Elimination NCLEX-RN Practice Questions

Elimination NCLEX-RN Practice Questions

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Elimination NCLEX-RN Practice Questions help you sharpen core competencies in the Basic Care & Comfort domain, focusing on urinary and bowel elimination across the lifespan. This topic integrates assessment, prioritization, and evidence-based interventions for issues like urinary retention, incontinence, catheter care, CAUTI prevention, fecal impaction, ostomy management, bowel training, and safe specimen collection. You’ll also review medication effects on elimination, fluid balance, and post-procedural care. Designed to mirror NCLEX-RN rigor, these questions emphasize patient safety, delegation, infection control, and patient education. Whether you’re refining clinical judgment or reinforcing fundamentals, this set builds confidence for exam-level decision-making in real-world elimination scenarios. Practice carefully, focus on rational choices, and translate knowledge into safe nursing actions.

Q1. A post-operative patient has produced 50 mL of urine over the past 4 hours and reports suprapubic discomfort. Which action should the nurse take first?

  • Perform a bladder scan to assess post-void residual volume
  • Increase the IV fluid rate without a provider order
  • Notify the provider immediately
  • Insert a straight catheter without an order

Correct Answer: Perform a bladder scan to assess post-void residual volume

Q2. The nurse is teaching a UAP about caring for a patient with an indwelling urinary catheter. Which statement indicates correct understanding of CAUTI prevention?

  • Keep the drainage bag below bladder level and avoid dependent loops in the tubing
  • Disconnect the catheter from the drainage tubing each shift to reduce kinking
  • Irrigate the catheter daily to prevent obstruction
  • Clean the meatus with antiseptic every 2 hours

Correct Answer: Keep the drainage bag below bladder level and avoid dependent loops in the tubing

Q3. An older adult with chronic constipation now reports frequent small-volume liquid stools and abdominal distention. Which assessment finding is most consistent with fecal impaction?

  • Small, frequent liquid stools leaking around a fecal mass
  • Hypoactive bowel sounds with no tenderness
  • Relief of symptoms after passing flatus
  • Positive fecal occult blood test

Correct Answer: Small, frequent liquid stools leaking around a fecal mass

Q4. The provider prescribes a hypertonic sodium phosphate enema for a patient. Which condition is a priority contraindication for this enema?

  • Dehydration and renal impairment
  • Diarrhea from suspected infectious etiology
  • External hemorrhoids
  • Post-operative day 2 following cholecystectomy

Correct Answer: Dehydration and renal impairment

Q5. A patient with a newly created colostomy asks what to expect in the first 24–48 hours post-op. Which response is most accurate?

  • You may see a small amount of serosanguinous drainage and gas; fecal output usually increases after a few days
  • You should expect continuous liquid effluent in the pouch immediately after surgery
  • No output is expected for several days, and a dark purple stoma is normal
  • You will have black tarry stool until your diet is advanced

Correct Answer: You may see a small amount of serosanguinous drainage and gas; fecal output usually increases after a few days

Q6. The nurse is reinforcing teaching for a patient with an ileostomy. Which instruction best helps prevent dehydration and electrolyte imbalance?

  • Increase fluid and sodium intake, especially during hot weather or increased output
  • Avoid high-fiber foods permanently to prevent blockage
  • Irrigate the stoma at the same time daily
  • Use barrier paste with each pouch change

Correct Answer: Increase fluid and sodium intake, especially during hot weather or increased output

Q7. A patient reports leakage of urine when sneezing and laughing. Which type of urinary incontinence is most likely?

  • Urge incontinence
  • Stress incontinence
  • Overflow incontinence
  • Functional incontinence

Correct Answer: Stress incontinence

Q8. A patient with BPH presents with dribbling, a weak stream, and sensation of incomplete bladder emptying. Which assessment finding is expected with overflow incontinence?

  • Post-void residual greater than 300 mL
  • Strong, continuous urinary stream
  • Dysuria without frequency
  • Polyuria with no nocturia

Correct Answer: Post-void residual greater than 300 mL

Q9. The nurse needs to collect a urine specimen for culture from a patient with an indwelling catheter. What is the correct method?

