS question set contains how many questions, and what score indicates severe symptoms?

A.5 questions; ≥15 is severe

B.7 questions; ≥20 is severe

C.7 questions; ≥15 is severe

D.10 questions; ≥25 is severe

Explanation: The IPSS has 7 symptom questions plus one quality-of-life question. Symptom-score bands are 0-7 mild, 8-19 moderate, and 20-35 severe. Severe scores often prompt surgical consideration.

7A 54-year-old male with hypertension reports inability to achieve erections for 8 months. First-line pharmacotherapy is:

A.Testosterone replacement therapy

B.A PDE5 inhibitor

C.Intracavernosal alprostadil injection

D.Penile prosthesis implantation

Explanation: PDE5 inhibitors (sildenafil, tadalafil, vardenafil, avanafil) are first-line for ED. They enhance NO-mediated smooth muscle relaxation, producing erection with sexual stimulation.

8A patient taking nitrates for angina asks about sildenafil for ED. The CUNP should:

A.Prescribe sildenafil 25 mg to minimize risk

B.Advise that the combination is contraindicated due to severe hypotension

C.Switch the patient from nitrates to a beta-blocker first

D.Prescribe tadalafil 5 mg daily as safer

Explanation: All PDE5 inhibitors are absolutely contraindicated with organic nitrates (any form) due to synergistic hypotension that can be severe or fatal.

9A patient on tadalafil 10 mg reports it is ineffective. Which counseling point should be assessed FIRST?

A.Whether the dose was taken with a high-fat meal

B.Whether adequate sexual stimulation was present

C.Whether he took the medication within 15 minutes of activity

D.Whether he has liver disease

Explanation: PDE5 inhibitors require sexual stimulation to work; they do not produce spontaneous erections. This is the most common reason for perceived failure and must be assessed before escalating dose.

10A patient self-administering intracavernosal alprostadil develops a painful erection lasting 4 hours. The CUNP should:

A.Advise the patient to apply ice and wait another hour

B.Direct the patient to the emergency department for priapism management

C.Increase the alprostadil dose at the next injection

D.Prescribe a PDE5 inhibitor concurrently

Explanation: An erection lasting >4 hours (priapism) is a urologic emergency. Ischemic priapism causes cavernosal hypoxia; delayed treatment risks permanent erectile dysfunction. ED management includes aspiration and intracavernosal sympathomimetics.

About the CUNP Exam

The CUNP certification validates advanced urologic nursing practice at the nurse practitioner level. Administered by CBUNA, the exam covers 175 multiple-choice items across key domains including obstructive uropathies and BPH (24%), voiding dysfunctions and incontinence (18%), infertility and sexual dysfunctions (25%), clinical assessment (23%), genitourinary cancers (5%), and urinary tract disorders (5%). Eligibility requires a master's degree or DNP, current NP certification, and 800 clinical urology hours within 3 years.

Questions

175 scored questions

Time Limit

Contact CBUNA for current time limit

Passing Score

72% (Angoff-determined standard)

Exam Fee

$350-445 (Certification Board for Urologic Nurses and Associates (CBUNA))

CUNP Exam Content Outline

25%

Infertility, Sexual Dysfunctions, Disorders of Male Genitalia

Male infertility workup, erectile dysfunction (PDE5 inhibitors, ICI, IPP), vasectomy, orchiopexy, scrotal conditions, hematospermia, testosterone disorders

24%

Obstructive Uropathies and Trauma (Stones and BPH)

Urolithiasis composition, SWL/URS/PCNL, MET, BPH/LUTS, alpha-blockers, 5-ARIs, combination therapy, urethral stricture, pelvic fracture

23%

Assessment and Monitoring of Urologic Conditions

History and physical, urodynamics, cystoscopy, imaging (CT/MRI/ultrasound), PSA interpretation, post-void residual, IPSS scoring

18%

Voiding Dysfunctions including Incontinence

Stress/urge/overflow/mixed incontinence, PFMT, bladder training, anticholinergics, mirabegron, Botox, sling, sacral neuromodulation, neurogenic bladder, CIC

