NORCET Nursing Foundation – Catheterization & Enema

Test 01 • 50 MCQs • 50 Marks • 30 Minutes

Conceptual + Clinical + Case-Based + Scenario-Based Questions

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Q1. What is the primary purpose of an indwelling urinary catheter?

A. To provide continuous drainage of urine from the bladder B. To increase urine production C. To prevent all urinary infections D. To replace oral fluids

Answer: A. To provide continuous drainage of urine from the bladder
An indwelling urinary catheter remains in the bladder and provides continuous urine drainage into a collection system.

Q2. Which catheter is designed to remain in the bladder because it has an inflatable balloon?

A. Foley catheter B. Straight catheter C. Suction catheter D. Rectal catheter

Answer: A. Foley catheter
A Foley catheter is an indwelling urinary catheter that uses a balloon to help keep the catheter in the bladder.

Q3. Which catheterization technique involves inserting a catheter, draining the bladder, and then removing the catheter?

A. Intermittent catheterization B. Continuous catheterization C. Suprapubic drainage only D. External drainage

Answer: A. Intermittent catheterization
Intermittent catheterization provides temporary bladder drainage and the catheter is removed after the bladder has been emptied.

Q4. What is the most important principle for preventing catheter-associated urinary tract infection (CAUTI)?

A. Use a catheter only when clinically indicated and remove it as soon as appropriate B. Irrigate every catheter routinely C. Disconnect the drainage system frequently D. Keep the catheter in place indefinitely

Answer: A. Use a catheter only when clinically indicated and remove it as soon as appropriate
Limiting unnecessary catheter use and duration is a key CAUTI prevention strategy.

Q5. During urinary catheterization, which technique is essential for inserting an indwelling catheter?

A. Aseptic technique according to institutional policy B. Clean technique without hand hygiene C. Touching the sterile catheter with bare hands D. Reusing disposable equipment

Answer: A. Aseptic technique according to institutional policy
Urinary catheter insertion requires appropriate hand hygiene and aseptic/sterile technique according to the setting and policy.

Q6. Where should the urinary drainage bag be positioned?

A. Above the patient's bladder B. Below the level of the bladder C. On the patient's abdomen D. On the bed above the patient

Answer: B. Below the level of the bladder
The drainage bag should remain below bladder level to promote gravity drainage and reduce the risk of backflow.

Q7. Which action should be avoided when caring for an indwelling urinary catheter?

A. Maintaining a closed drainage system B. Allowing the drainage tubing to become kinked C. Keeping the bag below bladder level D. Performing appropriate catheter hygiene

Answer: B. Allowing the drainage tubing to become kinked
Kinking can obstruct urine flow and contribute to bladder distension and other complications.

Q8. A patient with a Foley catheter reports lower abdominal discomfort and the drainage bag contains very little urine. What should the nurse assess first?

A. Whether the tubing is kinked or obstructed B. The patient's appetite C. The patient's hearing D. The patient's sleep pattern

Answer: A. Whether the tubing is kinked or obstructed
Reduced drainage with bladder discomfort may indicate an obstruction or other problem. Check the system and assess the patient promptly.

Q9. Which method is preferred for collecting a sterile urine specimen from a patient with an indwelling catheter?

A. Collect from the drainage bag B. Use the catheter sampling port using aseptic technique C. Pour urine from the floor D. Disconnect the catheter from the tubing

Answer: B. Use the catheter sampling port using aseptic technique
When a specimen is required from an indwelling catheter, the sampling port is used according to facility protocol rather than obtaining the sample from the drainage bag.

Q10. Which finding may indicate a possible catheter-associated urinary tract infection?

A. Fever and new urinary symptoms B. Clear tubing C. Urine flowing freely D. Bag below bladder level

Answer: A. Fever and new urinary symptoms
Fever, suprapubic discomfort, altered mental status in selected patients and other clinical findings may suggest infection and require assessment.

Q11. What is the purpose of securing an indwelling urinary catheter?

A. To prevent unnecessary traction and urethral injury B. To increase urine production C. To block urine flow D. To keep the patient immobile

Answer: A. To prevent unnecessary traction and urethral injury
Proper securement reduces catheter movement and traction, improving patient comfort and reducing injury risk.

Q12. A male patient is undergoing urethral catheterization. Which principle is correct?

A. Use appropriate aseptic technique and adequate lubrication B. Force the catheter if resistance occurs C. Skip cleansing D. Inflate the balloon before urine return

Answer: A. Use appropriate aseptic technique and adequate lubrication
Lubrication helps reduce trauma and discomfort. Resistance should never be overcome by force.

Q13. If resistance is encountered during urinary catheter insertion, what should the nurse do?

