Since I'm on a roll, here are Monday's questions!

[twinmommy+2]

1. The nurse is caring for a client with a resolved intestinal obstruction who has a nasogastric tube in place. The client has tolerated the tube being clamped every 2 hours for 1 hour. The physician has now ordered the nasogastric tube to be removed. Before removing the tube, the nurse assesses for

a. proper nasogastric tube placement

b. normal serum electgrolyte levels

c. the presence of bowel sounds in all four quadrants

d. Normal pH of the gastric aspirate

2. The nurse has administered about half of the enema solution when the client complains of pain and cramping. which nursing action is the most appropriate?

a. Raise the enema bag so that the solution can be completed quickly

b. Clamp the tubing for 30 seconds and restart the flow at a slower rate

c. Reassure the client and continue the flow

d. Discontinue the enema and notify the physician.

3. The nurse is preparing to administer an emema. The nurse positions the client in the

a. Left lateral position with the right leg acutely flexed

b. Right Sims' position

c. Dorsal recombent position

d. Right lateral position with the left leg acutely flexed

4. The nurse aspirates 40 mL of undigested formula from the client's nasogastric tube. Before administering an intermittent tube feeding, the nurse understands that 40 mL of gastric aspirate should be

a. Discarded properly and recorded as output on the client's intake and output record

b. Poured into the nasogastric tube through a syringe with the plunger removed

c. Mixed with the formula and poured into the nasogastric tube through a syringe with the plunder removed

d. Diluted with water and injected into the nasogastric tube by putting pressure on the plunger

[hzrizen]

1-c

2-b

3-b

4-a

We will see. Thanks for posting these i really like them alot.

Donna

[suzy253, RN]

c, b, a, b

[grinnurse, RN]

1. C

2. B

3. B

4. A

[Love4Me, RN]

1. C

2. B

3. A

4. B

[Bevi]

1. C

2. B

3. A

4. A

1. The nurse is caring for a client with a resolved intestinal obstruction who has a nasogastric tube in place. The client has tolerated the tube being clamped every 2 hours for 1 hour. The physician has now ordered the nasogastric tube to be removed. Before removing the tube, the nurse assesses for

a. proper nasogastric tube placement

b. normal serum electgrolyte levels

c. the presence of bowel sounds in all four quadrants

d. Normal pH of the gastric aspirate

2. The nurse has administered about half of the enema solution when the client complains of pain and cramping. which nursing action is the most appropriate?

a. Raise the enema bag so that the solution can be completed quickly

b. Clamp the tubing for 30 seconds and restart the flow at a slower rate

c. Reassure the client and continue the flow

d. Discontinue the enema and notify the physician.

3. The nurse is preparing to administer an emema. The nurse positions the client in the

a. Left lateral position with the right leg acutely flexed

b. Right Sims' position

c. Dorsal recombent position

d. Right lateral position with the left leg acutely flexed

4. The nurse aspirates 40 mL of undigested formula from the client's nasogastric tube. Before administering an intermittent tube feeding, the nurse understands that 40 mL of gastric aspirate should be

a. Discarded properly and recorded as output on the client's intake and output record

b. Poured into the nasogastric tube through a syringe with the plunger removed

c. Mixed with the formula and poured into the nasogastric tube through a syringe with the plunder removed

d. Diluted with water and injected into the nasogastric tube by putting pressure on the plunger

[twinmommy+2, ADN, BSN, MSN]

1. = C Rational- Distention, vomiting, and abdominal pain are a few of the symptoms associated with intestinal obstruction. Nasogastric tubes may be used to remove gas and fluid from the stomach, thus relieving distention and vomiting. Bowel sounds return to normal as the obstruction is resolved and normal bowel function is restored. Discontinuing the nasogastric tube before normal bowel function returns may result in a return of the symptoms, necessitating reinsertion of the nasogastric tube. Serum electrolyte levels, tube placement, and pH of gastgric aspirate are important assessments for the client with a nasogastric tube in place but would not assist in determining the readiness for removing the nasogastric tube.

2. = B Rational- The enema fluid should be administered slowly. If the client complains of fullness or pain, the flow is stopped for 30 seconds and restarted at a slower rate. Slow enema administration and stopping the flow temporarily, if necessary, will decrease the likelihood of intestinal spasm and premature ejection of the solution. The higher the solution container is held above the rectum, the faster the flow and the greater the force in the rectum. The nurse does not need to discontinue the enema and notify the physician at this time. Although the client reassurance is important, continuing the flow is inappropriate.

3. = A Rational- The sigmoid and descending colon are located on the left side. Therefore the left lateral position uses gravity to facilitate the flow of solution into the sigmoid and descending colon. Acute flexion of the right leg allows for adequate exposure of the orifice. Options b, c, and d are incorrect positions.

4. = B Rational- After checking residual feeding contents, the gastric contents are reinstilled into the stomach by removing the syringe bulb or plunger and pouring the gastric contents into the syringe and through the nasogastric tube. Gastric contents should be reinstilled to maintain the client's electrolyte balance. The gastric contents should be poured into the nasogastric tube throughh a syringe without a plunger and not injected by putting pressure on the plunger. Gastric contents do not need to be mixed with water nor should the contents be discarded.