A nurse is caring for a client who is receiving continuous enteral feeding via NG tube.

Which of the following is an unexpected finding?

The correct answer is d. Unplug the pump.

Rationale for Choice A:

• While notifying the biomedical department to fix the pump is important,it is not the immediate priority in this situation.The first step is to ensure patient and staff safety by removing the potential electrical hazard.
• Delaying the removal of the sparking pump could lead to electrical shock,fire,or other serious consequences.
• Biomedical staff can be notified after the immediate safety risk has been addressed.

Rationale for Choice B:

• Obtaining a replacement pump is necessary to continue the client's IV therapy,but it is not the first action the nurse should take.
• The priority is to eliminate the electrical hazard posed by the sparking pump.
• Once the faulty pump is unplugged and safety is ensured,the nurse can then proceed to obtain a replacement pump.

Rationale for Choice C:

• Labeling the pump with a defective equipment sticker is important to prevent others from using it,but it does not address the immediate safety risk.
• The priority is to disconnect the pump from the power source to eliminate the risk of electrical shock or fire.
• Labeling can be done after the pump has been unplugged and the situation has been assessed.

Rationale for Choice D:

• Unplugging the pump is the correct first action because it immediately removes the electrical hazard,preventing potential harm to the patient,staff,or equipment.
• This action prioritizes safety and mitigates the risk of electrical shock,burns,fire,or other serious consequences.
• It is essential to act quickly and decisively in such situations to ensure a safe environment for everyone involved.

When preparing medication from a vial for subcutaneous injection for a client, the nurse should hold the vial with the top facing upward while injecting air into the vial.
This is because injecting air into the vial equalizes the pressure inside and makes it easier to withdraw the medication 1.
Choice A is wrong because holding the syringe so that bubbles collect at the level of the plunger is not necessary when preparing medication from a vial.
Choice C is wrong because injecting air into the vial with the eye of the needle immersed in the fluid can contaminate the medication.
Choice D is wrong because holding the syringe at a 45° angle is not necessary when verifying dosage.