CNA Catheter Care and Urinary Management 1 — Questions and Answers

Question 1: What is the PRIMARY purpose of an indwelling urinary (Foley) catheter?

To treat urinary tract infections
To drain urine continuously from the bladder (Correct answer)
To measure blood pressure
To administer medications

Correct answer: To drain urine continuously from the bladder

An indwelling catheter is a tube inserted into the bladder to continuously drain urine. It is used for urinary retention, monitoring output, or when residents cannot void independently.

Question 2: When caring for a resident with an indwelling catheter, the drainage bag should ALWAYS be kept:

At the level of the resident's bladder
Higher than the level of the bladder
Below the level of the bladder (Correct answer)
At any height as long as it is draining

Correct answer: Below the level of the bladder

The drainage bag must be kept below the level of the bladder at all times to use gravity for drainage and to prevent urine from backflowing into the bladder, which could cause infection.

Question 3: A CNA is transferring a catheterized resident from the bed to a wheelchair. What should be done with the catheter bag?

Clamp the tubing and leave the bag on the bed rail
Hang the bag on the IV pole above the resident's waist
Secure the bag below the bladder level on the wheelchair frame, not on the floor (Correct answer)
Disconnect the bag and reconnect after transfer

Correct answer: Secure the bag below the bladder level on the wheelchair frame, not on the floor

The catheter bag must remain below bladder level during all transfers to maintain gravity drainage and prevent backflow. It should never touch the floor (infection risk) or be disconnected.

Question 4: Catheter tubing should NEVER be kinked or compressed because:

It can cause the catheter to be expelled
It blocks urine flow, causing bladder distension and risk of infection (Correct answer)
It increases the risk of bladder spasms only
It makes ambulation more difficult

Correct answer: It blocks urine flow, causing bladder distension and risk of infection

Kinked or compressed tubing blocks urine drainage, causing urine to accumulate in the bladder (distension) and increasing the risk of urinary tract infection and catheter complications.

Question 5: How often should perineal care be performed for a resident with an indwelling catheter?

Once a week
Only when visible soiling occurs
At least once daily and after each bowel movement (Correct answer)
Once every 8-hour shift, regardless of soiling

Correct answer: At least once daily and after each bowel movement

Perineal hygiene should be performed at least once daily and after each bowel movement to remove bacteria near the catheter insertion site, the primary route for catheter-associated UTIs.

Question 6: When performing catheter perineal care, the CNA should clean:

From the meatus outward along the catheter tubing (Correct answer)
In a circular motion around the meatus
From the perineum toward the catheter
From distal to proximal along the tubing toward the body

Correct answer: From the meatus outward along the catheter tubing

Clean from the urethral meatus outward along the catheter (away from the body) using a single downward stroke per wipe. This removes bacteria from the insertion site and prevents introducing new organisms.

Question 7: Which of the following is a sign of a urinary tract infection (UTI) in a catheterized resident?

Clear, pale yellow urine with no odor
Cloudy, dark, or foul-smelling urine and fever (Correct answer)
Increased urine output with normal color
Transparent urine with no sediment

Correct answer: Cloudy, dark, or foul-smelling urine and fever

Signs of catheter-associated UTI include cloudy or dark urine, strong or foul odor, decreased output, sediment, fever, chills, and complaints of burning or pelvic discomfort.

Question 8: The CNA notes that the catheter bag has not had any drainage for two hours. The BEST first action is to:

Irrigate the catheter immediately
Check the tubing for kinks, clamps, or compression, then report to the nurse (Correct answer)
Document the finding and wait until shift change
Ask the resident if they feel the urge to urinate

Correct answer: Check the tubing for kinks, clamps, or compression, then report to the nurse

No drainage for 2 hours may indicate a kinked tube, full bag, or catheter obstruction. Check for mechanical causes first; if resolved drainage still doesn't resume, notify the nurse.

