College Exams & Notes

Master your nursing exams with comprehensive practice questions and detailed explanations

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QUESTION #1
Fundamentals of Nursing Exam 2 Fundamentals
Which nursing intervention would be the highest priority when caring for a patient complaining of voiding small amounts of urine in relation to his fluid intake?
A Placing a disposable waterproof pad on the patient’s bed before he goes to sleep.
B Documenting in the patient’s electronic health record that he is complaining of anuria.
C Notifying the patient’s primary care provider (PCP) of the need for intermittent catheterization.
D Palpating the patient’s bladder for distention before scanning for possible retention.

Explanations

A
This is a comfort and safety measure but does not assess or address the underlying cause of decreased urine output. Priority should be given to assessment first.
B
The patient is voiding small amounts, not anuria, so this documentation would be inaccurate. Assessment must occur before labeling or documenting a diagnosis.
C
Catheterization is an invasive intervention and should not be initiated without first assessing for urinary retention. Nursing assessment comes before provider notification.
D
Bladder palpation is a quick, noninvasive assessment that helps determine urinary retention. This guides the need for further evaluation, such as bladder scanning.
When urine output is low, always assess for urinary retention before taking action. On exams, prioritize assessment before intervention, especially noninvasive measures like bladder palpation and scanning.
QUESTION #2
Fundamentals of Nursing Exam 2 Fundamentals
The nurse is placing an indwelling catheter in a female patient. The nurse accidentally inserts the catheter into the vagina. What is the next action for the nurse to implement?
A Collect a urine specimen and notify the primary care provider (PCP).
B Leave the catheter in place and insert a new catheter into the urethra.
C Remove the catheter from the vagina and place it into the urethra.
D Ask another nurse to attempt the catheterization of the patient.

Explanations

A
No urine specimen can be obtained from a catheter placed in the vagina, and provider notification is unnecessary for this common procedural error. Immediate corrective nursing action is required instead.
B
Leaving the misplaced catheter in the vagina acts as a landmark to help identify the urethral opening. A new sterile catheter must be used to maintain aseptic technique and prevent infection.
C
Once the catheter has touched the vaginal area, it is contaminated and cannot be reused. Reinserting it would increase the risk of urinary tract infection.
D
Another nurse is not required unless repeated attempts fail. The priority is to correct the error using proper sterile technique.
If a catheter is mistakenly placed in the vagina, never reuse it in the urethra due to contamination. On exams, remember to leave it in place as a landmark and insert a new sterile catheter.
QUESTION #3
Fundamentals of Nursing Exam 2 Fundamentals
The nurse is assessing a patient with an indwelling catheter and finds that the catheter is not draining and that the patient’s bladder is distended. What action should the nurse take next?
A Notify the primary care provider.
B Assess the tubing for kinks and ensure downward flow.
C Change the catheter as soon as possible.
D Aspirate the stagnant urine in the catheter for culture.

Explanations

A
The nurse should first perform independent nursing assessments and interventions. Provider notification is appropriate only if the problem cannot be resolved.
B
Catheter obstruction is often caused by kinks, dependent loops, or the drainage bag being positioned too high. Correcting these issues can immediately restore urine flow and relieve bladder distention.
C
Catheter replacement is invasive and increases infection risk, and it is not indicated until simpler causes of obstruction are ruled out. Assessment must come first.
D
Aspirating urine does not relieve bladder distention and is not appropriate unless a culture is specifically ordered. This action delays correction of the obstruction.
When a catheter is not draining, always assess the system before taking invasive action. On exams, think kinks, gravity, and bag position first before changing the catheter or calling the provider.
QUESTION #4
Fundamentals of Nursing Exam 2 Fundamentals
An indwelling catheter is ordered for a postoperative patient who is unable to void. What is the priority concern of the nurse performing the procedure?
A Teaching deep-breathing techniques
B Maintaining strict aseptic technique
C Medicating the patient for pain before the procedure
D Positioning the patient for comfort during the procedure

Explanations

A
Deep breathing may help reduce anxiety, but it does not address the primary safety risk of catheter insertion. Infection prevention takes priority.
B
Indwelling catheter insertion is an invasive procedure that places the patient at high risk for urinary tract infection. Strict aseptic technique is the most critical priority to prevent contamination.
C
Pain management is important but does not outweigh the need to prevent infection. Medication can be considered after ensuring safe sterile technique.
D
Proper positioning supports comfort and access, but it is secondary to maintaining sterility. Comfort measures do not supersede infection control.
Any invasive urinary procedure carries a significant risk for infection if sterile technique is broken. On exams, aseptic technique is always the top priority when inserting an indwelling catheter.
QUESTION #5
Fundamentals of Nursing Exam 2 Fundamentals
What self-care measure is most important for the nurse to include when developing a teaching plan for a patient who will be discharged with a urostomy?
A Change the appliance before going to bed.
B Cut the wafer 1 inch larger than the stoma.
C Cleanse the peristomal skin with mild soap and water.
D Use firm pressure to attach the wafer to the skin.

