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NURS 3632: Clinical Nursing Foundations | Volume II
100-Question Advanced & Alternate-Format Master Prep (UTA Edition)
Section 1: Bowel and Urinary Elimination
1. The nurse is assessing a new colostomy stoma on a postoperative client. Which
finding requires the nurse to notify the healthcare provider immediately?
A) The stoma is beefy red and moist.
B) The stoma is slightly edematous.
C) The stoma appears dark purple to black.
D) The stoma is oozing a small amount of blood when cleansed.
Elaboration: A dark purple or black stoma indicates ischemia or necrosis due to
compromised blood supply. A healthy stoma should be beefy red and moist.
Slight edema and minor bleeding during initial cleansing are normal
postoperative findings.
2. A client requires the insertion of an indwelling Foley catheter. Which action by the
nursing student requires the preceptor to intervene?
A) Positioning the female client in a dorsal recumbent position with knees flexed.
B) Cleansing the urethral meatus from front to back.
C) Testing the catheter balloon by inflating it with sterile water prior to
insertion.
D) Advancing the catheter 1 to 2 inches further after seeing a flash of urine.
Elaboration: Evidence-based practice guidelines now state that pre-testing the
balloon stretches the silicone, creating ridges that can cause micro-trauma to the
urethra during insertion. It is no longer recommended.
3. A nurse is preparing to administer a large-volume cleansing enema to an adult
client. In which position should the nurse place the client?
A) Right lateral with the right leg extended.
B) Left lateral (Sims') position with the right knee flexed.
C) Supine with the head of the bed elevated 45 degrees.
D) Prone with knees bent.
,Elaboration: The left lateral Sims' position aligns with the natural anatomical
curve of the descending colon and sigmoid colon, allowing gravity to facilitate
the flow of the enema solution deeper into the bowel.
4. (Select All That Apply) The nurse is initiating a 24-hour urine collection for a
client. Which of the following steps must the nurse include in the procedure?
A) Discard the very first voided urine specimen.
B) Keep the collection container on ice or in a designated refrigerator.
C) Ask the client to double-void before starting the collection.
D) Restart the entire test if any urine is accidentally flushed down the toilet.
E) Collect the urine directly from the indwelling catheter bag every 4 hours.
Elaboration: A 24-hour collection must start with an empty bladder (discard the
first void). All subsequent voids must be kept cold to prevent bacterial growth
and chemical breakdown. If a void is missed, the entire 24-hour cycle is invalid
and must be restarted.
5. A client with chronic constipation reports passing small amounts of liquid,
diarrheal stool over the past 24 hours. The nurse suspects which of the
following?
A) Clostridioides difficile infection.
B) Crohn's disease exacerbation.
C) Fecal impaction.
D) Paralytic ileus.
Elaboration: Liquid stool seeping around a hardened mass of stool in the rectum
is the hallmark sign of a fecal impaction, often mistaken for diarrhea.
6. When measuring the specific gravity of a client's urine, the nurse notes a result of
1.035. This finding indicates that the client is most likely experiencing:
A) Fluid volume excess.
B) Fluid volume deficit (dehydration).
C) Acute kidney injury.
D) Diabetes insipidus.
Elaboration: Normal specific gravity is 1.005 to 1.030. A high specific gravity (>
1.030) indicates highly concentrated urine, which is a compensatory response to
dehydration.
, 7. To prevent catheter-associated urinary tract infections (CAUTIs), the nurse
should ensure the drainage bag is always kept:
A) Placed on the client's bed for easy transport.
B) Below the level of the bladder but not resting on the floor.
C) Emptied only when it is completely full to maintain a closed system.
D) Clamped during patient repositioning.
Elaboration: Keeping the bag below the bladder prevents the backflow (reflux) of
stagnant, potentially contaminated urine into the urinary tract. It should never
touch the floor to prevent environmental contamination.
8. A client is prescribed a loop stoma. The nurse understands that a loop stoma is
typically:
A) Permanent and used for end-stage colorectal cancer.
B) Temporary and created by bringing a loop of bowel to the surface with
an intact posterior wall.
C) Created exclusively in the small intestine (ileostomy).
D) Characterized by two completely separated stomas (proximal and distal).
Elaboration: Loop stomas are usually temporary to rest the bowel distal to the
site (e.g., after surgery or trauma) and are supported by a plastic rod/bridge
initially.
9. A client is experiencing urinary retention with overflow. The provider orders a
post-void residual (PVR) assessment. How should the nurse perform this?
A) Ask the client to void, wait 30 minutes, and insert a straight catheter.
B) Perform a bladder ultrasound scan immediately after the client voids.
C) Measure the client's total urine output for the previous 12 hours.
D) Palpate the suprapubic area before the client voids.
Elaboration: A bladder scanner is the non-invasive, evidence-based gold
standard for measuring PVR. It must be done immediately after voiding to
accurately assess retention.
10. A client complains of cramping during the administration of a tap water enema.
What is the nurse's best initial action?
A) Stop the enema completely and remove the tube.
B) Lower the enema container to slow the rate of infusion.
