The management of the patient's gastrostomy is an assessment priority for the home care nurse. What statement would indicate that the patient is managing the tube correctly?

"The only time I flush my tube is when I'm putting in medications."

"I clean my stoma twice a day with alcohol."

"I try to stay still most of the time to avoid dislodging my tube."

"I flush my tube with water before and after each of my medications."

Answer and Explanation

The Correct Answer is D

Choice A reason:

Flushing the tube only when administering medications is not sufficient for proper maintenance. Regular flushing with water helps prevent clogs and ensures tube patency.

Choice B reason:

Cleaning the stoma with alcohol is not necessary and can be irritating to the skin. Mild soap and water are typically recommended for stoma care.

Choice C reason:

While being cautious to avoid dislodging the tube is important, it is not the primary indicator of correct tube management. Proper flushing and care are essential components of tube

maintenance.

Choice D reason:

Flushing the tube with water before and after each medication administration is a crucial step in maintaining tube patency and preventing clogs. This indicates that the patient is managing the

tube correctly.

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Correct Answer is A

Explanation

Choice A reason:

Asterixis is a characteristic sign of hepatic encephalopathy, characterized by a flapping tremor of the hands. It is associated with liver dysfunction and is indicative of impaired ammonia metabolism in the brain.

Choice B reason:

Fetor hepaticus refers to a musty, sweet odor of the breath that is associated with severe liver disease. It is not related to the flapping tremor observed in this case.

Choice C reason:

Palmar erythema is a reddening of the palms and is associated with various conditions, including liver disease. However, it is not the sign described in the scenario.

Choice D reason:

Constructional apraxia is a neurological deficit characterized by difficulty in copying or constructing simple drawings or designs. It is not related to the flapping tremor seen in hepatic encephalopathy.

Correct Answer is ["3.6"]

Explanation

To calculate the dose of Ceclor in mg, multiply the weight in kg by the dosage in mg/kg/day and divide by the number of doses per day.
To convert pounds to kg, divide by 2.2.
To calculate the volume of Ceclor in mL, divide the dose in mg by the concentration in mg/mL.
Convert 66 pounds to kg: 66 / 2.2 = 30 kg
Calculate the dose of Ceclor in mg: 30 x 45 / 3 = 450 mg
Calculate the volume of Ceclor in mL: 450 / 125 = 3.6 mL
The nurse would administer 3.6 mL per dose.

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The management of the patient's gastrostomy is an assessment priority for the home care nurse. What statement would indicate that the patient is managing the tube correctly?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a patient with hepatic encephalopathy. While making the initial shift assessment, the nurse notes that the patient has a flapping tremor of the hands. The nurse should document the presence of what sign of liver disease?

Correct Answer is A

Explanation

Give Ceclor 45mg/kg/day p.o. in 3 divided doses for a patient who weighs 66 pounds. A 75mL stock medication is labeled Ceclor 125mg/mL. How many mLs would the nurse administer per dose? Units in mL. (Please record your exact answer)

Correct Answer is ["3.6"]

Explanation

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