A nurse is planning care for a group of patients. Which task will the nurse assign to the nursing assistive personnel (AP)?

Irrigating a catheter

Interpreting a bladder scan result

Obtaining a midstream urine specimen

inserting a straight catheter

Answer and Explanation

The Correct Answer is C

A. Irrigating a catheter: Catheter irrigation requires sterile technique and nursing judgment, making it an inappropriate task for an AP. It must be performed by a licensed nurse.

B. Interpreting a bladder scan result: APs may perform bladder scans in some settings, but interpretation of results requires nursing knowledge and clinical decision-making, which is beyond their scope of practice.

C. Obtaining a midstream urine specimen: Collecting a urine specimen is a non-invasive task that falls within the scope of practice for an AP, as it does not require sterile technique or nursing assessment.

D. Inserting a straight catheter: Insertion of a catheter requires sterile technique and nursing assessment, making it a task reserved for licensed nurses.

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Correct Answer is C

Explanation

A. Measure bladder with the head of the bed raised to 60 degrees. The patient should be in the supine position for the most accurate measurement.

B. Measure bladder with the head of the bed raised to 90 degrees. The patient should be in a flat or slightly reclined position for bladder scanning.

C. Measure bladder within 15 minutes after the patient voids. Postvoid residual (PVR) is the amount of urine left in the bladder after urination. It should be measured within 15 minutes of voiding for accuracy.

D. Measure bladder before the patient voids. Measuring before voiding does not assess residual urine, which is the purpose of the test.

A. After the client feels abdominal cramping B. Immediately before the client has a meal C. Every 2 hr while the client is awake D. When the client has the urge to defecate

Correct Answer is D

Explanation

A. After the client feels abdominal cramping: Too late. Cramping may indicate constipation or excessive straining.

B. Immediately before the client has a meal: Not effective. The gastrocolic reflex occurs after eating, not before.

C. Every 2 hr while the client is awake: This is unnecessary and does not align with the body’s natural elimination pattern.

D. When the client has the urge to defecate: Most effective approach. Encourages natural elimination patterns.

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A nurse is planning care for a group of patients. Which task will the nurse assign to the nursing assistive personnel (AP)?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is preparing to test a patient for postvoid residual with a bladder scan. Which action will the nurse take?

Correct Answer is C

Explanation

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Correct Answer is D

Explanation

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