GRADE A+ Urinary Elimination Nclex style questions with Rationales 2025
A nurse is caring for a patient with urinary retention due to an
enlarged prostate. What would the nurse expect to find upon
Answer: b. Difficulty starting urination
assessment?
a. Increased urinary output
Rationale: Urinary retention due to an enlarged prostate often
b. Difficulty starting urination
causes difficulty in initiating urination.
c. Clear, pale yellow urine
d. Strong urge to urinate with no ability to void
When assessing a patient's urine for possible infection, which of
the following would be a concerning finding? Answer: c. Cloudy appearance
a. Pale yellow color
b. Clear consistency Rationale: Cloudy urine may indicate a urinary tract infection (UTI),
c. Cloudy appearance which can result from bacterial presence in the urine
d. Slight odor
Which condition is most likely to result in overflow incontinence?
Answer: a. Enlarged prostate
a. Enlarged prostate
b. Urinary tract infection
Rationale: An enlarged prostate can block the urethra, leading to
c. Urge incontinence
overflow incontinence due to incomplete bladder emptying.
d. Vaginal prolapse
A patient with an ileal conduit asks about mucus in their urine.
What should the nurse explain?
Answer: b. Mucus is a normal finding in the urine of patients with
a. Mucus is a sign of infection and requires immediate interven-
urinary diversions.
tion.
b. Mucus is a normal finding in the urine of patients with urinary
Rationale: The gastrointestinal tract continues to produce mucus,
diversions.
which may be present in the urine of patients with urinary diver-
c. Mucus in the urine indicates that the stoma is becoming infect-
sions like ileal conduits.
ed.
d. Mucus should be removed from the stoma to prevent blockage
A patient has a new ileal conduit urinary diversion. Which of the
Answer: c. Urine will be collected in a bag outside the body
following is important for the nurse to include in patient teaching?
a. Stoma will remain dry at all times.
Rationale: An ileal conduit diverts urine into a collection bag at-
b. Clean the stoma with soap and water only.
tached outside the body. The stoma should be pink, moist, and
c. Urine will be collected in a bag outside the body.
red.
d. The stoma should be pink, moist, and red.
Which of the following statements is true regarding the care of a
Answer: b. A dark, purple-blue stoma may indicate compromised
urinary stoma?
circulation.
a. The stoma should be kept moist at all times.
b. A dark, purple-blue stoma may indicate compromised circula-
Rationale: A healthy stoma should be pink to red. A dark pur-
tion.
ple-blue color can indicate ischemia and requires prompt medical
c. The stoma should be irrigated daily with warm water.
attention.
d. Skin around the stoma should be kept moist to prevent irritation
When performing a clean-catch urine specimen, which instruction
is correct? Answer: b. Start voiding into the toilet, stop, then collect the mid-
a. Void into the collection container immediately after cleaning. stream urine
b. Start voiding into the toilet, stop, then collect the midstream
urine. Rationale: A clean-catch urine specimen involves discarding the
c. Collect the first urine voided in the morning. first urine to clear contaminants and then collecting the midstream
d. Cleanse the area with an antiseptic solution, not soap and water
A nurse is preparing to collect a clean-catch urine specimen.
Which step is essential for the correct collection technique?
Answer: b. Cleanse the genital area with antiseptic towelettes
a. Use a sterile container to catch the urine.
before collecting the specimen.
b. Cleanse the genital area with antiseptic towelettes before col-
lecting the specimen.
Rationale: Proper cleaning of the genital area helps prevent con-
c. Begin the urine collection before cleaning the genital area.
tamination and ensures the accuracy of the specimen.
d. Keep the lid of the container face up until after the specimen is
collected.
A patient with an indwelling catheter is at risk for which complica-
tion? Answer: b. Urinary tract infection
a. Kidney stones
b. Urinary tract infection
1/6
,GRADE A+ Urinary Elimination Nclex style questions with Rationales 2025
c. Urinary retention Rationale: Indwelling catheters introduce a risk for infection, which
d. Bladder training can lead to urinary tract infections (UTIs)
Which of the following factors contributes to urinary incontinence
Answer: b. Lack of privacy
in older adults?
a. Increased bladder capacity
Rationale: Lack of privacy can increase stress and lead to in-
b. Lack of privacy
continence. Older adults may also experience changes in bladder
c. Improved muscle tone
control due to aging.
d. Increased urine production
A nurse observes a dark purple stoma on a patient with an ileal
Answer: a. Report the finding to the healthcare provider immedi-
conduit. What is the most appropriate action?
ately
a. Report the finding to the healthcare provider immediately.
b. Apply a fresh stoma appliance.
Rationale: A purple stoma indicates compromised circulation,
c. Clean the stoma with soap and water.
which requires immediate medical attention
d. Wait until the next routine check-up
The nurse is teaching a patient with a urinary diversion about
the care of their appliance. Which action is important to prevent
leakage? Answer: a. Apply the appliance over dry, intact skin.
a. Apply the appliance over dry, intact skin
.b. Use baby powder to absorb moisture before applying the Rationale: To ensure a secure seal and prevent leakage, the
appliance. appliance should be applied over clean, dry skin.
c. Change the appliance only when leakage occurs.
d. Keep the skin around the stoma moist to prevent irritation.
