A nurse is caring for a client who is receiving enteral feedings via NG tube. Which of the following actions should the nurse take prior to administering the formula?

Check for gastric residual volume.

Flush the tube with sterile 0.9% sodium chloride irrigation.

Encourage the client to take sips of water.

Encourage the client to breathe deeply and cough.

Answer and Explanation

The Correct Answer is A

A. Before administering enteral feeding, it is important to check the gastric residual volume to ensure that the previous feeding has been adequately digested and to reduce the risk of aspiration. High residual volumes can indicate delayed gastric emptying and may require holding the feeding.

B. While it is important to flush the tube, this is typically done with water (sterile or tap) rather than sterile 0.9% sodium chloride, unless specifically ordered for medical reasons. The primary step before feeding is to check the residual volume.

C. Encouraging the client to take sips of water is not applicable in the context of enteral feeding via NG tube, as the feeding is delivered directly into the stomach or intestines.

D. Encouraging deep breathing and coughing is not relevant to the administration of enteral feedings via an NG tube. These actions are more related to respiratory care.

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Correct Answer is B

Explanation

Cleanse hands with an alcohol-based hand rub before client contact. This action reduces the risk of transmitting microorganisms to the client who has a weakened immune system.

A. False imprisonment B. Assault C. Invasion of privacy D. Negligence

Correct Answer is A

Explanation

False imprisonment. The rationale for this answer is that false imprisonment is the unlawful confinement of a person without consent or legal justification. The nurse violated the client's right to freedom of movement by placing him in restraints without a valid prescription or indication.

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A nurse is caring for a client who is receiving enteral feedings via NG tube. Which of the following actions should the nurse take prior to administering the formula?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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