A. Force the catheter through the resistance B. Stop and follow appropriate clinical protocol or seek assistance C. Inflate the balloon immediately D. Rotate forcefully

Answer: B. Stop and follow appropriate clinical protocol or seek assistance
Forcing a catheter can cause urethral trauma. Resistance should be handled carefully and according to clinical policy.

Q14. Which finding should be reported after urinary catheter insertion?

A. Severe pain or significant bleeding B. Normal urine drainage C. Comfortable patient D. Secure catheter

Answer: A. Severe pain or significant bleeding
Severe pain or significant bleeding may indicate trauma or another complication and requires prompt assessment.

Q15. Which statement about catheter size is correct?

A. The largest possible catheter should always be used B. The smallest appropriate catheter size should generally be selected C. Size does not matter D. Only pediatric sizes should be used

Answer: B. The smallest appropriate catheter size should generally be selected
Using the smallest appropriate catheter can reduce urethral trauma and irritation while still providing adequate drainage.

Q16. What is the main purpose of catheter balloon inflation?

A. To keep the indwelling catheter in the bladder B. To increase urine production C. To sterilize the bladder D. To prevent all bladder spasms

Answer: A. To keep the indwelling catheter in the bladder
The retention balloon helps prevent the catheter from being accidentally withdrawn from the bladder.

Q17. When should the balloon of a Foley catheter normally be inflated during insertion?

A. Before the catheter enters the urethra B. After appropriate catheter placement and urine return, according to the device instructions C. Before cleansing D. Immediately after opening the package

Answer: B. After appropriate catheter placement and urine return, according to the device instructions
Inflating the balloon before the catheter is correctly positioned can cause urethral injury.

Q18. Which practice helps maintain a closed urinary drainage system?

A. Disconnect the tubing every shift B. Avoid unnecessary disconnections C. Leave the connection open D. Empty urine onto the floor

Answer: B. Avoid unnecessary disconnections
Maintaining a closed drainage system reduces opportunities for microorganisms to enter the system.

Q19. A patient with an indwelling catheter asks why the drainage bag cannot be placed on the bed beside the bladder. What is the best explanation?

A. It can allow urine to flow backward toward the bladder B. It increases appetite C. It prevents urination completely D. It increases body temperature

Answer: A. It can allow urine to flow backward toward the bladder
The drainage bag should be below bladder level to facilitate gravity drainage and reduce backflow.

Q20. Which intervention is appropriate for routine catheter care?

A. Routine hygiene around the urethral opening and catheter B. Aggressive scrubbing every hour C. Disconnecting the system daily D. Applying antibiotics routinely without indication

Answer: A. Routine hygiene around the urethral opening and catheter
Routine hygiene and appropriate catheter care are important. Routine antimicrobial cleansing or prophylactic antibiotics are not generally indicated without a specific clinical reason.

Q21. What is an enema?

A. Introduction of fluid into the rectum and lower bowel B. Introduction of fluid into the bladder C. Injection into a vein D. Oral administration of medication

Answer: A. Introduction of fluid into the rectum and lower bowel
An enema involves introducing a solution into the rectum, usually for therapeutic, cleansing or diagnostic purposes.

Q22. Which type of enema is primarily used to soften hard stool?

A. Oil-retention enema B. Cleansing enema C. Carminative enema D. Diagnostic enema only

Answer: A. Oil-retention enema
Oil-retention enemas can soften hardened stool and lubricate the rectum, facilitating evacuation.

Q23. What is the primary purpose of a cleansing enema?

A. To stimulate bowel evacuation and clear the lower bowel B. To increase blood pressure C. To treat urinary retention D. To administer oxygen

Answer: A. To stimulate bowel evacuation and clear the lower bowel
Cleansing enemas are commonly used to stimulate defecation and clear fecal material from the rectum and lower colon.

Q24. Which position is commonly used for administering an enema to an adult patient?

A. Left lateral Sims' position B. Standing position C. Lithotomy only D. Prone with legs extended

Answer: A. Left lateral Sims' position
The left lateral Sims' position follows the natural direction of the sigmoid and descending colon and is commonly used for enema administration.

Q25. Why is the left lateral position commonly used for an enema?

A. It follows the anatomical direction of the lower colon B. It increases urinary output C. It prevents all abdominal pain D. It is required for every rectal procedure

Answer: A. It follows the anatomical direction of the lower colon
The left lateral position facilitates movement of the solution along the descending and sigmoid colon.

Q26. Which lubricant should be used before inserting an enema rectal tube?

A. Water-soluble lubricant B. Concentrated antiseptic solution C. Powder D. Alcohol

Answer: A. Water-soluble lubricant
Water-soluble lubricant helps reduce friction, discomfort and mucosal trauma during rectal insertion.

