A nurse is preparing to administer a nasogastric (NG) tube feeding to a school-age child. Which of the following actions should the nurse plan to take?
Measure the tubing from the nose to the distal port.
Position the chud at a 10 to 20 angle after feeding.
Complete the feeding in 5 min.
Warm the formula in the microwave
The Correct Answer is A
A. Measure the tubing from the nose to the distal port. Proper placement of an NG tube requires measuring from the tip of the nose to the earlobe, then to the xiphoid process. This ensures the tube reaches the stomach without curling or entering the airway.
B. Position the child at a 10 to 20 angle after feeding. A head elevation of at least 30 to 45 degrees is necessary during and after NG feedings to reduce the risk of aspiration. A 10 to 20 degree angle is too low and unsafe for post-feeding positioning.
C. Complete the feeding in 5 min. NG feedings should be given slowly over 20 to 30 minutes to prevent gastrointestinal discomfort, cramping, or vomiting. A 5-minute infusion is too rapid and may overwhelm the child’s digestive capacity.
D. Warm the formula in the microwave. Microwaving formula can lead to uneven heating and hot spots, which pose a burn risk to the child. Formula should be warmed by placing the container in warm water and testing the temperature before administration.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"}}
Explanation
- Provide the client with high-calorie fluids every hr: Clients in manic states often experience poor nutritional intake due to hyperactivity and distractibility. Frequent, easy-to-consume high-calorie fluids help support caloric and hydration needs without requiring the client to sit for meals, making this an appropriate intervention.
- Minimize environmental stimuli for the client: Clients experiencing mania are often overstimulated and agitated due to their heightened sensitivity and rapid thought processes. A low-stimulation environment helps reduce agitation, prevent escalation, and promote safety.
- Weigh the client each day: While weight monitoring may be important in some psychiatric or medical conditions, daily weights are not a priority in the acute management of mania, particularly when the client is hyperactive, distracted, and unable to participate reliably. This could also increase agitation or preoccupation in some clients.
- Encourage the client to avoid napping during the day: Manic clients often suffer from significantly reduced sleep, which contributes to worsening symptoms. Encouraging rest and short naps would be more therapeutic than promoting wakefulness, so avoiding naps is contraindicated in this scenario.
Correct Answer is B
Explanation
A. Have the client store smaller tanks under his bed. Oxygen tanks should never be stored in enclosed or confined spaces such as under a bed due to the risk of fire and poor ventilation, which can increase the danger of oxygen accumulation.
B. Place the oxygen tank away from curtains or drapes. This is essential to reduce the risk of fire. Oxygen supports combustion, so keeping the tank away from flammable materials like curtains helps ensure a safe home environment.
C. Store the oxygen tank wrench in a locked cabinet. The wrench should be kept accessible, not locked away, to allow quick adjustments or shut-off in case of emergency. Immediate access is a priority in safe oxygen use.
D. Ensure that the client checks the gauge weekly. The oxygen tank gauge should be monitored more frequently than once a week to avoid running out of oxygen unexpectedly, especially in clients with chronic respiratory conditions like COPD.
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