NCLEX-RN · Question #75
A 74-year-old female client is 3 days postoperative. She has an indwelling catheter and has been progressing well. While the nurse is in the room, the client states, "Oh dear, I feel like I have to…
The correct answer is B. Check the collection bag and tubing to verify that the catheter is draining properly. (A) Although this may be an appropriate response, the initial response would be to assure the patency of the catheter. (B) The most frequent reason for an urge to void with an indwelling catheter is blocked tubing. This response would be the best initial response. (C) Kegel…
Question
A 74-year-old female client is 3 days postoperative. She has an indwelling catheter and has been progressing well. While the nurse is in the room, the client states, "Oh dear, I feel like I have to urinate again!" Which of the following is the most appropriate initial nursing response?
Options
- AAssure her that this is most likely the result of bladder spasms.
- BCheck the collection bag and tubing to verify that the catheter is draining properly.
- CInstruct her to do Kegel exercises to diminish the urge to void.
- DAsk her if she has felt this way before.
How the community answered
(22 responses)- A9% (2)
- B86% (19)
- C5% (1)
Explanation
(A) Although this may be an appropriate response, the initial response would be to assure the patency of the catheter. (B) The most frequent reason for an urge to void with an indwelling catheter is blocked tubing. This response would be the best initial response. (C) Kegel exercises while a retention catheter is in place would not help to prevent a voiding urge and could irritate the urethral sphincter. (D) Though the nurse would want to ascertain whether the client has felt the same urge to void before, the initial response should be to assure the patency of the catheter.
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