A nurse is administering a liquid medication to a client who has an NG tube set to intermittent suction. Identify the sequence of steps the nurse should take when administering the medication. (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.) (ORDERED RESPONSE)

Check the client's gastric residual.

Verify the tube placement.

Pour the medication into the syringe and allow it to flow by gravity.

Clamp the NG tube for 20 to 30 min.

Answer and Explanation

Correct Answer : A,B,C,D

A. Check the client's gastric residual: After confirming tube placement, gastric residual is assessed to evaluate delayed gastric emptying, which could increase the risk of aspiration. This is done before administering medications or feedings.

B. Verify the tube placement: Tube placement is verified first to ensure the medication is delivered into the stomach and not the lungs. This prevents aspiration and other complications associated with incorrect tube placement.

C. Pour the medication into the syringe and allow it to flow by gravity: Once placement is confirmed and residual checked, the medication is administered via gravity through the syringe to minimize pressure on the NG tube and promote safe delivery.

D. Clamp the NG tube for 20 to 30 min: After administering the medication, the NG tube is clamped to allow for medication absorption before suction is resumed. Immediate suctioning would remove the medication before it can take effect.

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

A. The stoma protrudes slightly from the abdomen: A stoma that protrudes slightly (about 1–2 cm) above the skin surface is normal and indicates healthy placement. This finding does not require reporting.

B. The stoma bleeds lightly when touched: Light bleeding with gentle palpation or cleaning is common due to the stoma’s rich blood supply and is generally not concerning unless bleeding is excessive.

C. The stoma is draining a small amount of liquid stool: Liquid stool drainage is expected from a colostomy, especially in the early postoperative period. This is a normal finding that does not require reporting.

D. The stoma appears dark in color: A dark, dusky, or black stoma indicates compromised blood flow and possible ischemia or necrosis. This is a serious finding that requires immediate reporting to prevent further complications.

A. Registered dietitian B. Respiratory therapist C. Speech-language pathologist D. Occupational therapist

Correct Answer is C

Explanation

A. Registered dietitian: A dietitian can assess nutritional needs and recommend appropriate diets based on swallowing ability, but they do not directly evaluate or treat swallowing disorders. Their role becomes relevant after the dysphagia has been assessed and a safe diet established.

B. Respiratory therapist: Respiratory therapists focus on managing breathing and airway clearance, which can be important if aspiration pneumonia occurs. However, they do not assess or treat the swallowing difficulties themselves.

C. Speech-language pathologist: Speech-language pathologists evaluate and treat swallowing disorders as well as communication impairments following stroke. They perform swallowing assessments and develop individualized therapy plans to improve swallowing safety and function.

D. Occupational therapist: Occupational therapists assist clients with regaining independence in activities of daily living but do not specialize in swallowing assessments or treatments. Their focus is more on motor skills, cognition, and adaptive strategies.

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Naxlex Comprehensive Predictor Exams

A nurse is collecting data from a client who is 2 days postoperative following the placement of a colostomy. Which of the following findings should the nurse report to the provider?

Correct Answer is D

Explanation

A nurse is assisting with the care of a client who is experiencing dysphagia following a recent stroke. The nurse should initiate a referral to which of the following interprofessional team members?

Correct Answer is C

Explanation

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