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CMS Lab Enteral Feed Name: Multiple Choice Identify the choice that best completes the statement or answers the question. C____ 1. Of the patients listed below, which would be a candidate for nasoenteric feeding tube placement? a. Post-motor vehicle accident victim with a broken nose and jaw b. Patient with a bleeding ulcer and possible esophageal varices c. Elderly patient with a diagnosis of failure to thrive and an inability to chew d. Patient with an esophageal tumor _D___ 2. The nurse has just inserted a nasogastric (NG) feeding tube into a patient. What should the nurse do to definitely ascertain that the tube is in the stomach or in the intestine? a. Test the pH of the contents. b. Use a carbon dioxide sensor. c. Lower the head of the bed to 15 degrees. d. Obtain an order for a chest radiograph. A____ 3. The nurse is checking gastric residual on a patient who has a continuously running tube feeding. She finds that the patient has a 600-mL residual volume. How should the nurse respond? a. Stop the tube feeding. b. Slow the tube feeding. c. Continue the tube feeding at the same rate. d. Increase the rate of the tube feeding. ___B_ 4. Before insertion of a nasogastric (NG) tube, of which finding should the physician be notified? a. Patent nares b. Absent bowel sounds c. Evident gag reflex d. Impaired swallowing _C___ 5. An appropriate technique for nasogastric (NG) tube insertion is for the nurse to: a. position the patient supine. b. apply oil-based lubricant to the plastic tube. c. advance the tube while the patient swallows. d. measure the tube length from the nose to the sternum. _B___ 6. Which technique is appropriate for the nurse to implement during nasogastric (NG) tube insertion? a. Use sterile gloves. b. Have the patient mouth-breathe. c. Advance the tube quickly when the patient coughs. d. Bend the patient’s head backward after the tube is through the nasopharynx. ___D_ 7. The nurse has inserted a nasogastric (NG) feeding tube. The feeding tube has a stylet in place to aid insertion. What should the nurse do once the tube is in place? a. Remove the stylet immediately. b. Reinsert the stylet if the radiograph determines incorrect placement. c. Fasten the end of the NG tube to the patient’s gown using tape and a safety pin. d. Leave the stylet in place and obtain a chest/abdomen radiograph. __A__ 8. The nurse is caring for a patient who is receiving continuous tube feedings. What must the nurse do to care for this patient? a. Verify tube position every 4 to 6 hours. b. Obtain a radiograph every 4 to 12 hours. c. Instill air into the stomach via the tube and listen for bubbles. d. Do not worry about tube placement because the tube has already been determined to be in the right place. __C__ 9. The home health nurse evaluates the provision of intermittent tube feedings by the patient’s family member. The nurse notes that additional teaching is required when she notices that the family member: a. keeps the formula refrigerated between feedings. b. keeps the feeding tube capped between feedings. c. begins the feeding before checking tube placement. d. irrigates the tube with 30 to 60 mL of water before and after feedings. __C__ 10. Which evaluation indicates that placement of a nasogastric or enteric tube is correct? a. Nasointestinal aspirate with a pH of less than 6 b. Pleural fluid pH of less than 6 c. Gastric aspirate with a pH of 5 or less after patient fasting d. Gastric aspirate with a pH of 4 and continuous tube feedings C____ 11. The nurse is checking the residual volume on a patient who is getting intermittent tube feedings via his NG tube. Which of the following may indicate that the patient has started to bleed again? a. The nurse obtains brown aspirate. b. The nurse notices that the abdomen is distended. c. The nurse obtains red aspirate. d. The nurse notices severe respiratory distress. _D___ 12. The nurse determines that a nasogastric (NG) tube needs irrigation when she: a. obtains more than 200 mL of residual volume. b. obtains a small amount of thin watery residual. c. does not encounter resistance when aspirating the residual. d. obtains a unusually thick secretions. __B__ 13. What is an appropriate amount of nasogastric irrigant for an adult patient? a. 1 or 2 mL b. 30 mL c. 5 to 15 mL d. 250 mL ___C_ 14. Which technique is appropriate for providing intermittent tube feeding once placement of the tube has been checked? a. Cooling the formula b. Lowering the head of the bed c. Allowing the bag to empty gradually over 30 to 45 minutes d. Adding food coloring to detect aspiration _C___ 15. The nurse is preparing to administer an enteral feeding for the patient. The patient has been on enteral feedings for 2 days. The nurse knows that the most appropriate technique for implementing enteral feeding is: a. weighing the patient weekly. b. measuring the gastric residual every hour. c. changing the formula every 12 hours in an open system. d. leaving the formula in place in an open system for up to 24 hours. _B___ 16. The nurse is initiating a continuous tube feeding for a patient who has a gastrostomy tube. Which of the following procedures indicates proper practice? a. Allow the container to empty gradually over 60 minutes. b. Change the bag every 24 hours. c. Do not use water to flush the tube. d. Quickly increase the rate of administration. ___D_ 17. The nurse would anticipate the need for an enteral access device in which of the following patients? a. Patient whose bowel sounds have not yet returned after abdominal surgery b. Patient who recently suffered a cerebrovascular accident (CVA) c. Patient who dislikes the taste of facility meals d. Patient who suffers from severe acute dysphagia

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