Nokea
Which of the following makes catheterization difficult but represents normal anatomy in older women?
- A. The vaginal opening is enlarged.
- B. The urinary meatus is located in the vaginal opening because of atrophy of perineal tissues.
- C. The perineal area becomes very dry.
- D. The clitoris atrophies.
Correct Answer: B
Rationale: Atrophy of perineal tissues in older women can cause the urinary meatus to recede or appear within the vaginal opening, complicating catheterization.
You may also like to solve these questions
You are teaching a home care patient about self-catheterization. You know more teaching is needed when the patient states
- A. I will not need sterile gloves and a new sterile catheter every time I catheterize myself at home.
- B. I will use clean gloves and wash the catheters between uses.
- C. I do not need gloves or any special precautions because I am in my own home.
- D. This is a clean, rather than a sterile, procedure at home.
Correct Answer: C
Rationale: Self-catheterization at home is a clean procedure, but gloves and proper cleaning are necessary to prevent infection; stating no precautions are needed is incorrect.
You are caring for a patient who sustained a spinal cord injury 14 years ago. Two days ago, the health-care provider inserted an indwelling urinary catheter, size 18 Fr, which is to remain in place for several weeks to allow pressure ulcers to heal. The patient has had catheters off and on for many years. You note that urine is leaking around the catheter insertion site and that the patient's meatus is getting red and irritated. Which of the following actions represents the nursing interventions most likely to resolve this situation?
- A. Request medication to calm bladder spasms, which are probably the cause of the leakage.
- B. Obtain an order to remove the current catheter and replace it with a size 22 Fr catheter.
- C. Obtain an order to replace the current catheter with a size 14 Fr catheter.
- D. Obtain an order to remove the current catheter and replace it with a condom catheter.
Correct Answer: C
Rationale: A smaller catheter (14 Fr) may reduce irritation and leakage, as a larger catheter can cause pressure and inflammation at the meatus.
In addition to collecting all urine passed in a 24-hour period, one of the most important steps in obtaining a 24-hour urine sample is to
- A. Have the patient void, discard this urine, note the time, and then begin collecting.
- B. Begin the collection at 8:00 a.m.
- C. Make sure there is a preservative in the collection bottle.
- D. Keep the sample at room temperature.
Correct Answer: A
Rationale: Discarding the first void and noting the time ensures the 24-hour collection period is accurately timed.
Contraction of which muscle causes the bladder to empty?
- A. Internal urinary sphincter
- B. Detrusor
- C. External urinary sphincter
- D. Peristalsis
Correct Answer: B
Rationale: The detrusor muscle contracts to expel urine from the bladder during voiding.
Which of the following best describes the importance of monitoring intake and output?
- A. It helps determine the patient's fluid replacement needs.
- B. It can be used to correlate with daily weights.
- C. It is a good way to assess overall fluid balance.
- D. It helps determine the greatest source of fluid losses (for example, through diarrhea, insensible losses, or urine output).
Correct Answer: A,B,C,D
Rationale: Monitoring intake and output assesses fluid balance, guides replacement needs, correlates with weight changes, and identifies sources of fluid loss.