  • Cleanse the sampling port, clamp tubing briefly, and aspirate urine from the port using sterile technique
  • Drain urine from the collection bag into a sterile container
  • Disconnect the catheter from the drainage tubing and collect fresh urine
  • Obtain a midstream clean-catch sample from the patient

Correct Answer: Cleanse the sampling port, clamp tubing briefly, and aspirate urine from the port using sterile technique

Q10. A hospitalized patient has profuse watery diarrhea due to Clostridioides difficile. Which infection-control action is priority?

  • Use alcohol-based hand sanitizer before leaving the room
  • Use soap-and-water hand hygiene and implement contact precautions with gown and gloves
  • Place the patient in airborne isolation with N95 mask
  • Use droplet precautions with surgical mask

Correct Answer: Use soap-and-water hand hygiene and implement contact precautions with gown and gloves

Q11. Which medication most commonly causes constipation and should be anticipated to affect bowel elimination?

  • Morphine
  • Metformin
  • Magnesium hydroxide
  • Docusate sodium

Correct Answer: Morphine

Q12. The nurse plans a bowel training program for a patient with a neurogenic bowel. Which component is essential?

  • Establish a regular time each day with a stimulant suppository and warm fluid to promote defecation
  • Use random timing and avoid laxatives
  • Perform routine digital removal of stool weekly
  • Increase dietary fat to stimulate the gastrocolic reflex

Correct Answer: Establish a regular time each day with a stimulant suppository and warm fluid to promote defecation

Q13. The nurse delegates toileting to a UAP. Which report from the UAP requires immediate follow-up?

  • New frank red blood noted in the stool
  • Small amount of mucus in a colostomy pouch
  • Formed brown stool
  • Foul odor from stool

Correct Answer: New frank red blood noted in the stool

Q14. The nurse is documenting intake and output. Which should be recorded as output?

  • Urine, emesis, and measurable wound drainage
  • Oral fluids, tube feedings, and IV fluids
  • Only urine and stool
  • Perspiration and respiratory losses

Correct Answer: Urine, emesis, and measurable wound drainage

Q15. Which action reflects correct perineal care for a patient with an indwelling urinary catheter?

  • Clean from the urinary meatus outward with soap and water daily and after soiling
  • Apply povidone-iodine to the meatus every 4 hours
  • Reposition the catheter frequently to reduce pressure points
  • Remove the catheter daily for thorough cleaning

Correct Answer: Clean from the urinary meatus outward with soap and water daily and after soiling

Q16. The nurse is teaching ostomy care. When should a pouch be emptied?

  • When it is one-third to one-half full
  • When it is completely full to avoid waste
  • Once per day in the morning only
  • Every 8 hours on a fixed schedule regardless of volume

Correct Answer: When it is one-third to one-half full

Q17. Eight hours after Foley catheter removal, a post-op patient has not voided and reports lower abdominal fullness. Which action should the nurse take first?

  • Assist the patient to the bathroom and run water to facilitate voiding
  • Perform immediate straight catheterization
  • Notify the surgeon for reinsertion of a Foley catheter
  • Restrict fluids to reduce bladder pressure

Correct Answer: Assist the patient to the bathroom and run water to facilitate voiding

Q18. Which medication may be prescribed to promote bladder emptying in non-obstructive urinary retention?

  • Bethanechol
  • Oxybutynin
  • Tolterodine
  • Pseudoephedrine

Correct Answer: Bethanechol

Q19. The nurse teaches a patient about collecting a home fecal occult blood test (guaiac). Which instruction is correct?

  • Avoid red meat, vitamin C supplements, and NSAIDs for several days before testing
  • No dietary or medication restrictions are needed
  • Collect the sample from a single spot in one bowel movement
  • Moisten the test card with urine if stool is dry

Correct Answer: Avoid red meat, vitamin C supplements, and NSAIDs for several days before testing

Q20. A patient with chronic constipation asks about diet. Which food is the best choice to promote bowel regularity?

