An older adult with severe knee osteoarthritis is continent at home but has repeated urinary incontinence in the hospital because walking to the bathroom takes too long. Which intervention should the nurse implement?
1Limit evening fluids so the client produces less urine overnight
2Request an indwelling catheter to prevent further incontinent episodes
3Place absorbent briefs and wait for the client to request toileting help
4Offer scheduled toileting and keep a bedside commode within easy reach✓ Correct answer
Explanation
The pattern suggests functional incontinence caused by limited mobility rather than loss of bladder control. Scheduled assistance and an accessible bedside commode address the barrier while avoiding an unnecessary indwelling catheter and its infection risk.
Quick answer Use scheduled toileting and place a bedside commode within reach. Remove the mobility barrier to continence.
Why this is correct The client can control urination but cannot reach the bathroom in time. Prompted assistance and a shorter, safer route support normal voiding and preserve independence without exposing the client to an unnecessary catheter.
Easy analogy or mental picture The bladder system works, but the path to the bathroom is like a hallway with a blocked exit. Bringing the commode closer removes the access barrier, but the analogy does not rule out a new urinary disorder if other symptoms appear.
Memory hook Functional incontinence means the toilet is inaccessible; fix access before using devices.
NCLEX decision rule When continence is limited by mobility or environment, first modify access and schedule assistance. Avoid fluid restriction and indwelling catheterization unless a separate clinical indication is present.
Why the other choices are wrong Fluid restriction can cause dehydration and does not correct access. An indwelling catheter is inappropriate for routine incontinence management, and briefs without proactive toileting leave the functional cause unaddressed.
References
[1]
NCSBN: 2026 NCLEX-RN Test PlanNational Council of State Boards of Nursing
[2]
AHRQ: Skin Care in the Incontinent PatientAgency for Healthcare Research and Quality
[3]
CDC: CAUTI Prevention Facility Assessment ToolCenters for Disease Control and Prevention