A nurse is checking for proper placement of a feeding tube.
Which of the following methods is the most reliable for verification of tube placement?
Verify the bilirubin level of the tube contents.
Check the pH level of gastric contents.
Auscultate for air insufflation.
Request a chest x-ray.
The Correct Answer is D
Choice A rationale
Verifying the bilirubin level of the tube contents is not a standard or reliable method for checking the placement of a feeding tube. Bilirubin is a bile pigment found in the liver and bile ducts, and its levels are not indicative of tube placement in the gastrointestinal tract.
Choice B rationale
Checking the pH level of gastric contents can help determine if the tube is in the stomach, but it is not the most reliable method. Gastric pH is typically acidic (1.5-3.5), but the pH can vary, and this method does not rule out respiratory placement or other incorrect placements.
Choice C rationale
Auscultating for air insufflation involves listening for the sound of air injected through the tube into the stomach. However, this method is not reliable as it does not confirm the exact location of the tube and can give false positives if the tube is in the esophagus or respiratory tract.
Choice D rationale
Requesting a chest x-ray is the most reliable method for verifying feeding tube placement. It provides a clear visual confirmation of the tube's location, ensuring it is correctly positioned in the stomach or small intestine and not in the respiratory tract or other incorrect locations.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Standing with the crutch tips against the feet is incorrect. Proper crutch placement involves positioning the crutches slightly forward and to the side of the feet to provide stability and prevent tripping.
Choice B rationale
Bearing weight on the unaffected leg is the correct instruction for using the three-point gait. This technique allows the client to move the crutches and the affected leg together while bearing weight on the unaffected leg, promoting balance and mobility.
Choice C rationale
Keeping the crutches at the level of the axillae is incorrect. Crutches should be positioned with a 1-2 inch gap below the axillae to prevent nerve damage and ensure proper support.
Choice D rationale
Holding the arms straight when walking is incorrect. The elbows should be slightly bent to allow for comfortable movement and better control of the crutches.
Correct Answer is A
Explanation
Choice A rationale
Unequal height of the shoulders is a common indication of scoliosis. This asymmetry is often observed when a person bends forward and is a key sign during scoliosis screening.
Choice B rationale
Increased concave curve of the thoracic spine is more indicative of kyphosis, not scoliosis. Scoliosis involves a lateral curvature of the spine rather than an increase in the concave curve.
Choice C rationale
Expansion of the upper intercostal spaces is not typically associated with scoliosis. This finding is more related to respiratory conditions and does not indicate spinal curvature.
Choice D rationale
Increased convex curve of the cervical spine indicates lordosis, a condition affecting the lower spine. It is not a sign of scoliosis, which involves a lateral curve rather than a convex or concave increase.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.