Urinary Catheters, Devices, and Special Populations Practice Questions

25 multiple-choice questions on Urinary catheters, devices, and special populations for paramedic and EMT students, from Chapter 22 (Genitourinary and Renal Emergencies). Read each question, pick your answer, then tap Show answer to check it and read the explanation.

25 practice questions

1. An indwelling (Foley) catheter is held in the bladder by:

   1. A. A suture in the skin
   2. B. An inflated balloon
   3. C. Adhesive tape on the thigh
   4. D. A clamp on the tubing
   Show answer

   Answer: B. An inflated balloon

   A small balloon inflated with sterile water keeps the tip in the bladder. Never pull a Foley out without deflating the balloon.

2. The urine collection bag should be kept:

   1. A. Above the patient's chest
   2. B. Below bladder level
   3. C. On the patient's abdomen
   4. D. Clamped during transport
   Show answer

   Answer: B. Below bladder level

   Keeping the bag low prevents backflow of urine into the bladder, which raises infection risk.

3. A suprapubic catheter enters the bladder through the:

   1. A. Urethral opening
   2. B. Left flank
   3. C. Abdominal wall
   4. D. Rectal wall
   Show answer

   Answer: C. Abdominal wall

   A suprapubic catheter is placed through the abdomen above the pubic bone, often for long-term use.

4. A patient's nephrostomy tube has stopped draining, and he now has flank pain and fever. You should suspect:

   1. A. A blocked tube with infection
   2. B. Normal healing of the tube site
   3. C. A kidney stone forming in the bag
   4. D. A bladder spasm
   Show answer

   Answer: A. A blocked tube with infection

   A blocked nephrostomy lets urine back up in an obstructed kidney, which can quickly become infected and septic. These patients need urgent evaluation to unblock or replace the tube.

5. A nephrostomy tube drains urine directly from the:

   1. A. Bladder
   2. B. Urethra
   3. C. Prostate
   4. D. Kidney
   Show answer

   Answer: D. Kidney

   A nephrostomy tube goes through the back into the renal pelvis, usually when the ureter is blocked.

6. A patient with a urostomy has a stoma that:

   1. A. Drains stool into a bag
   2. B. Feeds into the stomach
   3. C. Drains urine into a pouch
   4. D. Removes air from the chest
   Show answer

   Answer: C. Drains urine into a pouch

   A urostomy diverts urine, often after bladder removal. Output should be continuous.

7. A patient with an ileal conduit (urostomy) is worried about white mucus strands in his pouch. You should explain that this is:

   1. A. A sign of kidney failure
   2. B. Pus from a severe infection
   3. C. Leakage of stool into the urine
   4. D. Normal, from the bowel segment
   Show answer

   Answer: D. Normal, from the bowel segment

   An ileal conduit is made from a piece of small bowel, which keeps making mucus, so mucus in the urine is expected. Fever, flank pain, or foul urine would suggest infection.

8. An older adult recently started oxybutynin for an overactive bladder and is now confused. You should suspect:

   1. A. Cholinergic excess from the drug
   2. B. Anticholinergic side effects
   3. C. Drug-induced low blood sugar
   4. D. A normal response to the drug
   Show answer

   Answer: B. Anticholinergic side effects

   Oxybutynin is strongly anticholinergic and can cause confusion, dry mouth, constipation, and retention in older adults; the Beers Criteria advise avoiding it. Report the new medication. The drug blocks acetylcholine rather than adding to it, it does not lower glucose, and confusion is not an expected response.

9. Which is the most common trigger of autonomic dysreflexia?

   1. A. A full bladder
   2. B. An ingrown toenail
   3. C. A warm room
   4. D. Bright lights in the room
   Show answer

   Answer: A. A full bladder

   Bladder distension is the leading cause, followed by constipation, pressure sores, and tight clothing. An ingrown toenail can also trigger it but far less often, and a warm room or bright lights are not typical triggers.

10. A woman who has bladder leakage limits how much she drinks so she will not have accidents. This raises her risk of:

    1. A. Kidney stones only
    2. B. Dehydration and UTIs
    3. C. Higher blood pressure
    4. D. Swelling of the legs
    Show answer

    Answer: B. Dehydration and UTIs

    Restricting fluids concentrates urine, increasing bladder irritation, UTIs, constipation, and dehydration, especially in older adults. Stones are also a risk, but not the only one.

11. Kidney injury after trauma is suggested by:

    1. A. Flank bruising and hematuria
    2. B. Pain only in the left shoulder
    3. C. Bright red rectal bleeding
    4. D. Pleuritic chest pain on inhaling
    Show answer

    Answer: A. Flank bruising and hematuria

    Blunt trauma to the flank can injure the kidney. Look for bruising and blood in the urine.

12. A child with blood in the urine after a minor fall may have:

    1. A. A normal response to a fall
    2. B. A bladder infection only, no injury
    3. C. An underlying kidney problem
    4. D. Muscle strain
    Show answer

    Answer: C. An underlying kidney problem

    Hematuria after minor trauma can reveal tumors or congenital abnormalities.

