A nurse is assessing a client who is receiving enteral feedings via an NG tube. The client has developed hyperosmolar dehydration. Which of the following actions should the nurse take when administering the client's feedings?

Switch to a lactose-free formula.

Reposition the NG tube.

Increase the rate of formula delivery.

Add water to the formula.

Answer and Explanation

The Correct Answer is D

A. Switch to a lactose-free formula – A lactose-free formula is necessary for clients with lactose intolerance but does not address the issue of hyperosmolar dehydration, which results from insufficient free water intake rather than intolerance to lactose.

B. Reposition the NG tube – Repositioning the tube is necessary if there is displacement, but it does not treat dehydration caused by hyperosmolar feedings.

C. Increase the rate of formula delivery – Increasing the rate can worsen dehydration by further increasing the solute load, leading to a greater fluid shift from intracellular to extracellular spaces.

D. Add water to the formula – This is the correct answer because hyperosmolar dehydration occurs when high-solute enteral formulas pull water into the intestines, leading to excessive fluid loss. To prevent this, the nurse should ensure the client receives adequate free water flushes alongside tube feedings.

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Correct Answer is D

Explanation

A. Emptying an indwelling urinary catheter bag with clean gloves is appropriate and does not require intervention.

B. Performing a simple dressing change on a client’s foot is within the AP's scope of practice if the dressing is not complex or sterile.

C. Providing postmortem care is within the AP's role and does not require intervention unless specific contraindications exist.

D. Clostridium difficile (C. diff) spores are resistant to alcohol-based hand rubs. The AP must use soap and water for hand hygiene to effectively remove spores. This is an infection control breach that requires immediate intervention.

A. Potassium level B. Thyroid function tests C. Uric acid level D. Liver function tests

Correct Answer is D

Explanation

A. Potassium level – Valproic acid does not significantly affect potassium levels, so this is not a necessary baseline test.

B. Thyroid function tests – Valproic acid is not known to significantly impact thyroid function, making this an unnecessary test.

C. Uric acid level – Uric acid levels are more relevant for conditions like gout, and valproic acid does not typically cause hyperuricemia.

D. Liver function tests – This is the correct answer because valproic acid is metabolized in the liver and can cause hepatotoxicity. Baseline liver function tests (LFTs) should be reviewed before starting the medication to assess liver health.

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A nurse is assessing a client who is receiving enteral feedings via an NG tube. The client has developed hyperosmolar dehydration. Which of the following actions should the nurse take when administering the client's feedings?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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