Catheterization and Urinary Care - NURS 101L (2026 Update) WCU
1. When preparing to insert an indwelling catheter in a female patient, which
position is most appropriate for optimal visualization?
A. Lithotomy
B. Sims’
C. Dorsal recumbent
D. Trendelenburg
Answer: C
Rationale: The dorsal recumbent position (supine with knees flexed and legs externally
rotated) is the standard position for female catheterization to provide the best access to the
meatus.
2. While inserting a catheter into a male patient, the nurse encounters
resistance at the level of the prostate. What is the most appropriate initial
action?
A. Ask the patient to take deep breaths and apply gentle, steady pressure.
B. Withdraw the catheter and notify the provider immediately.
C. Force the catheter past the resistance to ensure it reaches the bladder.
D. Switch to a smaller diameter catheter.
Answer: A
Rationale: Resistance in males is often due to the external sphincter or an enlarged
prostate. Having the patient take deep breaths helps relax the sphincter; gentle pressure is
advised, but forcing is contraindicated.
,3. The nurse is performing perineal care for a female patient with an indwelling
catheter. In what order should the nurse clean the area?
A. Meatus, then labia majora, then labia minora.
B. Labia majora, then labia minora, then meatus.
C. Anus, then labia majora, then meatus.
D. Meatus, then catheter tubing, then labia.
Answer: B
Rationale: Perineal care should move from the least contaminated area to the most
contaminated. Cleaning the labia majora, then minora, then meatus follows the principle of
moving from periphery to the center/meatus.
4. According to the latest 2026 evidence-based guidelines, which action should
be avoided when preparing a sterile catheter kit?
A. Donning sterile gloves before touching the catheter.
B. Lubricating the catheter tip prior to insertion.
C. Testing the balloon by pre-inflating it with sterile water.
D. Cleansing the meatus with antiseptic-soaked cotton balls.
Answer: C
Rationale: Recent evidence-based practices suggest that pre-inflating the balloon can
stretch the material and cause micro-tears or uneven inflation, potentially leading to
irritation or trauma upon insertion.
, 5. A patient has an indwelling catheter for 48 hours. Which assessment finding
is the most significant indicator of a possible Catheter-Associated Urinary Tract
Infection (CAUTI)?
A. Urine output of 400 mL over 8 hours.
B. A temperature of 100.8°F (38.2°C) and new-onset confusion.
C. Slightly cloudy urine with no odor.
D. Complaints of mild pressure in the bladder area.
Answer: B
Rationale: Fever and systemic changes like confusion (especially in older adults) are
primary indicators of infection. Cloudy urine alone or mild pressure can be related to the
catheter presence or concentration.
6. When collecting a sterile urine specimen from a patient with an indwelling
catheter, where should the nurse withdraw the urine?
A. From the drainage bag tap.
B. From the needleless sampling port on the drainage tubing.
C. By disconnecting the catheter from the drainage tubing.
D. From the balloon inflation port.
Answer: B
Rationale: Urine should always be collected from the dedicated needleless sampling port
using a sterile syringe after clamping the tube below the port to allow fresh urine to
accumulate. The bag contains stagnant urine.
1. When preparing to insert an indwelling catheter in a female patient, which
position is most appropriate for optimal visualization?
A. Lithotomy
B. Sims’
C. Dorsal recumbent
D. Trendelenburg
Answer: C
Rationale: The dorsal recumbent position (supine with knees flexed and legs externally
rotated) is the standard position for female catheterization to provide the best access to the
meatus.
2. While inserting a catheter into a male patient, the nurse encounters
resistance at the level of the prostate. What is the most appropriate initial
action?
A. Ask the patient to take deep breaths and apply gentle, steady pressure.
B. Withdraw the catheter and notify the provider immediately.
C. Force the catheter past the resistance to ensure it reaches the bladder.
D. Switch to a smaller diameter catheter.
Answer: A
Rationale: Resistance in males is often due to the external sphincter or an enlarged
prostate. Having the patient take deep breaths helps relax the sphincter; gentle pressure is
advised, but forcing is contraindicated.
,3. The nurse is performing perineal care for a female patient with an indwelling
catheter. In what order should the nurse clean the area?
A. Meatus, then labia majora, then labia minora.
B. Labia majora, then labia minora, then meatus.
C. Anus, then labia majora, then meatus.
D. Meatus, then catheter tubing, then labia.
Answer: B
Rationale: Perineal care should move from the least contaminated area to the most
contaminated. Cleaning the labia majora, then minora, then meatus follows the principle of
moving from periphery to the center/meatus.
4. According to the latest 2026 evidence-based guidelines, which action should
be avoided when preparing a sterile catheter kit?
A. Donning sterile gloves before touching the catheter.
B. Lubricating the catheter tip prior to insertion.
C. Testing the balloon by pre-inflating it with sterile water.
D. Cleansing the meatus with antiseptic-soaked cotton balls.
Answer: C
Rationale: Recent evidence-based practices suggest that pre-inflating the balloon can
stretch the material and cause micro-tears or uneven inflation, potentially leading to
irritation or trauma upon insertion.
, 5. A patient has an indwelling catheter for 48 hours. Which assessment finding
is the most significant indicator of a possible Catheter-Associated Urinary Tract
Infection (CAUTI)?
A. Urine output of 400 mL over 8 hours.
B. A temperature of 100.8°F (38.2°C) and new-onset confusion.
C. Slightly cloudy urine with no odor.
D. Complaints of mild pressure in the bladder area.
Answer: B
Rationale: Fever and systemic changes like confusion (especially in older adults) are
primary indicators of infection. Cloudy urine alone or mild pressure can be related to the
catheter presence or concentration.
6. When collecting a sterile urine specimen from a patient with an indwelling
catheter, where should the nurse withdraw the urine?
A. From the drainage bag tap.
B. From the needleless sampling port on the drainage tubing.
C. By disconnecting the catheter from the drainage tubing.
D. From the balloon inflation port.
Answer: B
Rationale: Urine should always be collected from the dedicated needleless sampling port
using a sterile syringe after clamping the tube below the port to allow fresh urine to
accumulate. The bag contains stagnant urine.