Question 9: A catheterized resident complains of pain and pressure in the lower abdomen. The CNA should:

Reassure the resident it is normal discomfort
Check catheter tubing and drainage, then report to the nurse promptly (Correct answer)
Administer a pain reliever from the medication cart
Apply a heating pad to the abdomen

Correct answer: Check catheter tubing and drainage, then report to the nurse promptly

Lower abdominal pain and pressure in a catheterized resident may indicate bladder spasm, obstruction, or infection. Check for drainage issues and report symptoms immediately to the nurse.

Question 10: When should the CNA wear gloves during catheter care?

Only if the resident has a known infection
During all catheter care and when handling the drainage bag or tubing (Correct answer)
Only when emptying the drainage bag
Gloves are optional if hands are washed beforehand

Correct answer: During all catheter care and when handling the drainage bag or tubing

Gloves must be worn during all catheter care, including perineal hygiene, handling the catheter tubing, and emptying the drainage bag, because urine is a body fluid and a potential infection source.

Question 11: How should the CNA empty a urinary drainage bag?

Disconnect the tubing from the catheter to drain
Use the drain port at the bottom of the bag, collect in a graduate cylinder, and measure output (Correct answer)
Squeeze the bag to push urine through the tubing
Turn the bag upside down to use gravity

Correct answer: Use the drain port at the bottom of the bag, collect in a graduate cylinder, and measure output

Empty the bag through the drain port into a clean graduate cylinder, measure the output, document it, and close the port securely. Never disconnect the system at the catheter junction.

Question 12: How full should the drainage bag be allowed to get before emptying?

Wait until completely full before emptying
Empty when it reaches about two-thirds to three-quarters full (Correct answer)
Empty exactly every 2 hours regardless of fill level
Empty only at shift change

Correct answer: Empty when it reaches about two-thirds to three-quarters full

Catheter drainage bags should be emptied when about 2/3 to 3/4 full to prevent overfilling, which can create back-pressure, raise the bag above bladder level, or cause urine backflow.

Question 13: The CNA should NEVER allow the drain spigot of the catheter bag to touch:

The collection container
Anything other than the inside of the sterile collection container (Correct answer)
The measuring graduate
The side of the toilet bowl

Correct answer: Anything other than the inside of the sterile collection container

The drain spigot is a critical infection control point. If it touches a non-sterile surface (floor, graduate outside rim, toilet), it must be cleaned per policy before closing to prevent introducing bacteria into the system.

Question 14: Securing the catheter tubing to the resident's inner thigh is done to:

Mark the catheter as belonging to that resident
Prevent traction on the urethra and reduce discomfort (Correct answer)
Keep the drainage bag above bladder level
Prevent the resident from removing the catheter

Correct answer: Prevent traction on the urethra and reduce discomfort

Securing the catheter to the thigh with a leg strap or tape prevents the catheter from pulling on the urethra, reducing irritation, discomfort, and the risk of catheter dislodgement.

Question 15: A condom (external) catheter is used for:

Female residents with urinary incontinence
Male residents with urinary incontinence who can void on their own (Correct answer)
All residents regardless of gender
Residents with urinary retention who cannot void

Correct answer: Male residents with urinary incontinence who can void on their own

A condom catheter is a non-invasive device that fits over the penis and collects urine as the resident voids normally. It is an option for male residents with incontinence who retain the ability to urinate.

Question 16: Which of the following should be reported when monitoring a catheterized resident?

Clear yellow urine with a volume of 50 mL/hour
Cloudy brown urine with sediment and strong odor (Correct answer)
Urine that smells slightly of what the resident ate
Pale urine with no visible sediment

Correct answer: Cloudy brown urine with sediment and strong odor

Cloudy, brown, or foul-smelling urine with sediment is abnormal and may indicate infection, dehydration, or other pathology. This must be reported to the nurse promptly.

Question 17: Normal urine output for an adult is approximately:

100–300 mL per day
800–2,000 mL per day (Correct answer)
3,000–4,000 mL per day
5,000–6,000 mL per day

Correct answer: 800–2,000 mL per day

Normal adult urine output is approximately 800–2,000 mL per day (about 30–50 mL/hour). Output significantly below 30 mL/hour may indicate dehydration or kidney problems.

