CHARLES

EXAM PRACTICE
Tube care
1. 
Which of the following is not true regarding the types of a nasogastric tube?

2. 
A newly RN nurse is about to insert a nasogastric tube to a client with Guillain-Barre Syndrome. To determine the accurate measurement of the length of the tube be inserted, the nurse should:

3. 
A stroke client who was initially on NGT feeding was able to tolerate soft diet so the physician ordered for the removal of it. The nurse would instruct the client to do which of the following before he removes the tube?

4. 
The nurse is preparing to give bolus enteral feedings via a nasogastric tube to a comatose client. Which of the following actions is an inappropriate practice by the nurse?

5. 
A nurse is checking the nasogastric tube position of a client receiving a long term therapy of Omeprazole (Prisolec) by aspirating the stomach contents to check for the PH level. The nurse proves that correct tube placement if the PH level is?

6. 
Before feeding a client via NGT, the nurse checks for residual and obtains a residual amount of 90ml. What is the appropriate action for the nurse to take?

7. 
Continuous type of feedings is administered over a __ hour period.?  

8. 
A client is subjected to undergo a chest x-ray to confirm the endotracheal tube placement. The tube should be how many centimeters above the carina?

9. 
After the client had tolerated the weaning process, the physician ordered the removal of the endotracheal tube and will be shifted into a nasal cannula. Which of the following findings after the removal requires immediate intervention by the physician?

10. 
The nurse is assessing a client with an endotracheal tube and observes that the client can make verbal sounds. What is the most likely cause of this?

11. 
While changing the tapes on a tracheostomy tube, the client coughs and the tube is dislodged. Which is the initial nursing action?

12. 
The nurse caring for a client with a pneumothorax and who has had a chest tube inserted notes continuous gentle bubbling in the suction control chamber. What action is most appropriate of the nurse?

13. 
The nurse is assessing the functioning of a chest tube drainage system in a client with hemothorax. Which of the following findings should prompt the nurse to notify the physician?

14. 
A nurse is supervising a student nurse who is performing tracheostomy care for a client. Which of the following actions by the student should the nurse intervene?

15. 
The nurse is handling a client with a chest tube. Suddenly, the chest drainage system is accidentally disconnected, what is the most appropriate action for the nurse to take?

16. 
When preparing to change a right subclavian vein TPN bag and tubing, the patient instructions must include:

17. 
Total Parenteral Nutrition (TPN) may not have any medications added to it except:

18. 
A patient receiving parenteral nutrition may have it administered via the following routes except:

19. 
Parenteral nutrition differs from enteral nutrition because:

20. 
Your patient has a PEG tube and you are about to administer a feeding. While checking residual you obtain 95 ml of stomach contents. What would be your next nursing intervention?

21. 
Which patient would benefit from a Nasogastric Tube?

22. 
Your patient has a PEG tube and you are about to administer a tube feeding using the feeding pump. You note that the last feeding tube hanging on the pole is labeled Aug 16 and today's date is Aug 18. Which nursing action is correct.

23. 
You just inserted a Nasogastric tube. Which of the following is not a correct way to check correct placement of the tube?

24. 
You are receiving report from a nurse at another hospital who will be transferring a patient to your ICU. The patient has a Sengstaken-Blackmore Tube. Which of the following statement is incorrect about this tubing?

25. 
You are caring for a patient with a nephrostomy tube. What nursing intervention would you include in your plan of care?

26. 
Your patient has an endotracheal tube. You are assessing placement by listening to the lung sounds and you notice that the breath sounds and chest wall movement are absent on the left side? What is usually the cause of this?

27. 
You patient is ordered a chest x-ray to confirm endotracheal tube placement. The tube should be how many cm above the carina?

28. 
You are assessing your patient with an endotracheal tube and note that the patient is able to make verbal sounds. What is the most likely cause?

29. 
A patient with a tracheostomy needs to be suctioned. What would you do first before suctioning the patient?

30. 
Your patient has a chest tube. Your assessing the water seal chamber and you note that the water moves up as the patient inhales and then moves down when the patient exhales. What may be causing this to happen?

31. 
A patient with a pneumothorax has a chest tube present. The water seal chamber has continuous bubbling. What intervention would you take?

32. 
During the morning assessment of your patient with a chest tube, you note that there is no fluctuation in the water seal chamber. The patient does not appear to be in respiratory distress. What could have caused this ceasing of fluctuation?

33. 
Your outside the patient's room when you hear a "thud". You run into the room and the patient has fallen and the patient's chest tube was accidentally pulled out. You quickly do the following?