Q27. A patient experiences severe abdominal pain while an enema is being administered. What should the nurse do first?

A. Continue rapidly B. Stop the administration and assess the patient C. Increase the height of the solution container D. Force the tube deeper

Answer: B. Stop the administration and assess the patient
Severe pain may indicate intolerance, excessive pressure or another complication. The procedure should be stopped and the patient assessed.

Q28. What may happen if an enema solution is administered too rapidly?

A. Abdominal cramping and discomfort B. Immediate cure of constipation C. Increased hearing D. Increased visual acuity

Answer: A. Abdominal cramping and discomfort
Rapid instillation can cause bowel distension, cramping and discomfort. The solution should be administered at an appropriate rate.

Q29. A patient repeatedly asks to stop during an enema because of mild cramping. What should the nurse do?

A. Assess the patient and slow or temporarily stop the flow as appropriate B. Force the entire solution rapidly C. Ignore the patient D. Increase the solution pressure

Answer: A. Assess the patient and slow or temporarily stop the flow as appropriate
Mild cramping can occur, but patient tolerance must be monitored and the flow adjusted according to the situation and clinical protocol.

Q30. Which finding after an enema requires prompt attention?

A. Severe abdominal pain or rectal bleeding B. Normal bowel movement C. Mild temporary fullness D. Patient reports relief

Answer: A. Severe abdominal pain or rectal bleeding
Severe pain or bleeding may indicate trauma or another complication and requires prompt assessment.

Q31. Which type of enema may be used to relieve intestinal gas?

A. Carminative enema B. Oil-retention enema only C. Medication-free urinary catheter D. Suction enema

Answer: A. Carminative enema
Carminative enemas have historically been used to help relieve intestinal gas and abdominal distension.

Q32. Which patient should receive additional assessment before an enema is administered?

A. A patient with suspected bowel obstruction B. A patient with uncomplicated constipation and a valid order C. A stable patient awaiting routine bowel care D. A patient with normal bowel function

Answer: A. A patient with suspected bowel obstruction
Enemas may be contraindicated in suspected bowel obstruction and certain acute abdominal conditions. The patient must be assessed before administration.

Q33. A patient has severe abdominal distension, vomiting and suspected intestinal obstruction. What should the nurse do regarding an ordered enema?

A. Administer it immediately without assessment B. Hold the procedure and notify the appropriate healthcare professional C. Double the volume D. Use maximum pressure

Answer: B. Hold the procedure and notify the appropriate healthcare professional
Suspected bowel obstruction requires medical evaluation. An enema may be unsafe in this situation.

Q34. Which patient position is generally avoided during an enema because it can make administration more difficult and uncomfortable?

A. Standing upright B. Left lateral Sims' position C. Appropriate lateral position D. Side-lying position

Answer: A. Standing upright
For a standard adult enema, a lateral position provides better access and promotes comfortable administration.

Q35. A nurse is preparing to administer an enema. Which action should be performed before insertion of the rectal tube?

A. Explain the procedure, provide privacy and position the patient appropriately B. Insert the tube without explanation C. Remove all bed linens D. Ask the patient to stand on the bed

Answer: A. Explain the procedure, provide privacy and position the patient appropriately
Patient education, privacy, dignity and correct positioning are essential components of safe nursing care.

Q36. Which nursing action helps prevent injury during rectal tube insertion?

A. Never force the tube against resistance B. Insert rapidly with force C. Avoid lubrication D. Use maximum pressure

Answer: A. Never force the tube against resistance
Gentle technique, adequate lubrication and stopping when significant resistance or pain occurs reduce the risk of rectal injury.

Q37. Which assessment is important before administering an enema?

A. Bowel pattern, abdominal assessment and relevant contraindications B. Hair color only C. Visual acuity only D. Hearing only

Answer: A. Bowel pattern, abdominal assessment and relevant contraindications
Assessment helps determine whether an enema is appropriate and identifies possible complications or contraindications.

Q38. A patient has chronic constipation and asks for an enema every day. What is the nurse's best response?

A. Daily enemas are always harmless B. Frequent enemas may have risks, so the cause and bowel-management plan should be evaluated C. Use the largest volume available D. Ignore the request

Answer: B. Frequent enemas may have risks, so the cause and bowel-management plan should be evaluated
Chronic constipation should be assessed for underlying causes and managed using an appropriate bowel regimen rather than relying on frequent enemas without evaluation.

Q39. Which complication can occur with repeated or inappropriate use of some enemas?

