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While assessing placement of a nasogastric tube (NGT), the nurse aspirates cloudy green fluid into a syringe. Which intervention should the nurse implement?

Send fluid specimen to the lab.

Withdraw the NGT and reinsert.

Connect the NGT to wall suction.

Determine pH value of specimen.

Answer and Explanation

The Correct Answer is D

Choice A

This is unnecessary and not a standard clinical practice for confirming NGT placement.

Choice B

Withdrawing the NGT and reinsert should not be implemented. If the NGT is in the wrong place, reinserting it without further assessment could worsen the situation. The nurse should not reinsert the NGT until the correct placement is confirmed.

Choice C

Connecting the NGT to wall suction should not be implemented. Connecting the NGT to wall suction without verifying its placement could cause harm, especially if the tube is in the respiratory tract.

Choice D

This is the most evidence-based bedside method to confirm placement after the initial X-ray. Gastric aspirate typically has a pH of 5.0 or less. If the pH is higher (e.g., >6.0), it may indicate that the tube is in the lungs or the small intestine.

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Correct Answer is A

Explanation

Choice A

Body mass index (BMI) of 17 is the correct finding. A low Body Mass Index (BMI) is a common indicator of malnutrition. BMI is a measurement that considers a person's weight in relation to their height. A BMI of 17 suggests that the person is underweight, which can be indicative of malnutrition. Malnutrition is characterized by inadequate intake of calories, protein, vitamins, and minerals that are essential for maintaining health and well-being.

Choice B

Decrease in appetite is not correct finding. While a decrease in appetite might contribute to malnutrition, it's a symptom rather than a definitive indicator.

Choice C

Dry mucosal membranes are not the correct finding. Dry mucosal membranes can be related to dehydration or other conditions, but they are not specific enough to confirm malnutrition on their own.

Choice D

Weight of 227 pounds (103 kg) is not the correct finding. This weight is not necessarily indicative of malnutrition on its own. It's important to consider the individual's height, BMI, and other factors when assessing malnutrition.

A. Sweaty palms. B. Bunions. C. Dry skin. D. Fatigue.

Correct Answer is D

Explanation

Choice A

Sweaty palms are incorrect. Sweaty palms could be a normal response to physical activity and might not necessarily indicate a significant underlying issue.

Choice B

Bunions are incorrect. While bunions can cause discomfort, they might not be directly related to overall health, especially in comparison to fatigue.

Choice C

Dry skin is incorrect. Dry skin could be related to various factors, including environmental conditions or skincare habits. While it's worth addressing, it might not be as immediately concerning as unexplained fatigue.

Choice D

Fatigue is correct. For a professional dancer, fatigue should be an issue that alerts the nurse to perform further assessment. While all of the options can provide information about the client's health, fatigue in a professional dancer could be indicative of various underlying issues that may affect their overall well-being and performance.

Fatigue in a dancer might result from factors such as inadequate nutrition, overtraining, insufficient rest, or underlying medical conditions. It's important for the nurse to explore further to understand the potential causes of the fatigue and address them appropriately.

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While assessing placement of a nasogastric tube (NGT), the nurse aspirates cloudy green fluid into a syringe. Which intervention should the nurse implement?

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Correct Answer is D

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