A nurse is caring for a client who is receiving continuous enteral feeding via NG tube.
Which of the following is an unexpected finding?
Gastric residual of 300 mL at the end of the shift.
Weight gain of 0.91 kg (2 Ib) in 2 days.
Blood glucose level of 110 mg/dL.
Diarrhea one time in a 24-hr period.
The Correct Answer is A
Gastric residual of 300 mL at the end of the shift is an unexpected finding.
Gastric residual volume refers to the volume of fluid remaining in the stomach during enteral feeding.
A gastric residual volume of less than or equal to 500 mL every 6 hours is considered safe and indicates that the gastrointestinal tract is functioning.
Choice B is wrong because weight gain is expected during enteral feeding.
Choice C is wrong because a blood glucose level of 110 mg/dL is within the normal range.
Choice D is wrong because diarrhea can be a common side effect of enteral feeding.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
This is because before providing the client with information about insulin self-administration and other resources, it is important to first determine whether the client can afford the insulin administration supplies.
This will help to ensure that the client has access to the necessary supplies for managing their diabetes mellitus.
Choice A is wrong because making a copy of the medication reconciliation form for the client is not the first action that should be taken.
While it is important to provide the client with a copy of their medication reconciliation form, this should be done after determining whether the client can afford the insulin administration supplies.
Choice B is wrong because obtaining printed information about insulin self-administration is not the first action that should be taken.
While it is important to provide the client with information about insulin self-administration, this should be done after determining whether the client can afford the insulin administration supplies.
Choice C is wrong because providing the client with the contact number for a diabetes education specialist is not the first action that should be taken.
While it is important to provide the client with resources for diabetes education, this should be done after determining whether the client can afford insulin administration supplies.
Correct Answer is ["C","D","E"]
Explanation
“I need to have a fire escape plan with my family,” “I will use the grab bars when getting in and out of the bathtub,” and “I need to check my medications for expiration dates” are all important home safety measures.
Choice A is wrong because setting the hot water heater to 140 degrees Fahrenheit is too high and can increase the risk of scalding.
The recommended temperature for a hot water heater is 120 degrees Fahrenheit.
Choice B is wrong because applying tape over frayed areas of electrical cords is not a safe solution.
Frayed electrical cords should be replaced to prevent electrical hazards.
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