A. Fluid or electrolyte disturbances B. Improved kidney function in every patient C. Permanent prevention of constipation D. Increased bone density

Answer: A. Fluid or electrolyte disturbances
Some enema solutions can affect fluid and electrolyte balance, particularly when used excessively or in vulnerable patients.

Q40. A patient with severe renal impairment is prescribed an enema. What is the nurse's priority?

A. Check the type of enema and consider the patient's renal status before administration B. Administer any enema without assessment C. Double the dose D. Repeat the enema automatically

Answer: A. Check the type of enema and consider the patient's renal status before administration
Certain enemas, particularly phosphate-containing products, may pose electrolyte risks in patients with renal impairment. Appropriate clinical guidance is essential.

Q41. Which finding is expected after a successful cleansing enema?

A. Passage of stool and/or solution B. Severe persistent abdominal pain C. Heavy rectal bleeding D. Loss of consciousness

Answer: A. Passage of stool and/or solution
The expected therapeutic response is bowel evacuation. Severe pain, bleeding or systemic deterioration would require further assessment.

Q42. Which action is appropriate after administering an enema?

A. Provide hygiene, assess the response and document appropriately B. Leave the patient without assistance C. Ignore the bowel movement D. Immediately repeat the procedure

Answer: A. Provide hygiene, assess the response and document appropriately
Post-procedure care includes patient hygiene, assessment of results and documentation of the procedure and response.

Q43. A patient with an indwelling catheter is being transported. Which action is correct?

A. Keep the drainage bag below bladder level and prevent tubing kinks B. Place the bag on the patient's chest C. Disconnect the catheter routinely D. Allow the tubing to drag on the floor

Answer: A. Keep the drainage bag below bladder level and prevent tubing kinks
Maintaining dependent drainage and protecting the closed system are important during transportation.

Q44. A patient with a Foley catheter accidentally pulls on the catheter and develops bleeding. What is the nurse's priority?

A. Assess the patient and catheter, and report significant bleeding promptly B. Pull the catheter out forcefully C. Ignore the bleeding D. Inflate the balloon further without assessment

Answer: A. Assess the patient and catheter, and report significant bleeding promptly
Traction can cause urethral injury. Bleeding requires assessment and appropriate clinical intervention.

Q45. Which statement about urinary catheter removal is correct?

A. The retention balloon should be completely deflated before removal B. The catheter should be pulled out with the balloon inflated C. The drainage tubing should be cut routinely D. Removal never requires assessment

Answer: A. The retention balloon should be completely deflated before removal
The balloon must be fully deflated before gently removing an indwelling catheter to prevent urethral trauma.

Q46. After urinary catheter removal, which finding should the nurse monitor?

A. Ability to void and signs of urinary retention B. Hair growth C. Visual acuity D. Appetite only

Answer: A. Ability to void and signs of urinary retention
After catheter removal, monitoring for spontaneous urination and urinary retention is important.

Q47. A patient has not voided several hours after catheter removal and reports suprapubic discomfort. What should the nurse do?

A. Assess for urinary retention and follow the clinical protocol B. Ignore the symptoms C. Give an enema automatically D. Encourage the patient to wait indefinitely

Answer: A. Assess for urinary retention and follow the clinical protocol
Failure to void with suprapubic discomfort may indicate urinary retention and requires timely assessment.

Q48. Which patient has the highest priority for assessment before routine catheterization?

A. A patient with suspected urethral injury after pelvic trauma B. A stable patient with a documented indication C. A patient requesting routine hygiene D. A patient with normal urinary function

Answer: A. A patient with suspected urethral injury after pelvic trauma
Urethral injury must be considered after certain pelvic trauma. Catheterization may be contraindicated until appropriate evaluation is completed.

Q49. A nurse is caring for a patient with a catheter who is confused and repeatedly pulls at the tubing. Which intervention is most appropriate?

A. Secure the catheter appropriately, protect the tubing and address the cause of agitation B. Tie the catheter tightly to the bed rail C. Ignore the behavior D. Remove the drainage bag

Answer: A. Secure the catheter appropriately, protect the tubing and address the cause of agitation
Safe catheter securement, environmental measures and assessment of the patient's underlying needs help prevent accidental removal and injury.

Q50. A postoperative patient has an indwelling catheter. The urine output suddenly stops, the patient develops suprapubic discomfort, and the tubing appears kinked. What is the nurse's best initial action?

A. Check and correct the tubing obstruction while assessing the patient B. Immediately remove the catheter C. Clamp the catheter D. Place the drainage bag above the bladder

Answer: A. Check and correct the tubing obstruction while assessing the patient
A kinked tube can obstruct drainage and cause bladder discomfort. The system should be checked and corrected promptly while the patient's condition is assessed.

NORCET Exams Preparation Series - Day 3 ( Catheterization and Enema )