urinary elimination practice questions - Sheet1

Question 1

1. A patient is scheduled to have an intravenous pyelogram (IVP) tomorrow morning. Which nursing measures should be implemented before the test? (Select all that apply.)
2. Ask the patient about any allergies and reactions.
3. Instruct the patient that a full bladder is required for the test.
4. Instruct the patient to save all urine in a special container.
5. Ensure that informed consent has been obtained.
6. Instruct the patient that facial flushing can occur when the contrast medium is given.

Answer 1

Answer: 1, 4, 5
Rationale: Allergies must be assessed to prevent a reaction to the contrast. Informed consent is needed for the procedure, and patients should be aware that facial flushing may occur.

Question 2

2. What is a critical step when inserting an indwelling catheter into a male patient?
3. Slowly inflate the catheter balloon with sterile saline.
4. Secure the catheter drainage tubing to the bedsheets.
5. Advance the catheter to the bifurcation of the drainage and balloon ports.
6. Advance the catheter until urine flows, then insert ¼ inch more.

Answer 2

Answer: 3
Rationale: Advancing the catheter to the bifurcation ensures it is correctly positioned within the bladder before inflating the balloon.

Question 3

3. Which instruction should the nurse give the assistive personnel (AP) concerning a patient who has had an indwelling urinary catheter removed that day?
4. Limit oral fluid intake to avoid possible UI.
5. Expect patient complaints of suprapubic fullness and discomfort.
6. Report the time and amount of first voiding.
7. Instruct patient to stay in bed and use a urinal or bedpan.

Answer 3

Answer: 3
Rationale: The AP should report the time and amount of the first void to monitor for urinary retention or other issues after catheter removal.

Question 4

4. A patient with a three-way indwelling urinary catheter and CBI complains of lower abdominal pain and distention after surgery. What should be the nurse’s initial intervention(s)? (Select all that apply.)
5. Increase the rate of the CBI.
6. Assess the patency of the drainage system.
7. Measure urine output.
8. Assess vital signs.
9. Administer ordered pain medication.

Answer 4

Answer: 2, 3
Rationale: Lower abdominal pain and distention may indicate blockage. Checking the patency and measuring output help address the issue before further complications occur.

Question 5

5. After abdominal surgery, the patient is on the surgical unit with an indwelling urinary catheter placed. What aspects of care for this patient can be delegated to the assistive personnel (AP)? (Select all that apply.)
6. Assessing the patient for any postoperative issues with the indwelling catheter
7. Assisting the nurse with patient positioning and maintaining privacy during catheter care
8. Teaching the patient signs and symptoms of a UTI
9. Reporting to the nurse any patient discomfort or fever
10. Reporting any abnormal color, odor, or amount of urine in the drainage bag

Answer 5

Answer: 2, 4, 5
Rationale: The AP can assist with positioning, report discomfort or fever, and observe and report abnormal urine, but cannot assess or teach.

Question 6

6. What should the nurse teach a young woman with a history of UTIs about UTI prevention? (Select all that apply.)
7. Maintain regular bowel elimination.
8. Limit water intake to 1 to 2 glasses a day.
9. Wear cotton underwear.
10. Cleanse the perineum from front to back.
11. Practice pelvic muscle exercises (Kegel) daily.

Answer 6

Answer: 1, 3, 4
Rationale: Regular bowel elimination, cotton underwear, and cleaning front to back help prevent bacterial contamination of the urinary tract.

Question 7

7. Place the following steps for insertion of an indwelling catheter in a female patient in appropriate order.
8. Insert and advance catheter.
9. Lubricate catheter.
10. Inflate catheter balloon.
11. Cleanse urethral meatus with antiseptic solution.
12. Drape patient with the sterile square and fenestrated drapes.
13. When urine appears, advance another 2.5 to 5 cm.
14. Prepare sterile field and supplies.
15. Gently pull catheter until resistance is felt.
16. Attach drainage tubing.

Answer 7

Answer: 5, 7, 2, 4, 1, 6, 3, 8, 9
Rationale: Following the proper sequence ensures sterility, safety, and effectiveness during catheter insertion.

Question 8

8. Which nursing interventions should a nurse implement when removing an indwelling urinary catheter in an adult patient? (Select all that apply.)
9. Attach a 3-mL syringe to the inflation port.
10. Allow the balloon to drain into the syringe by gravity.
11. Initiate a voiding record/bladder diary.
12. Pull the catheter quickly.
13. Clamp the catheter before removal.

Answer 8

Answer: 2, 3
Rationale: Draining the balloon by gravity ensures it is completely deflated, and a voiding record helps monitor for urinary retention post-removal.

Question 9

9. Which nursing intervention decreases the risk for CAUTI?
10. Cleansing the urinary meatus 3 to 4 times daily with antiseptic solution.
11. Hanging the urinary drainage bag below the level of the bladder.
12. Emptying the urinary drainage bag daily.
13. Irrigating the urinary catheter with sterile water.

Answer 9

Answer: 2
Rationale: Keeping the drainage bag below bladder level prevents backflow and reduces the risk of catheter-associated urinary tract infections (CAUTIs).

Question 10

10. The nurse is inserting a urinary catheter for a female patient, and after the catheter has been inserted 3 inches, no urine is returned. What should the nurse do next?
11. Remove the catheter and start all over with a new kit and catheter.
12. Leave the catheter there and start over with a new catheter.
13. Pull the catheter back and reinsert at a different angle.
14. Ask the patient to bear down and insert the catheter farther.

Answer 10

Answer: 2
Rationale: Leaving the first catheter in place serves as a guide to avoid reinserting into the vaginal opening when attempting placement again.