  • A fresh pear with skin
  • White rice
  • Cheddar cheese
  • Scrambled eggs

Correct Answer: A fresh pear with skin

Q21. An infant is 24 hours old and has not passed meconium. What is the priority nursing action?

  • Assess abdominal distention and bowel sounds and notify the provider
  • Reassure the parents that this is normal
  • Administer a glycerin suppository without an order
  • Initiate formula feeding to stimulate the bowel

Correct Answer: Assess abdominal distention and bowel sounds and notify the provider

Q22. During insertion of a Foley catheter in a female patient, which action breaks sterile technique?

  • Placing the sterile drape shiny side down on the field
  • Lubricating the catheter tip before insertion
  • Resting the catheter on the bed after opening it while preparing supplies
  • Designating the non-dominant hand as contaminated after touching the labia

Correct Answer: Resting the catheter on the bed after opening it while preparing supplies

Q23. The nurse teaches a patient with urge incontinence about bladder training. Which instruction is most appropriate?

  • Use a timed-voiding schedule with gradual interval increases between voids
  • Restrict all evening fluids to prevent accidents
  • Bear down (Valsalva) to suppress the urge to void
  • Rely on absorbent pads instead of scheduling voids

Correct Answer: Use a timed-voiding schedule with gradual interval increases between voids

Q24. A patient with a small bowel obstruction has an NG tube to low intermittent suction. Which finding is most concerning?

  • No urine output for 6 hours with tachycardia and dry mucous membranes
  • 800 mL of green fluid from the NG tube over 8 hours
  • 50 mL of light sanguineous drainage from the NG tube immediately post-insertion
  • 400 mL of clear yellow urine over 8 hours

Correct Answer: No urine output for 6 hours with tachycardia and dry mucous membranes

Q25. After an outpatient cystoscopy, which finding requires immediate provider notification?

  • Bright red urine with clots
  • Painful urination with pink-tinged urine
  • Urinary frequency
  • Mild suprapubic discomfort

Correct Answer: Bright red urine with clots

Q26. A hemodynamically stable adult with acute non-bloody traveler’s diarrhea asks about diet. What is the best advice?

  • Use oral rehydration solutions; start clear liquids and advance to bland, low-fiber foods; avoid dairy, caffeine, and high-fat foods
  • Increase high-fat foods to slow transit time
  • Drink milk to replace calcium losses
  • Use loperamide immediately even if stool becomes bloody

Correct Answer: Use oral rehydration solutions; start clear liquids and advance to bland, low-fiber foods; avoid dairy, caffeine, and high-fat foods

Q27. Which position is best for administering a cleansing enema to an adult?

  • Left Sims’ position with the right knee flexed
  • Supine with knees extended
  • High Fowler’s position
  • Prone with a pillow under the abdomen

Correct Answer: Left Sims’ position with the right knee flexed

Q28. A patient is receiving continuous bladder irrigation (CBI) after a TURP. Which finding indicates the need to adjust the irrigation and possibly manually irrigate per protocol?

  • Bladder spasms with decreased outflow and increasingly red urine
  • Urine that is light pink with a few small clots
  • Output exceeds input by 300 mL over 8 hours
  • Patient reports thirst

Correct Answer: Bladder spasms with decreased outflow and increasingly red urine

Q29. A patient with end-stage kidney disease on fluid restriction reports constipation. Which laxative is safest?

  • Polyethylene glycol (PEG)
  • Magnesium citrate
  • Sodium phosphate enema
  • Psyllium fiber supplement without additional fluids

Correct Answer: Polyethylene glycol (PEG)

Q30. The nurse prepares to administer a rectal suppository to an adult with fecal impaction. Which technique is correct?

  • Insert the suppository past the internal sphincter along the rectal wall, 2–3 inches (5–7.5 cm)
  • Insert directly into the stool mass to soften it
  • Lubricate with petroleum jelly and cut the suppository lengthwise
  • Ask the patient to sit on the toilet immediately after insertion

Correct Answer: Insert the suppository past the internal sphincter along the rectal wall, 2–3 inches (5–7.5 cm)

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