Explanations

A
Changing the appliance at bedtime increases the risk of leakage because urine output continues during sleep. Appliance changes are best done when urine output is lowest, such as in the morning.
B
The wafer should fit closely around the stoma to protect the surrounding skin. Cutting it too large exposes skin to urine and increases the risk of irritation and breakdown.
C
Gentle cleansing removes urine residue and protects skin integrity without causing irritation. This is a foundational self-care practice for preventing peristomal skin complications.
D
Excessive pressure can damage fragile peristomal skin. Gentle, even pressure is sufficient to ensure adhesion without causing injury.
Urostomy care prioritizes protecting the skin from constant exposure to urine. On exams, choose interventions that maintain peristomal skin integrity, especially gentle cleansing with mild soap and water.
QUESTION #6
Fundamentals of Nursing Exam 2 Fundamentals
A patient is scheduled for an intravenous pyelogram (IVP). Which piece of data would be most important to know before the procedure is carried out?
A Urinalysis negative for sugar and acetone
B History of allergies
C History of a recent thyroid scan
D Frequency of urination

Explanations

A
While useful for overall kidney assessment, this information does not determine immediate safety for an IVP. It is not the priority preprocedure concern.
B
IVP requires iodinated contrast dye, which can cause severe allergic reactions in sensitive patients. Identifying allergies, especially to iodine or shellfish, is critical for patient safety.
C
A recent thyroid scan may be relevant due to iodine exposure, but it does not pose the most immediate risk compared with a potential allergic reaction. This is secondary information.
D
Urinary frequency provides baseline urinary function data but does not affect the immediate safety of administering contrast dye. It is not a priority assessment before the procedure.
Before any diagnostic test using contrast dye, always assess for allergies because reactions can be life-threatening. On exams, contrast procedures like IVP, CT with contrast, and angiography almost always point to checking allergy history first.
QUESTION #7
Fundamentals of Nursing Exam 2 Fundamentals
A female patient has had frequent urinary tract infections. Which statement by the patient indicates that the nurse’s teaching on prevention has been effective?
A “I will limit my fluid intake to 40 ounces per day.”
B “I will use only organic bath bombs when bathing.”
C “I will wait to wear my tight jeans until after my urine is clear.”
D “I will wipe from the front to back after voiding.”

Explanations

A
Limiting fluids increases urine concentration and bacterial growth, which raises the risk of UTIs. Adequate hydration helps flush bacteria from the urinary tract.
B
Bath products, even organic ones, can irritate the urethra and increase infection risk. Avoiding bath additives altogether is the recommended teaching.
C
Tight clothing can trap moisture and increase bacterial growth, but delaying use temporarily does not address long-term prevention. This choice shows incomplete understanding.
D
Wiping front to back prevents fecal bacteria from entering the urethra. This is a key and effective strategy for preventing recurrent UTIs.
UTI prevention focuses on reducing bacterial transfer to the urethra and promoting urine flow. On exams, front-to-back wiping, increased fluids, and avoiding irritants are classic correct teaching cues.
QUESTION #8
Fundamentals of Nursing Exam 2 Fundamentals
Which nursing instruction is correct when a urine specimen is collected for culture and sensitivity testing from a patient without a urinary catheter?
A Tell the patient to void and pour the urine into a labeled specimen container.
B Ask the patient to void first into the toilet, stop midstream, and finish voiding into the sterile specimen container.
C Instruct the patient to discard the first void and collect the next void for the specimen.
D Have the patient keep all voided urine for 24 hours in a chilled, opaque collection container.

Explanations

A
Pouring urine increases the risk of contamination from the skin or collection device. A sterile specimen must be collected directly into the container.
B
A midstream clean-catch specimen reduces contamination from urethral flora. This method provides the most accurate results for culture and sensitivity testing.
C
Discarding an entire void does not ensure a sterile midstream sample. This instruction is not appropriate for culture collection.
D
This describes a 24-hour urine collection, which is used for metabolic testing, not for culture and sensitivity. It would invalidate culture results.
For urine culture and sensitivity testing, always think midstream clean-catch to minimize contamination. On exams, sterile technique and midstream collection are key cues that point to the correct answer.
QUESTION #9
Fundamentals of Nursing Exam 2 Fundamentals
A patient with an indwelling catheter reports a need to void. What is the priority intervention for the nurse to perform?
A Check to see if the catheter is patent.
B Reassure the patient that it is not possible to void while catheterized.
C Catheterize the patient again with a larger gauge catheter.
D Notify the primary care provider.

Explanations

A
A sensation of needing to void may indicate catheter obstruction, kinking, or inadequate drainage. Assessing catheter patency is the priority to relieve discomfort and prevent bladder distention.
B
Patients can still feel bladder fullness or urgency if urine is not draining properly. Reassurance without assessment ignores a potential problem.
C
Recatheterization is not the first-line action and increases the risk of infection and trauma. The nurse should assess the current catheter before considering replacement.
D
The nurse should perform independent assessment and basic interventions first. Provider notification is appropriate only if the problem cannot be resolved.
When a patient with a urinary catheter reports discomfort or urgency, always assess the system first for kinks, blockage, or lack of urine flow. On exams, prioritize simple nursing assessments before invasive actions or notifying the provider.
QUESTION #10
Fundamentals of Nursing Exam 2 Fundamentals
A patient is experiencing diarrhea. After patient education which behavior by the patient shows that the teaching was effective?
A Limiting fluid intake to 1000 mL/day
B Administering a cathartic suppository
C Increasing fiber in the diet
D Limiting exercise

Explanations

A
Diarrhea causes fluid loss, and restricting fluids increases the risk of dehydration. Adequate fluid intake is essential during diarrhea.
B
Cathartics stimulate bowel movements and would worsen diarrhea. This action directly contradicts appropriate management.
C
Soluble fiber helps absorb excess water in the intestines and can improve stool consistency. This behavior reflects correct understanding of dietary management for diarrhea.
D
Exercise does not significantly worsen diarrhea and is not a primary focus of diarrhea management. This action does not address the underlying problem.
Diarrhea management focuses on maintaining hydration and improving stool consistency. On exams, increasing soluble fiber and fluids are correct strategies, while cathartics and fluid restriction are red flags.