A nurse is providing discharge instructions about clean intermittent self-catheterization to a patient who has benign prostatic hyperplasia.
Which of the following instructions should the nurse include?
“Use soap and water to clean the catheter after each use.”.
“Hold the penis at a 30 to 45-degree angle when inserting the catheter.”.
“Perform catheterization when you feel the urge to void.”.
“Inflate the balloon when the urine flow stops.”.
The Correct Answer is A
Choice A rationale
Cleaning the catheter after each use with soap and water is a crucial step in preventing infection during self-catheterization.
Choice B rationale
The angle at which the penis should be held during catheter insertion can vary, but a 30 to 45- degree angle is not typically recommended.
Choice C rationale
Performing catheterization when feeling the urge to void is not typically part of the instructions for clean intermittent self-catheterization.
Choice D rationale
Inflating the balloon when the urine flow stops is not a step in clean intermittent self- catheterization. This step is associated with indwelling catheters, not intermittent catheters.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Amoxicillin-clavulanate is a type of antibiotic that falls under the class of penicillin antibiotics. If a patient is allergic to penicillin, they should not take amoxicillin as it belongs to the penicillin class of antibiotics and must be avoided. Therefore, if a nurse is caring for a child who is allergic to penicillin, they should verify a prescription for amoxicillin-clavulanate with the provider.
Choice B rationale
Gentamicin is an aminoglycoside antibiotic, not a penicillin antibiotic. Therefore, it is generally safe for use in patients with a penicillin allergy.
Choice C rationale
Erythromycin is a macrolide antibiotic, not a penicillin antibiotic. Therefore, it is generally safe for use in patients with a penicillin allergy.
Choice D rationale
Amphotericin B is an antifungal medication, not an antibiotic. Therefore, it is generally safe for use in patients with a penicillin allergy.
Correct Answer is C
Explanation
Choice A rationale
Swabbing an area of skin away from the wound to identify the usual flora is not the correct action. This would not provide a representative sample of the wound infection.
Choice B rationale
Irrigating the wound with an antiseptic prior to obtaining the specimen is not the correct action. This could potentially alter the results of the culture.
Choice C rationale
Cleansing the wound with 0.9% sodium chloride saline irrigation before obtaining the specimen is the correct action. This helps to remove surface bacteria and ensures a more accurate culture result.
Choice D rationale
Including intact skin at the wound edges in the culture is not the correct action. This could contaminate the specimen with bacteria that are not part of the wound infection.
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