Genitourinary Cancers

Prostate cancer (PSA screening, Gleason/grade group, AS/RP/RT/ADT), bladder cancer (BCG, TURBT, cystectomy, diversions), RCC, testicular cancer

Urinary Tract Inflammations and Disorders

Uncomplicated/complicated UTI, recurrent UTI, pyelonephritis, asymptomatic bacteriuria, prostatitis (NIH categories), IC/BPS, CAUTI

How to Pass the CUNP Exam

What You Need to Know

Passing score: 72% (Angoff-determined standard)
Exam length: 175 questions
Time limit: Contact CBUNA for current time limit
Exam fee: $350-445

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

CUNP Study Tips from Top Performers

1Master BPH pharmacotherapy: alpha-blockers (tamsulosin, alfuzosin) for symptom relief, 5-ARIs (finasteride, dutasteride) for volume reduction

2Know IPSS scoring: 0-7 mild, 8-19 moderate, 20-35 severe; guides treatment decisions

3Understand ED treatment ladder: PDE5 inhibitors first, then ICI alprostadil, then IPP; nitrate contraindication is absolute

4Review urinary incontinence types and treatments: PFMT for SUI, behavioral + pharmacologic for UUI, address overflow underlying cause

5Study urolithiasis by stone type: calcium oxalate (most common), uric acid (radiolucent, alkalinize urine), struvite (urease bacteria), cystine (COLA mnemonic)

6Know urine alkalinization targets: potassium citrate to pH 6.5-7.0 for uric acid stones; avoid over-alkalinizing

7Learn neurogenic bladder patterns: suprapontine (DO with coordination), sub-pons/above sacrum (DSD), sacral/peripheral (areflexia)

8Understand BCG contraindications: gross hematuria, traumatic catheterization, active UTI — BCG must wait

9Review PSA biology: organ-specific but not cancer-specific; double PSA on 5-ARI therapy; USPSTF Grade C for 55-69

10Know CBUNA recertification: 3-year cycle, 800 clinical hours, 36 CE contact hours in urology

Frequently Asked Questions

What is the CUNP exam?

The CUNP (Certified Urologic Nurse Practitioner) is an advanced specialty certification offered by the Certification Board for Urologic Nurses and Associates (CBUNA). It validates expert-level knowledge in urologic nursing at the nurse practitioner level, covering BPH, incontinence, ED, urolithiasis, genitourinary cancers, and neurogenic bladder.

What are the CUNP eligibility requirements?

CUNP eligibility requires: (1) Master's degree in nursing (MSN) or DNP, (2) Current state NP recognition, (3) Current NP certification from ANCC, NCC, AANP, or PNCB, and (4) Minimum 2 years as an NP with 800 clinical hours providing urologic patient care within the last 3 years.

How many questions are on the CUNP exam?

The CUNP exam contains 175 multiple-choice questions. The exam is offered year-round at computer-based testing centers. The passing score is 72%, determined by the Angoff standard-setting procedure.

What topics are covered on the CUNP exam?

The CUNP blueprint covers: Infertility/sexual dysfunctions/male genitalia disorders (25%), obstructive uropathies/stones/BPH (24%), clinical assessment and monitoring (23%), planning and implementing urologic care (25%), voiding dysfunctions/incontinence (18%), genitourinary cancers (5%), and urinary tract inflammations (5%).

How long is CUNP certification valid?

CUNP certification is valid for 3 years. Recertification requires 800 hours of urologic clinical practice and 36 contact hours of continuing education in urology during the certification period.

What is the CUNP exam fee?

The CUNP exam fee is $350 for SUNA members and $445 for non-members. The retake fee is $250 for SUNA members and $345 for non-members. Joining SUNA before applying can reduce your exam cost.

How should I prepare for the CUNP exam?

Study systematically across all blueprint domains. Focus heavily on BPH pharmacotherapy (alpha-blockers, 5-ARIs), ED management (PDE5 inhibitors, ICI, IPP), urinary incontinence (behavioral, pharmacologic, surgical options), urolithiasis management (SWL/URS/PCNL, MET), urodynamics interpretation, and genitourinary cancer screening and staging. Plan 8-14 weeks of dedicated study time.