A small-bore feeding tube is placed. Which technique will the nurse use to best verify tube placement?
Auscultation
X-ray
Aspiration of contents
pH testing
The Correct Answer is B
A: Auscultation, or listening for air injected into the tube, is not a reliable method for verifying feeding tube placement. It can lead to false positives and does not confirm the tube’s location accurately.
B: X-ray is the gold standard for verifying feeding tube placement. It provides a clear image of the tube’s position, ensuring it is correctly placed in the stomach or small intestine, reducing the risk of complications.
C: Aspiration of contents can help verify placement by checking the appearance and pH of the aspirate. However, it is not as definitive as an X-ray and can sometimes be inconclusive.
D: pH testing of aspirate can indicate whether the tube is in the stomach (acidic pH) or intestines (less acidic). While useful, it is not as reliable as an X-ray for confirming placement.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A: Blood pressure of 178/90 mm Hg indicates hypertension, not dehydration. Dehydration typically leads to low blood pressure due to reduced blood volume.
B: Jugular vein distention is associated with fluid overload or heart failure, not dehydration. Dehydration usually results in flat neck veins.
C: A heart rate of 50 beats per minute is bradycardia and is not typically associated with dehydration. Dehydration often causes an increased heart rate (tachycardia) as the body tries to maintain adequate circulation.
D: Skin tenting present is a classic sign of dehydration. When the skin is pinched and does not return to its normal position quickly, it indicates a lack of fluid in the tissues.
Correct Answer is ["740"]
Explanation
Step 1: Convert 4 oz juice to mL. 4 oz × 30 mL per oz = 120 mL
Step 2: Convert 6 oz hot tea to mL. 6 oz × 30 mL per oz = 180 mL
Step 3: Ice chips are recorded at half their volume. 100 mL ÷ 2 = 50 mL
Step 4: IV bolus is already in mL. 150 mL
Step 5: Convert 8 oz broth to mL. 8 oz × 30 mL per oz = 240 mL
Step 6: Add all the volumes together. 120 mL + 180 mL + 50 mL + 150 mL + 240 mL = 740 mL
The nurse should record 740 mL of intake on the client’s record.
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