A nurse is preparing to insert a client's NG tube for enteral feedings. Which of the following actions should the nurse take first?

Mark the length to be inserted on the tube with tape.

Instruct the client to hyperextend her neck.

Place a water-based lubricant on the tip of the tube.

Compare the patency of the client's nares.

Answer and Explanation

The Correct Answer is D

A. Mark the length to be inserted on the tube with tape: Marking the insertion length is important to ensure correct placement, but this step should occur after assessing which nare to use and preparing the client.

B. Instruct the client to hyperextend her neck: Hyperextending the neck is not recommended during NG tube insertion; instead, the client should slightly flex the neck to facilitate tube passage.

C. Place a water-based lubricant on the tip of the tube: Lubricating the tube reduces discomfort and eases insertion, but this step comes after selecting the nostril and preparing the client.

D. Compare the patency of the client’s nares: Assessing which nostril is more patent is the first priority to ensure the tube is inserted through the nare that offers the least resistance, reducing trauma and improving comfort during insertion.

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Correct Answer is C

Explanation

A. Scrubs hands with antibacterial soap for 10 seconds: The recommended duration for effective handwashing is at least 20 seconds to ensure adequate removal of microbes and reduce infection risk. Washing for only 10 seconds is insufficient to properly cleanse the hands.

B. Washes his hands under hot running water: Using hot water can cause skin irritation and dryness, which may lead to compromised skin integrity. Warm or cold water is recommended as it effectively removes germs without damaging the skin.

C. Uses firm, circular motions to wash his hands: Using firm, circular motions ensures thorough cleansing of all hand surfaces, including between fingers and around nails. This technique promotes effective removal of dirt and microorganisms and is consistent with hand hygiene best practices.

D. Dries his hands from the forearms to the fingers: Drying should always proceed from the fingertips toward the forearms to prevent recontamination of clean hands. Drying from forearms to fingers can transfer contaminants back to the hands, defeating the purpose of handwashing.

A. "I'll use focused breathing to control my pain." B. "I'll listen to my favorite music to take my mind off the pain." C. "I'll think about my grandfather's farm to reduce pain." D. "I'll learn to notice the sensation of muscle tension."

Correct Answer is C

Explanation

A. "I'll use focused breathing to control my pain." Focused breathing is a relaxation technique, but it is distinct from guided imagery. Guided imagery specifically involves creating vivid mental pictures to distract and soothe the mind.

B. "I'll listen to my favourite music to take my mind off the pain." Listening to music is a form of distraction or music therapy, which can help with pain management but is different from guided imagery, which relies on mental visualization.

C. "I'll think about my grandfather's farm to reduce pain." This statement reflects guided imagery, where the client mentally pictures a peaceful, pleasant scene to divert attention from pain and promote relaxation, showing understanding of the technique.

D. "I'll learn to notice the sensation of muscle tension." Noticing muscle tension is related to mindfulness or biofeedback, focusing on awareness of bodily sensations rather than the visualization involved in guided imagery.

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A nurse is preparing to insert a client's NG tube for enteral feedings. Which of the following actions should the nurse take first?

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