34. 
You are assisting a MD with the removal of a chest tube. What activity may the MD have the patient perform while the chest tube is being removed?

35. 
A patient with poor wound healing and poor appetite has an order to begin total parental nutrition (TPN).  Which of the following the nurse should obtain?

36. 
The nurse is planning care for several children who were admitted during the shift.  Daily weights should be of the plan of care for the child who is receiving:

37. 
A nurse has just started total parenteral nutrition (TPN) as prescribed for a patient with severe dysphagia an low prealbumin levels.  In one to two hours, the nurse should anticipate assessing the patient’s.

38. 
A nurse is caring for a patient receiving parenteral nutrition (TPN).  The patient reports the sudden onset of feeling short of breath and anxious.  The nurse hears crackles in bilateral lower lobes of the lungs and the patient’s O2 saturation is 90% on room air.  The nurse must IMMEDIATELY.

39. 
A patient receiving parenteral nutrition is administered via the following routes except:

40. 
A nurse is monitoring the status of a client’s fat emulsion (lipid) infusion and notes that the infusion is 2 hours delay. The nurse should do which of the following actions?

41. 
A nurse is preparing to hang the initial bag of the parenteral nutrition (PN) solution via the central line of a malnourished client. The nurse ensure the availability of which medical equipment before hanging the solution?

42. 
A nurse is conducting a follow-up home visit to a client who has been discharged with a parenteral nutrition(PN).  Which of the following should the nurse most closely monitor in this kind of therapy?

43. 
 nurse is preparing to hang a fat emulsion (lipids) and observes some visible fat globules at the top of the solution. The nurse ensure to do which of the following actions?

44. 
A client is receiving nutrition via parenteral nutrition (PN). A nurse assess the client for complications of the therapy and assesses the client for which of the following signs of hyperglycemia?

45. 
A nurse is caring a client who disconnected the tubing of the parenteral nutrition from the central line catheter. A nurse suspects an occurrence of an air embolism. Which of the following is an appropriate position for the client in this kind of situation?

46. 
A client is being weaned off from parenteral nutrition (PN) and is given a go-signal to take a regular diet. The ongoing solution rate has been 120ml/hr. A nurse expects that which of the following prescriptions regarding the PN solution will accompany the diet order?

47. 
A nurse is making initial rounds at the beginning of the shift and notice that the parenteral nutrition (PN) bag of an assigned client is empty. Which of the following solutions readily available on the nursing unit should the nurse hang until another PN solution is mixed and delivered to the nursing unit?

48. 
A nurse is caring for a group of clients on a medical-surgical nursing unit. The nurse recognizes that which of the following clients would be the least likely candidate for parenteral nutrition?

49. 
A client is receiving parenteral nutrition (PN) suddenly is having a fever. A nurse notifies the physician and the physician initially prescribes that the solution and tubing be changed. The nurse should do which of the following with the discontinued materials?

50. 
A nurse is changing the central line dressing of a client receiving parenteral nutrition (PN) and notes that there are redness and drainage at the insertion site. The nurse next assesses which of the following?

51. 
A client receiving parenteral nutrition (PN) complains of a headache. A nurse notes that the client has a bounding pulse, jugular distension, and weight gain greater than desired. The nurse determines that the client is experiencing which complication of PN therapy?

52. 
A nurse is preparing to change the parenteral nutrition (PN) solution bag and tubing. The client’s central venous line is located in the right subclavian vein. The nurse ask the client to take which essential action during the tube change?

53. 
A nurse is preparing to change the parenteral nutrition (PN) solution bag and tubing. The client’s central venous line is located in the right subclavian vein. The nurse ask the client to take which essential action during the tube change?

54. 
A client receiving parenteral nutrition (PN) complains of shortness of breath and shoulder pain. A nurse notes that the client has an increased pulse rate. The nurse determines that the client is experiencing which complication of PN therapy?

55. 
A nurse is caring for a combative client who is ordered to have a nutritional therapy using parenteral nutrition (PN). The nurse should plan which of the following measures to prevent the client from injury?

56. 
Nurse Spencer is caring for an anorexic client who is having total parenteral nutrition solution for the first time. Which of the following assessments requires the most immediate attention?

57. 
Nurse Russell is preparing to give a total parenteral nutrition using a central line. Place the following steps for administration in the correct order?

1. Connect the tubing to the central line.
2. Regulate the electric infusion pump at the ordered rate.
3. Maintain aseptic technique when handling the injection cap.
4. Check the solution for cloudiness, particles, or a change in color.
5. Prime the IV tubing through an infusion pump.
6. Select and flush the correct tubing and filter.

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