2. Skills Enteral Feedings
A client who lives in a long term care facility is receiving intermittent enteral feedings and is experience social isolation. Which of the following interventions should the nurse recommend? A. Encourage the client to go to the dining room at meal times to talk with other clients. B. Suggest that the client watch television while feedings are being administered. C. Remind the client that they can have visitors after feeding administration times. D. Ask the facility chaplain to speak with the client.
A
A nurse is inserting a nasogastric tube for a client and asks the client to flex their head toward their chest after the tube passes through the nasopharynx. This action facilitates proper insertion of the tube by achieving which of the following? A. Closing off the glottis B. Preventing curling of the tube in the mouth C. Allowing the client to breathe through the mouth D. Opening the lower esophageal sphincter
A
A nurse is preparing to administer a continuous enteral tube feeding to a client. The nurse should take which of the following actions to prevent a complication of the tube feeding? A. Limit the time the formula hangs to 8 hr. B. Flush the tube every 8 hr. C. Deliver the formula at a brisk rate. D. Allow the feeding bag to empty before refilling it.
A
A nurse is caring for a client who has a paralytic ileus and requires nutritional support for approximately 2 weeks. Which of the following types of feeding tubes should the nurse anticipate the provider to prescribe? A. Nasogastric tube B. Nasointestinal tube C. Percutaneous endoscopic gastrostomy tube D. Percutaneous endoscopic jejunostomy tube
B
A nurse is caring for a client who has dysfunctional gastrointestinal tract and requires enteral feeding. Which of the following formulas should the nurse administer to the client? A. Modular B. Elemental C. Polymeric D. Specialty
B
A nurse is providing teaching about risk for aspiration with a client who is receiving intermittent bolus nasogastric feedings. Which of the following findings should the nurse instruct the client to report? A. A feeling of fullness B. Persistent coughing C. Discomfort in the naris D. Postfeeding belching
B
A nurse is caring for a group of client. The nurse should identify that which of the following clients requires an enteral tube feeding? A. A client who has a paralytic ileus B. A client who has recently experienced facial trauma C. A client who has dysphagia D. A client who has a decreased appetite
C
A nurse is inserting a small-bore feeding tube. Before initiating the feeding, the nurse should take which of the following actions to verify placement? A. Measure the pH of gastric aspirate. B. Auscultate the epigastric area while injecting air. C. Obtain an x-ray. D. Place the open end of the tube in a cup of water.
C
A nurse is administering an enteral tube feeding to a client. Which of the following actions should the nurse take to prevent aspiration? A. Flush the feeding tube with 30 mL of water. B. Add blue food coloring to the enteral formula. C. Ensure the formula is at room temperature. D. Place the client in Fowler's position.
D
To determine the length of a nasointestinal tube to insert, a nurse should measure the distance from the top of the client's nose to the earlobe and from the earlobe to the A. umbilicus. B. xiphoid process. C. manubrium plus 10 to 20 cm more. D. xiphoid process plus 20 to 30 cm more.
D
