A nurse is caring for a client who is receiving intermittent enteral tube feedings. Which of the following factors places the client at risk for aspiration?
A residual of 65 mL 1 hr postprandial.
A history of gastroesophageal reflux disease.
Receiving a high-osmolarity formula.
Sitting in high-Fowler's position during the feeding.
The Correct Answer is B
A. This amount of residual is generally considered safe; guidelines often cite higher residuals (e.g., >100 mL) as concerning.
B. Clients with a history of gastroesophageal reflux disease (GERD) are at increased risk for aspiration, particularly when lying flat, because the lower esophageal sphincter may not function properly, allowing stomach contents to move back into the esophagus.
C. While high-osmolarity formulas can contribute to diarrhea, they are not directly linked to an increased risk of aspiration.
D. Sitting in a high-Fowler’s position (semi-upright) during feedings is actually recommended to reduce the risk of aspiration.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A: Warm showers can help relieve stiffness and pain associated with osteoarthritis by improving circulation and relaxing muscles.
B: Placing a large pillow under the knees can actually exacerbate joint stiffness and pain in osteoarthritis by forcing the knee into a bent position.
C: There is no specific recommendation to limit dietary phosphorus for osteoarthritis pain management.
D: Placing an ice pack directly on the skin can cause frostbite and damage to the skin; it should be wrapped in a cloth first.
Correct Answer is A
Explanation
To calculate the IV infusion rate for dopamine hydrochloride, we first need to convert the dose from micrograms per kilogram per minute (mcg/kg/min) to milligrams per hour (mg/hr). The patient weighs 80 kg and the prescribed dose is 4 mcg/kg/min.
First, calculate the dose in mcg/hr: 4 mcg/kg/min x 80 kg x 60 min/hr = 19200 mcg/hr.
Next, convert mcg to mg: 19200 mcg/hr / 1000 mcg/mg = 19.2 mg/hr.
We have an 800 mg dopamine hydrochloride solution in a 250 mL bag. To find out how many mL/hr to administer, we use the following proportion:
(800 mg / 250 mL) = (19.2 mg / X mL).
Solving for X gives us X = (19.2 mg * 250 mL) / 800 mg, which equals 6 mL/hr.
Therefore, the nurse should set the IV infusion pump to deliver 6 mL/hr.
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