Question 1

The nurse notes that 8 hours after removing the patient's indwelling urinary catheter, the patient has not voided.Which action would the nurse take first?

Accepted Answer

A)   Run a trickle of water in the bathroom.
B)   Apply a rolling motion over the bladder.
C)   Ask about voiding difficulties in the past.
D)   Instruct the patient to run warm water on the perineum. C

Question 2

The charge nurse is reviewing patients on the unit who have indwelling urinary catheters for appropriateness of this treatment.Which of the following have catheters for appropriate reasons? (Select all that apply.)

Accepted Answer

A)   Frequently incontinent
B)   On high dose steroids
C)   Receiving fluid resuscitation for burns
D)   Critically ill
E)   On hospice, for comfort C, D, E

Question 3

The patient reports a sharp stabbing pain when the nurse inflates the balloon during insertion of an indwelling urinary catheter.What would the nurse do in response to the patient report of pain?

Accepted Answer

A)   Deflate the balloon.
B)   Remove the catheter.
C)   Advance the catheter 2 inches.
D)   Reassure the patient that it will pass. A

Question 4

The nurse is reviewing the instructions for applying a condom catheter with the NAP.Which of the following statements indicates an understanding of the procedure? (Select all that apply.)

Accepted Answer

A)   "I should shave the pubic hair first."
B)   "With my dominant hand, I hold the rolled condom sheath."
C)   "I allow 1-2 inches of space between the tip of the penis and the end of the condom."
D)   "I should not use any additional adhesive tape around the penis."
E)   "I should first provide perineal care."

Question 5

The nurse delegates the application of an external urinary catheter to nursing assistive personnel (NAP), including application of an external urinary catheter.Which aspect of applying the external catheter must the nurse perform?

Accepted Answer

A)   Placing the adhesive from the kit to hold the catheter in place
B)   Checking the condition of the penis and scrotum before the procedure
C)   Providing perineal care before catheter placement
D)   Allowing a space between the tip of the penis and the catheter

Question 6

A female patient with a hysterectomy now needs to have her bladder scanned because of difficulty voiding after back surgery.What action does the nurse take to obtain the most accurate scan?

Accepted Answer

A)   Place the scanner head on the symphysis pubis using ultrasound gel.
B)   Set the gender designation on the scanner as "male."
C)   Place the scanner head above the symphysis pubis without ultrasound gel.
D)   Set the gender designation on the scanner as "female."

Question 7

The nurse reviews an order for a continuous bladder irrigation after prostate surgery.Which action does the nurse take before starting the bladder irrigation?

Accepted Answer

A)   Label the irrigation solution genitourinary (GU)  irrigation only.
B)   Change the irrigation tubing at least once every 12 hours.
C)   Infuse the irrigation solution at 100 mL/hr for clear urine.
D)   Ensure that the patient has a triple-lumen urinary catheter.

Question 8

The nurse is making patient care assignments for the staff.Which elimination activity can the nurse delegate to nursing assistive personnel (NAP) for a patient with an indwelling urinary catheter?

Accepted Answer

A)   Catheterizing the patient
B)   Irrigating the catheter
C)   Obtaining a urine culture
D)   Providing catheter care

Question 9

The nurse is reviewing the interventions for prevention of urinary catheter infections (CAUTIs).Which of the following interventions will help prevent infection? (Select all that apply.)

Accepted Answer

A)   Maintain a closed system.
B)   Perform routine perineal hygiene daily.
C)   Only open the system when necessary.
D)   Secure the catheter to prevent pulling on the catheter.
E)   Maintain an unobstructed flow of urine.

Question 10

Four hours after applying an external urinary catheter, the nurse observes no urine output in the drainage bag.Which intervention does the nurse implement first?

Accepted Answer

A)   Check the catheter tubing for an obstruction.
B)   Ask the patient if he or she feels the urge to void.
C)   Notify the provider of inadequate urine output.
D)   Increase the patient's fluid intake over the next hour.

Question 11

In which position would the nurse place a female patient when preparing to insert a urinary catheter?

Accepted Answer

A)   Prone
B)   Supine
C)   High-Fowler's
D)   Dorsal recumbent

Question 12

The nurse set up the sterile field and is preparing to cleanse a male patient before inserting a urinary catheter.What step is essential for the nurse to use when cleaning the penis?

Accepted Answer

A)   Keep the foreskin over the penis tip.
B)   Use long strokes down the shaft of the penis.
C)   Hold the penis at a right angle to the body.
D)   Hold the cotton balls in the dominant hand.

Question 13

The nurse determines that the patient's urinary output from the suprapubic catheter is 150 mL for 8 hours.What does the nurse implement as a follow-up nursing intervention?

Accepted Answer

A)   Encourage the patient to change positions.
B)   Clamp the urinary catheter for 30 minutes.
C)   Contact the health care provider for a diuretic.
D)   Assess the patient's intake and catheter patency.

Question 14

The nurse is providing instructions to the NAP on applying a condom catheter on a male patient.Which of the following does the nurse instruct the NAP to report? (Select all that apply.)

Accepted Answer

A)   Patient reports pain at the site or when voiding.
B)   Redness or irritation at the site where the condom catheter is applied.
C)   Skin breakdown of the glans penis or penile shaft.
D)   Inability to apply the catheter.
E)   Urinary incontinence.

Question 15

The nurse is preparing to insert an indwelling urinary catheter into a female patient who is having major open-heart surgery and will be in the intensive care unit after surgery.Which statement about the purpose of the catheter by the patient best indicates that teaching by the nurse was effective?

Accepted Answer

A)   "An empty bladder always helps prevent bladder infections."
B)   "The catheter drains residual urine in case you get a urinary obstruction."
C)   "The catheter prevents urinary infections."
D)   "The catheter allows us to monitor your urine output closely after surgery."

Question 16

Discharge teaching for a male patient with an external urinary catheter would include which of the following instructions?

Accepted Answer

A)   Retract the foreskin of the penis before applying the catheter.
B)   Remove the hair at the base of the penis before applying the catheter.
C)   Apply a petroleum-based skin barrier to the penis first.
D)   Press the catheter adhesive to encourage adherence to the penis.

Question 17

The nurse encounters resistance during the insertion of a urinary catheter in a male patient.Which action would the nurse implement first?

Accepted Answer

A)   Tell the patient to bear down.
B)   Ask the patient to inhale quickly.
C)   Apply force to insert the catheter.
D)   Remove the catheter immediately.

Question 18

A patient is going to have an indwelling catheter for the next few weeks as a result of postoperative complications.Which action does the nurse use to prevent the most common complication of an indwelling urinary catheter?

Accepted Answer

A)   Maintain slight tension on the tubing.
B)   Keep the collection bag several inches from the floor.
C)   Empty the collection bag every 24 hours.
D)   Clean the catheter from the meatus to the tubing.

Question 19

Which technique does the nurse use to cleanse the perineum of a female patient during urinary catheter insertion?

Accepted Answer

A)   Rinse the perineum with warm antiseptic solution.
B)   Swab the perineum 3 times from the anus to the urinary meatus.
C)   Use the nondominant hand to keep the labia spread apart continuously.
D)   Use the nondominant hand to cleanse from the urinary meatus to the rectum.

Question 20

The nurse evaluates the effectiveness of the patient's intermittent urinary catheterization for residual urine.Which of the following requires follow-up nursing intervention?

Accepted Answer

A)   The patient is passing urine in the bathroom.
B)   The urine is clear yellow and without odor.
C)   The bladder is nonpalpable above the pubic bone.
D)   The patient reports frequency and urgency.

Exam 19: Urinary Elimination