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If a patient had an order to discontinue a catheter the day after surgery, under what circumstances might you consider delaying doing so until you talk with the physician?
- A. If the patient complained of burning or discomfort because of the catheter
- B. If the patient's output is greater than 50 mL/hr
- C. If the patient's output is less than 30 mL/hr
- D. If the patient's urine is dark amber
Correct Answer: C,D
Rationale: Low urine output (<30 mL/hr) or dark amber urine may indicate inadequate kidney function or dehydration, warranting consultation before catheter removal.
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You will need to push back the foreskin before catheterizing uncircumcised males. After you catheterize the patient, you should
- A. Pull the foreskin back over the glans.
- B. Leave the foreskin retracted.
- C. Lubricate the foreskin with petroleum jelly and then replace it.
- D. Elevate the penis on a folded towel to prevent swelling of the foreskin or glans.
Correct Answer: A
Rationale: Replacing the foreskin over the glans after catheterization prevents paraphimosis, a condition where the retracted foreskin causes swelling.
Spermicides can increase the risk for urinary tract infections in women.
- A. TRUE
- B. FALSE
Correct Answer: A
Rationale: Spermicides can disrupt vaginal flora, increasing UTI risk.
You are delegating the task of monitoring the output of an elderly male patient at risk for oliguria. He has an indwelling catheter in place. Which is the most appropriate direction for you to give to an unlicensed assistant?
- A. Tell me if his urine output decreases.
- B. Keep an eye on his output for me.
- C. Check his output halfway through the shift and let me know the total.
- D. Check his output after 2 hours. If it is not above 60 mL, let me know immediately.
Correct Answer: D
Rationale: Specific instructions to check output every 2 hours and report if it falls below 60 mL ensure timely detection of oliguria, which requires immediate attention.
Your patient returned from surgery (laparoscopy) 4 hours ago and complains of being unable to empty her bladder. What step should you take next?
- A. Palpate her bladder and, if distended, perform a bladder scan.
- B. Catheterize her.
- C. Have her drink a full glass of water and then have her try to void again.
- D. Check her vital signs.
Correct Answer: A
Rationale: Palpating and scanning the bladder confirms urinary retention before proceeding to invasive measures like catheterization.
You note that in the past 3 hours no urine has drained into your female patient's urinary collection bag. Which of the following is most likely responsible for this?
- A. Kinks in the tubing
- B. Acute renal failure
- C. Poor positioning of the drainage bag
- D. A kidney stone blocking the catheter
Correct Answer: A
Rationale: Kinks in the tubing are the most common cause of no urine flow, as they obstruct drainage.