A nurse is caring for a patient who receives intermittent enteral feedings through an NG tube.
Before administering a feeding, the nurse should measure the gastric residual for which of the following purposes?
To determine the patient’s electrolyte balance
To confirm the placement of the NG tube
To remove gastric acid that might cause dyspepsia
To identify delayed gastric emptying
The Correct Answer is D
Choice A rationale
While electrolyte balance is important in patient care, it is not the primary reason for measuring gastric residual before administering a feeding through an NG tube.
Choice B rationale
Confirming the placement of the NG tube is crucial before administering a feeding. However, measuring the gastric residual is not the primary method used to confirm tube placement.
Choice C rationale
Removing gastric acid that might cause dyspepsia is not the main purpose of measuring gastric residual. Dyspepsia, or indigestion, is typically managed with medications and dietary modifications.
Choice D rationale
The primary purpose of measuring gastric residual is to identify delayed gastric emptying. Gastric residual refers to the volume of formula or contents remaining in the stomach from the previous feeding. If gastric emptying is delayed, the nurse should avoid overfeeding the patient and causing gastric distention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
An elevated white blood cell (WBC) count in a urinalysis can indicate an infection or inflammation in the body. A count of 10 is higher than the normal range, which is typically 0 to 5 WBCs per high power field.
Choice B rationale
Occasional casts in the urine are not typically a cause for concern. Casts are tiny tube-shaped particles that can form due to kidney conditions, but occasional casts can be normal.
Choice C rationale
A pH of 5.0 is within the normal range for urine pH, which is typically between 4.6 and 8.0.
Therefore, this result would not typically need to be communicated to the provider.
Choice D rationale
Dark amber color of the urine can be a sign of dehydration, but it can also be influenced by certain foods, medications, and health conditions. It is not typically a result that needs to be communicated to the provider.
Correct Answer is D
Explanation
Choice A rationale
While it’s true that bulimia nervosa can have serious health consequences, telling the patient that they “should stop because they need to” may come across as dismissive of the patient’s struggle. It’s important to remember that bulimia nervosa is a complex mental health disorder that often requires professional treatment.
Choice B rationale
Asking the patient why they engage in their behavior might seem like a logical question, but it could potentially make the patient feel defensive or blamed for their condition. It’s important to approach the conversation with empathy and understanding.
Choice C rationale
While it’s important to validate the patient’s feelings and experiences, saying “I’m proud of you for recognizing that this behavior is not normal” might not be the most therapeutic response. This statement could potentially reinforce the idea that their behavior is “abnormal,” which could lead to feelings of shame or guilt.
Choice D rationale
Expressing empathy and understanding, as in “It seems like you are feeling helpless about this behavior,” can be a therapeutic response. This statement acknowledges the patient’s feelings and opens up the conversation for further exploration of their experiences and potential coping strategies.
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