NURS 3632: Clinical Nursing Foundations | Volume II
100-Question Advanced & Alternate-Format Master Prep (UTA Edition)
Section 1: Bowel and Urinary Elimination
1. The nurse is assessing a new colostomy stoma on a postoperative client. Which
finding requires the nurse to notify the healthcare provider immediately?
A) The stoma is beefy red and moist.
B) The stoma is slightly edematous.
C) The stoma appears dark purple to black.
D) The stoma is oozing a small amount of blood when cleansed.
Elaboration: A dark purple or black stoma indicates ischemia or necrosis due to
compromised blood supply. A healthy stoma should be beefy red and moist.
Slight edema and minor bleeding during initial cleansing are normal
postoperative findings.
2. A client requires the insertion of an indwelling Foley catheter. Which action by the
nursing student requires the preceptor to intervene?
A) Positioning the female client in a dorsal recumbent position with knees flexed.
B) Cleansing the urethral meatus from front to back.
C) Testing the catheter balloon by inflating it with sterile water prior to
insertion.
D) Advancing the catheter 1 to 2 inches further after seeing a flash of urine.
Elaboration: Evidence-based practice guidelines now state that pre-testing the
balloon stretches the silicone, creating ridges that can cause micro-trauma to the
urethra during insertion. It is no longer recommended.
3. A nurse is preparing to administer a large-volume cleansing enema to an adult
client. In which position should the nurse place the client?
A) Right lateral with the right leg extended.
B) Left lateral (Sims') position with the right knee flexed.
C) Supine with the head of the bed elevated 45 degrees.
D) Prone with knees bent.
,Elaboration: The left lateral Sims' position aligns with the natural anatomical
curve of the descending colon and sigmoid colon, allowing gravity to facilitate
the flow of the enema solution deeper into the bowel.
4. (Select All That Apply) The nurse is initiating a 24-hour urine collection for a
client. Which of the following steps must the nurse include in the procedure?
A) Discard the very first voided urine specimen.
B) Keep the collection container on ice or in a designated refrigerator.
C) Ask the client to double-void before starting the collection.
D) Restart the entire test if any urine is accidentally flushed down the toilet.
E) Collect the urine directly from the indwelling catheter bag every 4 hours.
Elaboration: A 24-hour collection must start with an empty bladder (discard the
first void). All subsequent voids must be kept cold to prevent bacterial growth
and chemical breakdown. If a void is missed, the entire 24-hour cycle is invalid
and must be restarted.
5. A client with chronic constipation reports passing small amounts of liquid,
diarrheal stool over the past 24 hours. The nurse suspects which of the
following?
A) Clostridioides difficile infection.
B) Crohn's disease exacerbation.
C) Fecal impaction.
D) Paralytic ileus.
Elaboration: Liquid stool seeping around a hardened mass of stool in the rectum
is the hallmark sign of a fecal impaction, often mistaken for diarrhea.
6. When measuring the specific gravity of a client's urine, the nurse notes a result of
1.035. This finding indicates that the client is most likely experiencing:
A) Fluid volume excess.
B) Fluid volume deficit (dehydration).
C) Acute kidney injury.
D) Diabetes insipidus.
Elaboration: Normal specific gravity is 1.005 to 1.030. A high specific gravity (>
1.030) indicates highly concentrated urine, which is a compensatory response to
dehydration.
, 7. To prevent catheter-associated urinary tract infections (CAUTIs), the nurse
should ensure the drainage bag is always kept:
A) Placed on the client's bed for easy transport.
B) Below the level of the bladder but not resting on the floor.
C) Emptied only when it is completely full to maintain a closed system.
D) Clamped during patient repositioning.
Elaboration: Keeping the bag below the bladder prevents the backflow (reflux) of
stagnant, potentially contaminated urine into the urinary tract. It should never
touch the floor to prevent environmental contamination.
8. A client is prescribed a loop stoma. The nurse understands that a loop stoma is
typically:
A) Permanent and used for end-stage colorectal cancer.
B) Temporary and created by bringing a loop of bowel to the surface with
an intact posterior wall.
C) Created exclusively in the small intestine (ileostomy).
D) Characterized by two completely separated stomas (proximal and distal).
Elaboration: Loop stomas are usually temporary to rest the bowel distal to the
site (e.g., after surgery or trauma) and are supported by a plastic rod/bridge
initially.
9. A client is experiencing urinary retention with overflow. The provider orders a
post-void residual (PVR) assessment. How should the nurse perform this?
A) Ask the client to void, wait 30 minutes, and insert a straight catheter.
B) Perform a bladder ultrasound scan immediately after the client voids.
C) Measure the client's total urine output for the previous 12 hours.
D) Palpate the suprapubic area before the client voids.
Elaboration: A bladder scanner is the non-invasive, evidence-based gold
standard for measuring PVR. It must be done immediately after voiding to
accurately assess retention.
10. A client complains of cramping during the administration of a tap water enema.
What is the nurse's best initial action?
A) Stop the enema completely and remove the tube.
B) Lower the enema container to slow the rate of infusion.