13. A patient taking warfarin has new blood in his urine. Which approach is correct?

    1. A. Assume the warfarin explains it
    2. B. Stop all his medications now
    3. C. Ignore it if the INR is in range
    4. D. Evaluate for an underlying cause
    Show answer

    Answer: D. Evaluate for an underlying cause

    Anticoagulants can unmask lesions such as tumors or stones, so hematuria on warfarin still needs a work-up as well as an INR check. Stopping medications is a decision for the prescriber.

14. Patients with neurogenic bladder from spinal cord injury often use:

    1. A. Oral antibiotics every day
    2. B. Bladder massage
    3. C. Self-catheterization
    4. D. Fluid restriction only
    Show answer

    Answer: C. Self-catheterization

    Many patients self-catheterize several times a day to empty the bladder.

15. A patient with a new Foley has bouts of crampy lower abdominal pain, and urine leaks around the tube, but the bag keeps filling. This is most likely:

    1. A. Bladder spasms
    2. B. A blocked catheter
    3. C. A kidney stone
    4. D. A burst balloon
    Show answer

    Answer: A. Bladder spasms

    When the bag keeps filling, the catheter is draining, so cramps with leakage suggest bladder spasms from the balloon irritating the bladder. If the bag stops filling, think obstruction.

16. After a ureteral stent was placed, a patient has mild blood in his urine and flank pain when he urinates. This is usually:

    1. A. A sign the stent has ruptured
    2. B. A common, expected stent effect
    3. C. Proof of kidney failure
    4. D. A reaction to the anesthetic drugs
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    Answer: B. A common, expected stent effect

    Stents commonly cause urgency, mild hematuria, and flank pain during voiding as urine refluxes up the stent. Fever, heavy bleeding, or inability to void would warrant urgent evaluation.

17. A patient on dialysis is septic. Which access site is a likely source of infection?

    1. A. A peripheral IV in the hand
    2. B. A healed old surgical scar
    3. C. A small pressure sore on the heel
    4. D. The dialysis catheter
    Show answer

    Answer: D. The dialysis catheter

    Central dialysis catheters are a common source of bloodstream infection.

18. Children with spina bifida who use catheters to empty their bladders are at high risk of:

    1. A. Diabetes
    2. B. Asthma
    3. C. Hearing loss in early life
    4. D. Latex allergy
    Show answer

    Answer: D. Latex allergy

    Repeated exposure to latex catheters and surgical products makes latex allergy common in spina bifida. Use latex-free equipment for these patients.

19. Catheter tubing lying under the thigh of a bedbound patient for hours can cause:

    1. A. A kidney stone
    2. B. A blood clot in the lung
    3. C. A pressure injury
    4. D. Low blood sugar
    Show answer

    Answer: C. A pressure injury

    Medical devices, including catheter tubing, cause device-related pressure injuries when they press on skin. Position tubing over the thigh and check skin under devices.

20. Which question helps assess a patient with a urinary device?

    1. A. When was it last changed?
    2. B. Do you smoke?
    3. C. What is your blood type, please?
    4. D. Have you flown recently?
    Show answer

    Answer: A. When was it last changed?

    Device age and recent changes help identify blockage or infection risk.

21. Older men with urinary retention may become:

    1. A. Calm with a slow pulse
    2. B. Confused and agitated
    3. C. Unusually hungry
    4. D. Flushed and hypotensive
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    Answer: B. Confused and agitated

    Pain and discomfort from a full bladder can cause delirium in older adults. Retention pain usually raises the pulse and blood pressure rather than slowing or lowering them.

22. A man wearing an external (condom) catheter has a swollen, dusky penis. You should:

    1. A. Tighten it to stop leakage
    2. B. Remove it and check the skin
    3. C. Leave it on until the hospital
    4. D. Add a second strap for support
    Show answer

    Answer: B. Remove it and check the skin

    An external catheter that is too tight can act as a tourniquet and cause swelling, ischemia, and skin breakdown. Remove it, assess circulation, and report the finding.

23. A dialysis patient tells you they feel 'just not right.' You should:

    1. A. Assess fully; take it seriously
    2. B. Assume they only need some rest
    3. C. Release them with advice
    4. D. Wait until symptoms worsen
    Show answer

    Answer: A. Assess fully; take it seriously

    Dialysis patients often know their bodies well. Vague complaints may signal serious problems.

24. Children with chronic kidney disease may have:

    1. A. Increased adult height
    2. B. Accelerated bone growth
    3. C. Growth delays
    4. D. Very early puberty
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    Answer: C. Growth delays

    CKD affects growth through anemia, bone problems, and poor nutrition.

25. A 9-year-old who had been dry at night starts wetting the bed and is very thirsty and losing weight. You should check:

    1. A. For a urinary catheter
    2. B. The blood pressure
    3. C. For a kidney stone
    4. D. The blood glucose
    Show answer

    Answer: D. The blood glucose

    New bedwetting with thirst and weight loss suggests new-onset type 1 diabetes, where high glucose causes osmotic diuresis. A fingerstick glucose can identify it and the risk of DKA.