A nurse is administering an enteral feeding through a client's NG tube. Which of the following actions should the nurse take?

Cleanse the top of the can of formula with an alcohol wipe.

Keep the formula cold until instillation.

Withhold the feeding if the residual volume is 150 mL.

Flush the tube with 30 mL of sterile water before the feeding.

None

Answer and Explanation

The Correct Answer is A

Correct answer: D

A. Wiping the top of the can before opening prevents contamination and reduces the risk of introducing pathogens into the feeding system.

B. Cold formula can cause gastric discomfort or cramping. It's recommended to bring the formula to room temperature before administration to avoid gastric irritation and enhance comfort during feeding.

C. The action of withholding the feeding depends on the institution's protocol and the specific clinical condition of the client. Typically, residuals greater than 200 mL might indicate delayed gastric emptying, but the threshold can vary. A residual volume of 150 mL may not necessarily require withholding the feeding, though it may warrant further assessment.

D. In most cases, flushing is done with tap water (if safe for drinking) or sterile water in immunocompromised clients. The key step is to flush before and after feedings, but the standard practice is not automatically sterile water for all patients.

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Correct Answer is A

Explanation

A. Constipation
This is correct. Inadequate dietary intake of fiber can lead to constipation. Fiber adds bulk to the stool and promotes regular bowel movements.

B. Memory loss
Memory loss is not typically associated with an inadequate dietary intake of fiber. It is more commonly related to other factors such as aging, medical conditions, or nutritional deficiencies.

C. Brittle hair
Brittle hair is not a direct result of an inadequate intake of dietary fiber. Hair health is influenced by various factors, including overall nutrition and hydration.

D. Bleeding gums
Bleeding gums are not directly linked to an inadequate intake of fiber. However, insufficient vitamin C intake, which is often found in fruits and vegetables (sources of fiber), can contribute to gum problems.

A. Choose orange juice instead of apple juice. B. Replace sugar with molasses when baking. C. Avoid using salt substitutes when cooking. D. Eat granola for breakfast.

Correct Answer is C

Explanation

A. Choose orange juice instead of apple juice:
Explanation: Orange juice is a source of potassium, so this choice would not be appropriate for a low potassium diet.

B. Replace sugar with molasses when baking:
Explanation: Molasses is a good alternative to sugar and does not contribute significantly to potassium intake, making it suitable for a low potassium diet.

C. Avoid using salt substitutes when cooking:
Explanation: Salt substitutes often contain potassium chloride, which can increase potassium intake. Therefore, it's advisable to avoid them on a low potassium diet.

D. Eat granola for breakfast:
Explanation: Granola can be a good source of potassium, so it may not be suitable for someone on a low potassium diet.

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A nurse is administering an enteral feeding through a client's NG tube. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is collecting data from a client who has an inadequate dietary intake of fiber. Which of the following findings should the nurse expect?

Correct Answer is A

Explanation

A nurse is assisting with teaching a client who is on a low potassium diet. Which of the following instructions should the nurse include?

Correct Answer is C

Explanation

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