Urinary Catheters

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1. The nurse is ordered to place an in- Sterile technique

dwelling catheter in a comatose patient.
It would be important for the nurse to The bladder and urinary tract are
maintain which of the following when considered sterile. Any invasive
inserting a catheter? procedures performed on these
structures must be done using
sterile technique.

2. The nurse is caring for a patient who Straight

was sedated during a procedure and is
unable to void due to the effects of the
medication. What type of catheter would
the physician most likely order for this
patient?
Foley and retention catheters
are indwelling catheters used for
longer periods of time

3. The nurse places an intermittent A straight catheter

catheter in a patient to drain the bladder.
What is another name for an intermittent
catheter?

4. The nurse is inserting an indwelling Fo- Bladder

ley catheter into a patient. Where should
the nurse ensure that the catheter is
placed prior to inflating the balloon?
Inadvertent insertion of the bal-
loon into the urethra or prostate
could cause trauma to these
structures

5. The nurse is ordered to place an in- Dorsal recumbent

dwelling catheter for a patient. In what
position will the nurse normally place Knees flexed, feet about two feet
the patient to insert the catheter? apart, and legs abducted

6. Which of the following patients would A female patient with a hip re-
the nurse most likely put in Sim's posi- placement
tion when placing a urinary catheter?
In cases where the patient has
limited mobility in the knees or
hips, this or lateral position avoids

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7. A nurse is placing an indwelling Over the perineal area
catheter in a female patient. Where
would the nurse place the sterile fenes- The nurse would place the sterile
trated drape during the procedure? drape under the patient's hips
8. The nurse is inserting an intermittent
catheter in the urinary bladder of a fe-
male patient. After cleaning the perineal
area, how would the nurse insert the
catheter into the meatus?
9. The nurse is placing an indwelling
catheter for a patient whose bladder
was previously being drained with an
intermittent catheter. What step would
the nurse perform immediately after po-
sitioning and draping the patient?
10. Following insertion of an indwelling
catheter into a female patient, the nurse
finds there is no urine in the catheter
tubing. Which of the following would be
an appropriate action by the nurse?
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putting pressure on the knees or
hips
Gently, 2-3 inches
Female urethra is about 1.5-2.5
inches long. Putting pressure is
likely to injure mucous mem-
branes.
Open all the supplies
First open supplies while both
hands are still sterile. Next pre-
pare cotton balls for cleansing the
perineal area, lubricate one to two
inches of the catheter tip, and
cleanse the perineal area.
Rotate the catheter slightly to
reposition the drainage holes
Several measures that may be
helpful prior to removing the
catheter and notifying the primary
care provider: (1) have the patient
take a deep breath to relax the
perineal and abdominal muscles,
(2) rotate the catheter slightly be-
cause a drainage hole may be
resting against the bladder wall,
(3) raise the head of the bed to
increase pressure in the bladder
area, (4) assess patient intake to
ensure there is adequate fluid in-
 Urinary Catheters
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take for urine production, or (5)
assess the catheter and drainage
tubing for kinks and occlusion.

11. The nurse who inserted a urinary Obtain assistance from another
catheter into a female patient finds that nurse to visualize the urethra
there is no urine in the tubing. Upon
closer inspection, the nurse finds that
the catheter was inadvertently insert-
ed into the vagina. What is one recom-
mended nursing action to take if this
occurs?

12. The nurse is ordered to insert an in- Use circular strokes from the tip of
dwelling catheter into a male patient to the penis, outward from the mea-
obtain accurate fluid intake and output tus, downward to the base
measurements. How would the nurse
clean the patient's penis with the cotton
balls soaked in antiseptic solution prior
to placing the catheter?

13. The nurse has finished cleaning the Instill lubricant into the penis
penis prior to inserting an indwelling
catheter. What would be the nurse's next
step?

14. When inserting an intermittent urinary 3

catheter, how many times should the
nurse clean the penis with an antiseptic
swab?

15. The nurse is performing intermittent 6-8 inches

catheterization for a male patient. How
far should the nurse insert the tip of the
intermittent catheter into the meatus of
the penis?

16. The nurse meets resistance when in- Do not force the catheter
serting a Foley catheter into a patient.
The nurse could rotate the
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What would be the recommended action catheter 1/2 turn and try to ad-
in this situation? vance it again

17. The nurse is caring for a patient with an Remove the old catheter and in-
indwelling urinary catheter. The nurse sert a new one
notices that urine is leaking out from
around the catheter. What would be the
appropriate action in this situation?