Question 18: Oliguria is defined as urine output:

Greater than 2,500 mL per day
Between 800–2,000 mL per day
Less than 400 mL per day (Correct answer)
Exactly 1,000 mL per day

Correct answer: Less than 400 mL per day

Oliguria means abnormally low urine output, generally less than 400 mL per day in adults. It is a sign of possible kidney dysfunction, severe dehydration, or shock and must be reported.

Question 19: When documenting urine output, the CNA should record:

An estimate based on the bag color
The exact measured amount in milliliters, time of measurement, and characteristics (Correct answer)
Only abnormalities, not routine output
The amount from the last two shifts combined

Correct answer: The exact measured amount in milliliters, time of measurement, and characteristics

Accurate fluid balance records require exact measurements in mL, timing, and a description of urine characteristics (color, clarity) to track trends and detect problems early.

Question 20: What is the MOST important step for preventing catheter-associated urinary tract infections (CAUTI)?

Irrigating the catheter daily with saline
Maintaining a closed drainage system and practicing proper hand hygiene (Correct answer)
Changing the catheter every 24 hours
Adding antiseptic solution to the drainage bag

Correct answer: Maintaining a closed drainage system and practicing proper hand hygiene

The closed drainage system is the most critical infection prevention measure. The system (catheter-to-tubing-to-bag junction) should never be broken, and hand hygiene must be performed before and after all catheter care.

Question 21: Which action would BREAK the sterile closed catheter system and increase infection risk?

Emptying the bag through the drain port
Securing the tubing to the thigh
Disconnecting the catheter tubing from the catheter to empty the bag (Correct answer)
Keeping the bag below the bladder

Correct answer: Disconnecting the catheter tubing from the catheter to empty the bag

Disconnecting the catheter from the drainage tubing breaks the closed system, introducing bacteria and dramatically increasing the risk of urinary tract infection.

Question 22: A resident's catheter appears to have come out partially. The CNA should:

Gently push the catheter back in
Do not reinsert; report to the nurse immediately (Correct answer)
Tape the catheter to the resident's leg and monitor
Clamp the tubing and continue care

Correct answer: Do not reinsert; report to the nurse immediately

CNA scope of practice does not include catheter insertion or reinsertion. If the catheter appears dislodged, the CNA must notify the nurse immediately without attempting to reinsert it.

Question 23: A urinary catheter balloon is used to:

Block urine flow during transfers
Hold the catheter securely in the bladder so it cannot be pulled out (Correct answer)
Measure bladder volume
Inflate the urethra for comfort

Correct answer: Hold the catheter securely in the bladder so it cannot be pulled out

The inflatable balloon at the tip of a Foley catheter is filled with sterile water after placement to anchor the catheter inside the bladder, preventing accidental removal.

Question 24: During ambulation with a catheterized resident, the drainage bag should be:

Hung on an IV pole at shoulder height
Clipped to the walker above waist level
Carried in a drainage bag holder below bladder level (Correct answer)
Left behind in the room until return

Correct answer: Carried in a drainage bag holder below bladder level

During ambulation, the drainage bag should be held or clipped below the level of the bladder at all times in a designated bag holder to prevent urine backflow and tripping hazards.

Question 25: Which of the following BEST prevents catheter-related trauma?

Inserting the catheter quickly
Securing the catheter to the thigh and avoiding tension on the tubing (Correct answer)
Using the smallest catheter size available
Irrigating daily to remove blockages

Correct answer: Securing the catheter to the thigh and avoiding tension on the tubing

Proper securement prevents the catheter from pulling on the urethra during movement. Tension on the catheter can cause urethral trauma, stricture, and discomfort.

Question 26: What color should normal urine be?

