CUA Surgical Procedures & Perioperative Care 3

Question 1

What is the primary function of a nephrostomy tube left in place after percutaneous nephrolithotomy (PCNL)?

Accepted Answer

Drain urine and blood from the kidney while the tract heals

Answer

The nephrostomy tube provides drainage of urine, blood, and residual stone debris from the renal collecting system while the percutaneous access tract heals, reducing obstruction and bleeding risk.

Question 2

Which drainage device is most commonly placed after open renal surgery to evacuate perinephric fluid?

Accepted Answer

Jackson-Pratt closed suction drain

Answer

Jackson-Pratt drains are closed suction systems that actively evacuate perinephric blood and lymph fluid after open renal procedures, reducing hematoma and seroma formation.

Question 3

Six hours after radical prostatectomy, a patient's urinary output suddenly drops to near zero. What is the most likely cause?

Accepted Answer

Urethral catheter obstruction from blood clots

Answer

Post-prostatectomy bleeding commonly produces blood clots that obstruct the urethral catheter lumen; catheter irrigation or replacement typically restores urine output immediately.

Question 4

Prior to radical cystectomy, which bowel preparation step is routinely performed and why?

Accepted Answer

Mechanical bowel preparation to cleanse the bowel segment used for diversion

Answer

Mechanical bowel preparation cleanses the bowel segment selected for urinary diversion (ileal conduit or neobladder), reducing luminal bacterial load and contamination risk during anastomosis.

Question 5

According to CAUTI prevention guidelines, when should a post-operative indwelling urinary catheter be removed?

Accepted Answer

As soon as it is no longer clinically indicated

Answer

CDC and HICPAC CAUTI guidelines recommend removing urinary catheters as soon as clinically unnecessary, since catheter dwell time is the primary modifiable risk factor for catheter-associated infection.

CUA - Certified Urologic Associate Practice Test

CUA - Certified Urologic Associate Practice Test

CUA Surgical Procedures & Perioperative Care 3