A nurse is inserting a catheter into a female patient. When the nurse inserts the catheter, no urine is obtained. The nurse suspects the catheter is not in the urethra.
What should the nurse do?

Fill the balloon with the recommended sterile water.

Remove the catheter, wipe with alcohol, and reinsert after lubrication.

Leave the catheter in the vagina as a landmark for insertion of a new, sterile catheter.

Discard the catheter and begin again.

Answer and Explanation

The Correct Answer is C

If the nurse suspects the catheter is not in the urethra, they should leave the catheter in the vagina as a landmark for insertion of a new, sterile catheter.

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Correct Answer is A

Explanation

Choice A rationale

A purplish-colored stoma may indicate compromised circulation, which is a serious condition that requires immediate medical attention18.

Choice B rationale

A rosebud-like stoma orifice is a normal finding and does not need to be reported18.

Choice C rationale

A stoma oozing red drainage is a normal finding immediately after surgery and does not need to be reported18.

Choice D rationale

A shiny, moist stoma is a normal finding and does not need to be reported18.

A. Constipation B. Diarrhea C. Electrolyte imbalance D. Delayed gastric emptying

Correct Answer is B

Explanation

Choice A rationale

Constipation is not typically resolved by diluting enteral feeding formula.

Choice B rationale

Diarrhea can be a common side effect of enteral feeding, and diluting the formula can help manage this.

Choice C rationale

While electrolyte imbalance can occur with enteral feeding, diluting the formula is not typically done to resolve this issue.

Choice D rationale

Delayed gastric emptying is not typically resolved by diluting enteral feeding formula.

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A nurse is inserting a catheter into a female patient. When the nurse inserts the catheter, no urine is obtained. The nurse suspects the catheter is not in the urethra. What should the nurse do?

Nursing Test Bank

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A nurse is inserting a catheter into a female patient. When the nurse inserts the catheter, no urine is obtained. The nurse suspects the catheter is not in the urethra.
What should the nurse do?