18. The nurse is obtaining a urine speci- The port

men from a patient with an indwelling
catheter. From what part of the system
would the nurse get the urine for the
specimen?

19. The nurse is obtaining a urine specimen Nonsterile gloves

from a patient with an indwelling urinary
catheter. Which of the following is a re-
quirement for the nurse to wear during
this procedure?

20. The nurse is collecting a urine sample Bend the drainage tubing back on
from an indwelling urinary catheter. Pri- itself distal to the port
or to cleaning the aspiration port, what
would be the appropriate nursing ac-
tion?

21. When obtaining a urine specimen from With an alcohol wipe

an indwelling urinary catheter, how
would the nurse clean the aspiration
port?

22. The nurse clamps the catheter drainage Up to 30 minutes

tubing to collect a urine specimen from
a patient's indwelling urinary catheter.
How long can the nurse leave the tubing
clamped to obtain a sufficient amount of
urine?

23.
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For which of the following patients
would clamping or bending back a
catheter drainage tube to collect a urine
specimen most likely be contraindicat-
ed?
A patient post bladder surgery.
Clamping of the catheter
drainage tubing for extended peri-
ods of time causes overdistention
of the bladder

24. The nurse is collecting a urine sample 10 mL

from the port of the patient's catheter
drainage tubing. How much urine is gen-
erally collected for a sample unless oth-
erwise indicated by the facility?

25. When collecting a urine sample from the Unclamp the drainage tubing
port of the patient's catheter drainage
tubing, the nurse inserts the syringe
into the aspiration port, slowly aspirates
enough urine for the specimen, and re-
moves the syringe. What would be the
nurse's next step?

26. The nurse has finished collecting a Empty the urine from the syringe
urine specimen from the patient's in- into a specimen cup with a lid
dwelling urinary catheter. What should
the nurse do with the collected speci-
men to prepare it to be sent to the lab?

27. When obtaining a urine specimen form
an indwelling urinary catheter, the nurse
places a label on the specimen contain-
er. How should the nurse check the in-
formation on the specimen label?
Compare it to the patient identifi-
cation band
The nurse would not rely upon the
patient's confirmation of the label

28. The nurse receives an order to remove Clean technique

an indwelling urinary catheter from a pa-
tient who is pregnant and on bed rest.
The nurse should be sure to maintain
which of the following when performing
this procedure?

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29. The nurse is removing an indwelling Before removing the catheter
catheter from a patient on bed rest fol-
lowing bowel surgery. At what point in
the procedure would the nurse deflate
the balloon?

30. A patient complains of a burning sen- Inform the patient that this is nor-
sation when urinating for the first time mal for the first few voidings
following the removal of an indwelling
urinary catheter. In this situation, what
would be the nurse's intervention?

31. The nurse is positioning a patient for On the patient's left side, if left
the removal of an indwelling urinary handed
catheter. Where should the nurse stand
during the procedure?

32. When removing an indwelling urinary
catheter from a patient, the nurse pre-
pares to deflate the catheter balloon.
Which of the following is the proper
method for deflating the balloon?
Insert a syringe into the balloon
inflation port and allow the water
to come back by gravity

33. What instruction would the nurse give "Take several slow, deep
the patient before removing an in- breaths."
dwelling urinary catheter?

34. What would the nurse do with an in- Place it on the waterproof pad
dwelling urinary catheter immediately and wrap it in the pad
after removing it?

35. When removing an indwelling catheter Reattach the syringe to the port,
from a patient, the nurse notices resis- aspirate again, and reattempt
tance while attempting to pull out of the catheter removal
catheter. What would be the immediate
intervention in this situation?

36. A patient with an indwelling catheter Irrigate the catheter with normal
has a PRN order for intermittent saline to restore patency
catheter irrigation. The nurse notices
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there is no urine coming out of the
catheter and that the patient is com-
plaining of bladder pain and pressure.
What might the nurse do to rectify the
situation?

37. The nurse irrigates an indwelling uri- Opening the catheter can lead to
nary catheter through a closed system. contamination and infection
Why is this preferable to opening the
catheter?

38. The nurse is irrigating a patient's uri-
nary catheter using a closed system.
What action would the nurse perform
after cleansing the access port on the
catheter?
Clamp or fold the catheter tubing
below the access port
To direct the irrigating solution
into the bladder, thereby prevent-
ing flow into the drainage bag

39. The nurse is performing an irrigation An antimicrobial swab

of the patient's catheter using a closed
system. What should the nurse use to
disinfect the aspiration port?

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