Which intervention is most appropriate for a patient with urinary
retention and an enlarged prostate? Answer: c. Catheterizing the patient to relieve bladder retention
a. Encouraging the patient to hold urine longer
b. Offering fluid restriction Rationale: Catheterization is appropriate to relieve retention and
c. Catheterizing the patient to relieve bladder retention decompress the bladder in patients with urinary retention.
d. Restricting activity to prevent further bladder distention
Which of the following urine characteristics would be most con-
cerning for a patient recovering from surgery? Answer: b. Dark amber color
a. Bright yellow color
b. Dark amber color Rationale: Dark amber urine could indicate dehydration, which can
c. Clear and odorless be a concern after surgery, especially if fluid intake is insufficient.
d. Presence of mucus in the urine
Which of the following is the most common sign of urinary tract
infection (UTI)? Answer: a. Painful urination
a. Painful urination
b. Decreased urine output Rationale: Pain or a burning sensation while urinating is a common
c. Dark, cloudy urine symptom of a urinary tract infection (UTI).
d. Urgency with incontinence
A nurse is teaching a patient with a newly inserted urinary
catheter. What is an important point to include in the teaching?
Answer: b. The drainage system should always remain closed to
a. The catheter can be removed after 24 hours.
prevent infection.
b. The drainage system should always remain closed to prevent
Rationale: Keeping the catheter and drainage system closed re-
infection.
duces the risk of urinary tract infections (UTIs).
c. The patient should attempt to void every 2 hours.
d. The catheter should be flushed with saline every day.
A nurse is inserting a catheter into a male patient. What is the
correct length of catheter insertion? Answer: c. 6-8 inches
a. 2-3 inches
b. 4-5 inches Rationale: For male patients, the catheter should be inserted 6-8
c. 6-8 inches inches into the urethra to reach the bladder
d. 10-12 inches
Which action should the nurse take when a patient's catheter is
Answer: b. Assess the catheter placement and check for kinks
leaking?
a. Change the catheter size to a larger one.
.Rationale: Leaking can occur if the catheter is not properly posi-
b. Assess the catheter placement and check for kinks.
tioned or if the tubing is kinked. It's essential to assess for these
c. Apply a dressing around the catheter to absorb the leakage.
factors first.
d. Replace the catheter with an indwelling one.
2/6
A nurse is caring for a patient with urinary retention due to an
enlarged prostate. What would the nurse expect to find upon
Answer: b. Difficulty starting urination
assessment?
a. Increased urinary output
Rationale: Urinary retention due to an enlarged prostate often
b. Difficulty starting urination
causes difficulty in initiating urination.
c. Clear, pale yellow urine
d. Strong urge to urinate with no ability to void
When assessing a patient's urine for possible infection, which of
the following would be a concerning finding? Answer: c. Cloudy appearance
a. Pale yellow color
b. Clear consistency Rationale: Cloudy urine may indicate a urinary tract infection (UTI),
c. Cloudy appearance which can result from bacterial presence in the urine
d. Slight odor
Which condition is most likely to result in overflow incontinence?
Answer: a. Enlarged prostate
a. Enlarged prostate
b. Urinary tract infection
Rationale: An enlarged prostate can block the urethra, leading to
c. Urge incontinence
overflow incontinence due to incomplete bladder emptying.
d. Vaginal prolapse
A patient with an ileal conduit asks about mucus in their urine.
What should the nurse explain?
Answer: b. Mucus is a normal finding in the urine of patients with
a. Mucus is a sign of infection and requires immediate interven-
urinary diversions.
tion.
b. Mucus is a normal finding in the urine of patients with urinary
Rationale: The gastrointestinal tract continues to produce mucus,
diversions.
which may be present in the urine of patients with urinary diver-
c. Mucus in the urine indicates that the stoma is becoming infect-
sions like ileal conduits.
ed.
d. Mucus should be removed from the stoma to prevent blockage
A patient has a new ileal conduit urinary diversion. Which of the
Answer: c. Urine will be collected in a bag outside the body
following is important for the nurse to include in patient teaching?
a. Stoma will remain dry at all times.
Rationale: An ileal conduit diverts urine into a collection bag at-
b. Clean the stoma with soap and water only.
tached outside the body. The stoma should be pink, moist, and
c. Urine will be collected in a bag outside the body.
red.
d. The stoma should be pink, moist, and red.
