A nurse is assessing for correct placement of a client's NG feeding tube prior to administering a bolus feeding. Which of the following actions should the nurse take?
Insert air in the tube and listen for gurgling sounds in the epigastric area.
Aspirate contents from the tube and verify the pH level.
Review the medical record for previous x-ray verification of placement.
Auscultate the lungs for adventitious breath sounds.
The Correct Answer is B
A. This is an incorrect action. Inserting air in the tube and listening for gurgling sounds in the epigastric area is not a reliable method to confirm NG tube placement, as it can produce false-positive results due to air entering the stomach or intestines.
B. This is a correct action. Aspirating contents from the tube and verifying the pH level is a valid method to confirm NG tube placement, as gastric contents typically have a pH of less than 5.5, while intestinal or respiratory contents have a higher pH.
C. This is an incorrect action. Reviewing the medical record for previous x-ray verification of placement is not sufficient to confirm NG tube placement, as the tube can migrate or become dislodged after insertion. X-ray verification should be done initially and whenever there is doubt about the tube's position.
D. This is an incorrect action. Auscultating the lungs for adventitious breath sounds is not a specific method to confirm NG tube placement, as it can indicate other conditions such as pneumonia or pulmonary edema. It can also miss signs of respiratory complications due to NG tube misplacement, such as pneumothorax or bronchial obstruction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. A client who has cellulitis and is receiving oral antibiotics every 8 hr has a mild to moderate infection that can be managed at home with proper wound care and medication adherence. The client does not require hospitalization unless there are signs of systemic infection or complications.
B. A client who is postoperative following an upper endoscopy procedure and is alert but does not have a gag reflex has a high risk of aspiration and airway obstruction due to impaired swallowing function. The client requires close monitoring and intervention until the gag reflex returns, which can take several hours or longer depending on the type and amount of anesthesia used.
C. A mother and their newborn 12 hr postdelivery have not completed the minimum recommended stay of 24 to 48 hours for uncomplicated vaginal deliveries or 72 to 96 hours for cesarean deliveries, according to the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists. The mother and their newborn require assessment, education, support, and follow-up care to ensure their health and well-being.
D. A client who has lower extremity weakness and is newly admitted for observation has an undiagnosed condition that could indicate a serious neurological or vascular problem, such as stroke, spinal cord injury, or peripheral artery disease. The client requires diagnostic testing, evaluation, treatment, and rehabilitation to prevent further deterioration or complications.
Correct Answer is C
Explanation
Choice A option:
Dietitian should not be consulted: The dietitian is an essential team member and will work closely with the client to ensure proper nutrition and dietary management. However, in the context of dysphagia, the speech-language pathologist's expertise is needed to determine safe swallowing strategies and food modifications.
Choice B option:
Physical therapist should not be consulted: The physical therapist focuses on maintaining and improving the client's physical function and mobility. While important in ALS management, the physical therapist's role is not directly related to the immediate issue of dysphagia.
Choice C option:
The speech-language pathologist is the correct answer because it specializes in assessing and treating communication and swallowing disorders. In this case, the speech-language pathologist is essential in evaluating the client's swallowing function, recommending appropriate dietary modifications (texture and consistency of foods), and implementing swallowing exercises or strategies to improve swallowing safety.
Choice D option:
Occupational therapist should not be consulted: The occupational therapist assists clients in regaining or maintaining independence in daily living activities. While the occupational therapist may address some aspects of mealtime activities and adaptive strategies, the speech-language pathologist is more specialized in evaluating and treating swallowing difficulties in clients with ALS.

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