Dark brown or amber
Bright red or pink
Pale yellow to amber (Correct answer)
Milky white

Correct answer: Pale yellow to amber

Normal urine ranges from pale yellow to amber depending on hydration level. Very dark urine suggests dehydration; red or pink urine may indicate blood and must be reported.

Question 27: Hematuria refers to:

No urine production
Blood in the urine (Correct answer)
Excess protein in the urine
Pus in the urine

Correct answer: Blood in the urine

Hematuria is the presence of blood in the urine, causing pink, red, or cola-colored urine. It must be reported immediately as it can indicate infection, kidney problems, or catheter trauma.

Question 28: When a resident has a suprapubic catheter, the CNA should be aware that it:

Drains urine through the urethra
Is inserted through the abdominal wall into the bladder (Correct answer)
Is changed daily by the CNA
Does not require any special care

Correct answer: Is inserted through the abdominal wall into the bladder

A suprapubic catheter is surgically inserted through the abdomen directly into the bladder. The insertion site requires skin care and observation for signs of infection, just like any surgical site.

Question 29: The MOST common complication associated with indwelling urinary catheters is:

Kidney stones
Urinary tract infection (CAUTI) (Correct answer)
Bladder rupture
Urethral stricture

Correct answer: Urinary tract infection (CAUTI)

Catheter-associated urinary tract infection (CAUTI) is the most frequent healthcare-associated infection and is strongly linked to indwelling catheters. Prevention is a top priority in catheter care.

Question 30: If a catheterized resident reports that they still feel the urge to urinate, the CNA should:

Tell the resident it is impossible to feel that urge with a catheter
Ignore the complaint as it is routine
Check tubing for obstruction, report the complaint to the nurse, and document it (Correct answer)
Ask the resident to try to void around the catheter

Correct answer: Check tubing for obstruction, report the complaint to the nurse, and document it

Persistent urge sensation in a catheterized resident may indicate bladder spasm, obstruction, or catheter displacement. It should never be dismissed — report to the nurse.

Question 31: Intake and output (I&O) records for a catheterized resident help the care team to:

Monitor dietary preferences only
Assess fluid balance and kidney function (Correct answer)
Determine medication timing
Track activity levels

Correct answer: Assess fluid balance and kidney function

Accurate I&O records allow nurses and physicians to evaluate fluid balance, kidney function, hydration status, and the effectiveness of diuretics or fluid restrictions.

Question 32: Which of the following indicates adequate urine output in a catheterized adult?

Less than 10 mL per hour
10–29 mL per hour
30–50 mL per hour (Correct answer)
Over 200 mL per hour

Correct answer: 30–50 mL per hour

Adequate urine output for an adult is at least 30 mL per hour (approximately 720 mL per day). Output below 30 mL/hour may signal dehydration, kidney dysfunction, or circulatory issues.

Question 33: When a resident with a catheter is placed in a lateral (side-lying) position, the CNA should ensure:

The drainage bag is placed on the mattress beside the resident
Tubing is not kinked or compressed between the mattress and bedrail (Correct answer)
The catheter balloon is deflated for comfort
The drainage bag is temporarily placed above bladder level

Correct answer: Tubing is not kinked or compressed between the mattress and bedrail

Side-lying positions can compress catheter tubing between the mattress and bed rail. The CNA must check and reposition tubing to prevent kinking that would obstruct drainage.

Question 34: What hand hygiene steps must be performed before and after catheter care?

Quick hand rinse with water only
Thorough handwashing with soap and water or alcohol-based hand rub, then gloves on before contact (Correct answer)
Wipe hands with a dry towel before donning gloves
No special hand hygiene is needed if gloves are worn

Correct answer: Thorough handwashing with soap and water or alcohol-based hand rub, then gloves on before contact

Standard hand hygiene (soap and water or alcohol-based rub) must be performed before donning gloves and after removing them following catheter care. Gloves do not replace hand hygiene.

CNA Catheter Care and Urinary Management 1

What is the PRIMARY purpose of an indwelling urinary (Foley) catheter?

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