Which of the following statements is true regarding the care of a
Answer: b. A dark, purple-blue stoma may indicate compromised
urinary stoma?
circulation.
a. The stoma should be kept moist at all times.
b. A dark, purple-blue stoma may indicate compromised circula-
Rationale: A healthy stoma should be pink to red. A dark pur-
tion.
ple-blue color can indicate ischemia and requires prompt medical
c. The stoma should be irrigated daily with warm water.
attention.
d. Skin around the stoma should be kept moist to prevent irritation
When performing a clean-catch urine specimen, which instruction
is correct? Answer: b. Start voiding into the toilet, stop, then collect the mid-
a. Void into the collection container immediately after cleaning. stream urine
b. Start voiding into the toilet, stop, then collect the midstream
urine. Rationale: A clean-catch urine specimen involves discarding the
c. Collect the first urine voided in the morning. first urine to clear contaminants and then collecting the midstream
d. Cleanse the area with an antiseptic solution, not soap and water
A nurse is preparing to collect a clean-catch urine specimen.
Which step is essential for the correct collection technique?
Answer: b. Cleanse the genital area with antiseptic towelettes
a. Use a sterile container to catch the urine.
before collecting the specimen.
b. Cleanse the genital area with antiseptic towelettes before col-
lecting the specimen.
Rationale: Proper cleaning of the genital area helps prevent con-
c. Begin the urine collection before cleaning the genital area.
tamination and ensures the accuracy of the specimen.
d. Keep the lid of the container face up until after the specimen is
collected.
A patient with an indwelling catheter is at risk for which complica-
tion? Answer: b. Urinary tract infection
a. Kidney stones
b. Urinary tract infection
1/6
,GRADE A+ Urinary Elimination Nclex style questions with Rationales 2025
c. Urinary retention Rationale: Indwelling catheters introduce a risk for infection, which
d. Bladder training can lead to urinary tract infections (UTIs)
Which of the following factors contributes to urinary incontinence
Answer: b. Lack of privacy
in older adults?
a. Increased bladder capacity
Rationale: Lack of privacy can increase stress and lead to in-
b. Lack of privacy
continence. Older adults may also experience changes in bladder
c. Improved muscle tone
control due to aging.
d. Increased urine production
A nurse observes a dark purple stoma on a patient with an ileal
Answer: a. Report the finding to the healthcare provider immedi-
conduit. What is the most appropriate action?
ately
a. Report the finding to the healthcare provider immediately.
b. Apply a fresh stoma appliance.
Rationale: A purple stoma indicates compromised circulation,
c. Clean the stoma with soap and water.
which requires immediate medical attention
d. Wait until the next routine check-up
The nurse is teaching a patient with a urinary diversion about
the care of their appliance. Which action is important to prevent
leakage? Answer: a. Apply the appliance over dry, intact skin.
a. Apply the appliance over dry, intact skin
.b. Use baby powder to absorb moisture before applying the Rationale: To ensure a secure seal and prevent leakage, the
appliance. appliance should be applied over clean, dry skin.
c. Change the appliance only when leakage occurs.
d. Keep the skin around the stoma moist to prevent irritation.
Which intervention is most appropriate for a patient with urinary
retention and an enlarged prostate? Answer: c. Catheterizing the patient to relieve bladder retention
a. Encouraging the patient to hold urine longer
b. Offering fluid restriction Rationale: Catheterization is appropriate to relieve retention and
c. Catheterizing the patient to relieve bladder retention decompress the bladder in patients with urinary retention.
d. Restricting activity to prevent further bladder distention
Which of the following urine characteristics would be most con-
cerning for a patient recovering from surgery? Answer: b. Dark amber color
a. Bright yellow color
b. Dark amber color Rationale: Dark amber urine could indicate dehydration, which can
c. Clear and odorless be a concern after surgery, especially if fluid intake is insufficient.
d. Presence of mucus in the urine
Which of the following is the most common sign of urinary tract
infection (UTI)? Answer: a. Painful urination
a. Painful urination
b. Decreased urine output Rationale: Pain or a burning sensation while urinating is a common
c. Dark, cloudy urine symptom of a urinary tract infection (UTI).
d. Urgency with incontinence
A nurse is teaching a patient with a newly inserted urinary
catheter. What is an important point to include in the teaching?
Answer: b. The drainage system should always remain closed to
a. The catheter can be removed after 24 hours.
prevent infection.
b. The drainage system should always remain closed to prevent
Rationale: Keeping the catheter and drainage system closed re-
infection.
duces the risk of urinary tract infections (UTIs).
c. The patient should attempt to void every 2 hours.
d. The catheter should be flushed with saline every day.
A nurse is inserting a catheter into a male patient. What is the
correct length of catheter insertion? Answer: c. 6-8 inches
a. 2-3 inches
b. 4-5 inches Rationale: For male patients, the catheter should be inserted 6-8
c. 6-8 inches inches into the urethra to reach the bladder
d. 10-12 inches
Which action should the nurse take when a patient's catheter is
Answer: b. Assess the catheter placement and check for kinks
leaking?
a. Change the catheter size to a larger one.
.Rationale: Leaking can occur if the catheter is not properly posi-
b. Assess the catheter placement and check for kinks.
tioned or if the tubing is kinked. It's essential to assess for these
c. Apply a dressing around the catheter to absorb the leakage.
factors first.
d. Replace the catheter with an indwelling one.
2/6
