The nurse is providing indwelling catheter care for a patient who is uncircumcised. What intervention will help prevent a catheter associated urinary tract infection?

Obtain daily urine specimens by opening the collection drainage system.

Keep the urine collection bag below the level of the bladder at all times.

Retract the foreskin to clean the catheter tubing and meatus outward leaving the foreskin retracted.

Change the indwelling catheter at least every one week.

Answer and Explanation

The Correct Answer is B

A. Obtain daily urine specimens by opening the collection drainage system: Opening the drainage system increases the risk of introducing bacteria into the catheter, which can lead to infection.

B. Keep the urine collection bag below the level of the bladder at all times: Keeping the bag below the bladder prevents urine from back flowing into the bladder, which reduces the risk of infection.

C. Retract the foreskin to clean the catheter tubing and meatus outward, leaving the foreskin retracted: While the foreskin should be retracted for cleaning, it must always be returned to its normal position to prevent paraphimosis, a condition where the foreskin becomes trapped and restricts blood flow.

D. Change the indwelling catheter at least every one week: Routine catheter changes are not recommended unless there is an indication such as obstruction or infection. Unnecessary changes increase infection risk.

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Correct Answer is C

Explanation

A. Avoid bathing this patient until they are stable: Hygiene is essential for preventing infection and promoting comfort. Bathing should not be entirely avoided unless the patient is critically unstable.

B. Only bathe the perineal area: While perineal care is important, other areas also require cleaning, and modifications can be made to prevent excessive exertion.

C. Perform the bath in a semi-Fowler's position: Semi-Fowler's position (30–45°) promotes lung expansion and reduces dyspnea, making it the best position for bathing a patient with breathing difficulty.

D. Delegate the task to the assistive personnel: While an assistive personnel (AP) can assist, the nurse should assess the patient first and be involved in care for clients with respiratory distress.

A. Applies non skid socks before getting the patient out of bed. B. Activates the chair alarm when the patient is sitting in the chair. C. Ensures that the bed is in the lowest position prior to leaving the room. D. Places the patient on bedrest.

Correct Answer is D

Explanation

A. Applies non-skid socks before getting the patient out of bed: Non-skid socks help prevent slipping and are an appropriate fall precaution.

B. Activates the chair alarm when the patient is sitting in the chair: Chair alarms alert staff if the patient attempts to get up unassisted, reducing fall risk.

C. Ensures that the bed is in the lowest position prior to leaving the room: Keeping the bed low reduces the severity of injury in case of a fall.

D. Places the patient on bed rest: Bed rest is not a standard fall precaution unless medically necessary. It can lead to deconditioning and further weakness, increasing fall risk.

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The nurse is providing indwelling catheter care for a patient who is uncircumcised. What intervention will help prevent a catheter associated urinary tract infection?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to bathe a client with dyspnea. Which of the following actions should the nurse plan to take?

Correct Answer is C

Explanation

The student nurse has identified that the patient is a risk for falling and has implemented fall precautions. What action taken by the student would require further teaching from the clinical faculty?

Correct Answer is D

Explanation

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