A nurse is caring for a client who has a nasogastric (NG) tube in place for gastric decompression and notes that the tube is not draining. Which of the following steps should the nurse take first?
Reposition the NG tube.
Inject 20 mL of air and aspirate in the NG tube.
Instill an irrigation solution slowly.
Check the functioning of the suction equipment.
The Correct Answer is D
Choice A reason: Repositioning the NG tube is a later step; checking suction function is first, as equipment failure is a common cause of no drainage. Assuming repositioning is initial risks delaying simple fixes, potentially prolonging discomfort, critical to avoid in ensuring effective gastric decompression.
Choice B reason: Injecting air and aspirating is a troubleshooting step but follows checking suction equipment, which may resolve no drainage. Assuming air injection is first risks unnecessary intervention, potentially causing discomfort, critical to prevent in ensuring efficient NG tube management for gastric decompression.
Choice C reason: Instilling irrigation solution is a later step after confirming suction function, as equipment issues are more common. Assuming irrigation is first risks clogging or discomfort, critical to avoid in ensuring proper NG tube function and effective gastric decompression in clients with non-draining tubes.
Choice D reason: Checking suction equipment function is the first step for a non-draining NG tube, as equipment failure is a common issue, easily corrected. This ensures effective decompression, critical for preventing gastric distention, supporting client comfort, and guiding further troubleshooting in managing NG tube care.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Playing with a jump rope requires advanced coordination, typical of older children, not 30-month-olds, who engage in simpler play like trucks. Assuming jump rope is appropriate risks overestimating development, potentially frustrating the child, critical to avoid in supporting age-appropriate activities for toddlers.
Choice B reason: Playing with a large plastic truck is developmentally appropriate for a 30-month-old, supporting gross motor and imaginative play, critical for cognitive and physical development. This activity aligns with toddler abilities, essential for fostering engagement, creativity, and motor skills in early childhood care settings.
Choice C reason: Imaginary friends typically emerge around 3-4 years, not at 30 months, when simpler play like trucks is common. Assuming imaginary play is expected risks misjudging development, potentially overlooking age-appropriate activities, critical to prevent in supporting toddler engagement and growth.
Choice D reason: Dress-up play is more typical for preschoolers (3-5 years), requiring advanced imagination beyond 30-month-olds, who prefer trucks. Assuming dress-up is appropriate risks developmental mismatch, potentially reducing engagement, critical to avoid in ensuring age-appropriate activities for toddlers in care settings.
Correct Answer is C
Explanation
Choice A reason: Protamine sulfate reverses heparin, not midazolam, a benzodiazepine requiring flumazenil for reversal. Assuming protamine is needed risks ineffective response to oversedation, critical to avoid in ensuring rapid reversal and safety in clients post-moderate sedation with midazolam in surgical settings.
Choice B reason: Acetylcysteine treats acetaminophen overdose, not midazolam, reversed by flumazenil. Assuming acetylcysteine is appropriate risks delayed reversal of sedation, potentially causing respiratory depression, critical to prevent in ensuring safe recovery for clients post-moderate sedation with midazolam in postoperative care.
Choice C reason: Flumazenil reverses midazolam’s benzodiazepine effects, critical for managing oversedation or respiratory depression post-moderate sedation. Having it on hand ensures rapid response, essential for client safety, preventing complications, and supporting recovery in surgical settings using midazolam for procedural sedation.
Choice D reason: Naloxone reverses opioids, not midazolam, a benzodiazepine requiring flumazenil. Assuming naloxone is needed risks ineffective treatment of sedation, potentially prolonging respiratory risks, critical to avoid in ensuring proper reversal and safety in clients post-moderate sedation with midazolam.
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