Basic Nursing Skills Urinary & Bowel Elimination 2 — Questions and Answers
Question 1: What is the priority nursing action when caring for a patient with an indwelling urinary catheter to prevent infection?
- Irrigate the catheter every shift
- Keep the drainage bag above bladder level
- Maintain a closed drainage system (Correct answer)
- Change the catheter every 24 hours
Correct answer: Maintain a closed drainage system
Maintaining a closed, sterile drainage system is the most important intervention to prevent catheter-associated urinary tract infections (CAUTIs).
Question 2: Dark, tarry (melena) stools are most commonly associated with:
- Lower gastrointestinal bleeding
- Upper gastrointestinal bleeding (Correct answer)
- Normal bowel function
- Excess dietary fiber intake
Correct answer: Upper gastrointestinal bleeding
Melena results from digested blood and typically indicates bleeding in the upper GI tract (esophagus, stomach, or proximal small intestine).
Question 3: The normal range for urine specific gravity is:
- 1.000–1.005
- 1.030–1.050
- 1.005–1.030 (Correct answer)
- 0.990–1.000
Correct answer: 1.005–1.030
Normal urine specific gravity ranges from 1.005 to 1.030, reflecting the kidney's ability to concentrate or dilute urine based on hydration status.
Question 4: When collecting a clean-catch midstream urine specimen from a female patient, the nurse should instruct the patient to:
- Collect all urine from the beginning of urination
- Cleanse the urethral area front to back, then collect midstream urine (Correct answer)
- Collect the last portion of the urine stream
- Void directly into the specimen cup without preparation
Correct answer: Cleanse the urethral area front to back, then collect midstream urine
Cleansing front to back prevents contamination with perineal flora, and collecting midstream urine reduces urethral meatal contamination.
Question 5: Which assessment finding is most consistent with urinary retention?
- Frequent urination of small amounts
- Urine output of 60 mL/hour
- Bladder distension with inability to void (Correct answer)
- Dilute urine with specific gravity of 1.002
Correct answer: Bladder distension with inability to void
Urinary retention is characterized by the inability to empty the bladder, leading to bladder distension, suprapubic discomfort, and urge without output.
Question 6: The correct position for administering a tap water enema is:
- Supine with arms at sides
- Right lateral position
- Left Sims' position (Correct answer)
- Dorsal recumbent position
Correct answer: Left Sims' position
Left Sims' position (left lateral with right knee flexed) aligns the sigmoid colon and rectum for easier instillation and patient comfort.
Question 7: A patient suddenly reports a strong urge to defecate. The nurse's first action should be to:
- Administer a PRN laxative as ordered
- Assist the patient to the commode or bathroom promptly (Correct answer)
- Apply a brief for incontinence management
- Document the report and continue current care
Correct answer: Assist the patient to the commode or bathroom promptly
Prompt assistance to the toilet or commode respects patient dignity, prevents incontinence, and maintains bowel continence.
Basic Nursing Skills Urinary & Bowel Elimination 2
What is the priority nursing action when caring for a patient with an indwelling urinary catheter to prevent infection?