A nurse is discussing indications for urinary catheterization with another nurse.
Which of the following indications should the nurse include? Select all that apply.
Measurement of residual urine after urination.
Relief of urinary retention.
Routine acquisition of a urine specimen.
Convenience for the nursing staff or the patient's family.
An open perineal wound.
Correct Answer : A,B,E
Choice A rationale
Measurement of post-void residual (PVR) urine volume is a valid indication for catheterization. This procedure assesses bladder emptying efficiency, particularly in patients experiencing urinary symptoms like hesitancy or incomplete voiding. Elevated PVR volumes (typically > 100 mL) can indicate outflow obstruction or bladder dysfunction, necessitating further investigation.
Choice B rationale
Relief of urinary retention is a primary indication for catheterization. Acute urinary retention, often caused by prostatic enlargement or neurologic dysfunction, results in painful bladder distention and potential renal compromise. Catheterization promptly drains the bladder, alleviating discomfort and preventing upper urinary tract damage by reducing intravesical pressure.
Choice C rationale
Routine acquisition of a urine specimen is generally not an indication for catheterization. Clean-catch midstream urine samples are typically sufficient for most diagnostic purposes, minimizing the risk of catheter-associated urinary tract infections (CAUTIs). Catheterization is invasive and should be reserved for situations where a clean voided specimen is unobtainable or specific sterile collection is required.
Choice D rationale
Convenience for nursing staff or the patient's family is not a legitimate medical indication for urinary catheterization. Catheterization is an invasive procedure associated with significant risks, including CAUTIs, urethral trauma, and patient discomfort. Its use should be medically justified and limited to situations where benefits clearly outweigh the potential harms, prioritizing patient safety.
Choice E rationale
An open perineal wound is a strong indication for urinary catheterization. Catheterization diverts urine away from the wound, preventing contamination and promoting optimal healing. Urine is inherently acidic and can introduce bacteria, impairing tissue repair and increasing infection risk in compromised perineal tissues, making diversion crucial for wound management.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Applying vitamin E ointment is not an evidence-based treatment for facial acne. While vitamin E has antioxidant properties, its topical application has not been shown to significantly reduce acne lesions and may even exacerbate some skin conditions by occluding pores.
Choice B rationale
Washing the face twice a day with mild soap and water helps to remove excess sebum, dirt, and dead skin cells, which contribute to acne formation. This simple hygienic practice reduces bacterial colonization and prevents clogged pores without irritating the skin, which can worsen acne.
Choice C rationale
Removing whiteheads and raised areas, also known as comedone extraction, by oneself can lead to skin trauma, inflammation, infection, and scarring. This procedure should only be performed by a healthcare professional, such as a dermatologist, using sterile techniques.
Choice D rationale
Tretinoin is a retinoid that can be effective for acne, but it increases photosensitivity, making the skin more susceptible to sunburn. Therefore, applying it in the morning and exposing the face to the sun is contraindicated; it should typically be applied at night, and sun protection is crucial.
Correct Answer is C
Explanation
Choice A rationale
Breads are generally well-tolerated and do not contain substances known to irritate the bladder. They are composed primarily of carbohydrates and are not acidic or caffeinated, making them a safe dietary choice for individuals with a urinary tract infection.
Choice B rationale
While some fresh fruits are acidic, many are not strong bladder irritants and contribute to overall hydration and nutrient intake. The impact of specific fruits can vary among individuals, but generally, fresh fruits are not a universal avoidance recommendation for UTIs.
Choice C rationale
Caffeine acts as a diuretic and a bladder irritant. It can increase urinary frequency, urgency, and may exacerbate bladder discomfort and inflammation in individuals with a urinary tract infection by stimulating the bladder detrusor muscle. Therefore, it should be avoided.
Choice D rationale
Cheeses, particularly aged cheeses, do not typically contain compounds that directly irritate the bladder. They are a source of protein and fat, and generally do not contribute to urinary symptoms in the context of a urinary tract infection.
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