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    HESI PN Exit Proctored ExamQuestion 135
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    HESI PN Exit Proctored Exam

    In assessing a client with an indwelling urinary catheter following the provision of care by an unlicensed assistive personnel (UAP), the practical nurse (PN) observes that the catheter drainage bag, which is half full, is attached to the side rail and the tubing is looped on the bed. Which action should the PN implement?

    Explanation & Rationale

    The correct answer is choice B. Attach the drainage bag to the bed frame. Choice A rationale: Measuring the urinary output in the bag is a routine task but does not address the improper placement of the drainage bag. The immediate concern is to ensure the drainage bag is correctly positioned to prevent complications. Choice B rationale: Attaching the drainage bag to the bed frame is the correct action. The drainage bag should be kept below the level of the bladder and attached to a non-movable part of the bed to prevent backflow and reduce the risk of infection. Choice C rationale: Applying gloves and emptying the drainage bag is not the immediate priority. The drainage bag should not be allowed to overfill, but in this scenario, it is only half-full, so this action is not urgent. Choice D rationale: Removing the looped tubing from the bed is important to ensure proper drainage and prevent backflow, but it does not address the incorrect placement of the drainage bag, which is the primary concern in this situation.

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