A nurse is preparing to insert an indwelling urinary catheter for a client. Which of the following actions should the nurse plan take?

Use one cotton swab to clean the client's urinary meatus.

Don sterile gloves before inserting the indwelling urinary catheter.

Test the balloon on the indwelling urinary catheter before insertion.

Apply an oil-based lubricant to the indwelling urinary catheter.

Answer and Explanation

The Correct Answer is B

A. Use one cotton swab to clean the client's urinary meatus: Multiple cotton swabs should be used to clean in a systematic manner to maintain asepsis.

B. Don sterile gloves before inserting the indwelling urinary catheter. Sterile technique is essential to prevent urinary tract infections (UTIs) during catheter insertion.

C. Test the balloon on the indwelling urinary catheter before insertion: Pretesting the balloon is unnecessary and may compromise sterility or damage the balloon.

D. Apply an oil-based lubricant to the indwelling urinary catheter: Only water-based lubricants should be used to prevent catheter damage or client harm.

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Correct Answer is D

Explanation

A. "Consume a low-fiber diet.": A high-fiber diet is recommended to promote bowel regularity.

B. "Reduce your daily activity.": Physical activity stimulates intestinal motility and reduces constipation.

C. "Try to defecate at different times of the day.": Consistency in bowel habits is essential for regulating elimination.

D. "Increase your daily fluid intake.": Adequate hydration softens stools and facilitates bowel movements, essential for managing constipation.

A. Obtain a prescription to check the client's glucose level. B. Obtain a prescription for supplemental oxygen. C. Obtain a prescription to administer intravenous fluids. D. Obtain a prescription to administer insulin.

Correct Answer is B

Explanation

A. Obtain a prescription to check the client's glucose level: Incorrect. While glucose monitoring is essential, addressing hypoxia takes precedence.

B. Obtain a prescription for supplemental oxygen: Hypoxia is life-threatening and must be addressed first to restore oxygenation and prevent further complications. The priority aligns with the Airway, Breathing, Circulation (ABC) framework.

C. Obtain a prescription to administer intravenous fluids: Incorrect. IV fluids are critical for DKA management, but oxygenation is a higher priority if hypoxia is present.

D. Obtain a prescription to administer insulin: Incorrect. Insulin is necessary to correct hyperglycemia in DKA but is not the immediate priority over addressing hypoxia.

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A nurse is preparing to insert an indwelling urinary catheter for a client. Which of the following actions should the nurse plan take?

Nursing Test Bank

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