The nurse is preparing to administer medication using a client’s nasogastric tube. Which actions should the nurse take before administering the medication? Select all that apply.
Aspirate the stomach contents.
Check the residual volume.
Remove the tube and place it in the other nostril.
Test the stomach contents for a pH indicating acidity.
Turn off the suction to the nasogastric tube.
Correct Answer : A,B,D,E
Choice A Reason:
Aspirating the stomach contents is essential to ensure the nasogastric tube is correctly positioned in the stomach. This step helps verify that the tube has not migrated and is safe for medication administration. If the aspirate is not obtained, further steps should be taken to confirm the tube’s placement.
Choice B Reason:
Checking the residual volume is important to assess the stomach’s contents and ensure that the patient is tolerating the feedings or medications. High residual volumes may indicate delayed gastric emptying or other gastrointestinal issues. This information helps guide the timing and amount of medication administration.
Choice C Reason:
Removing the tube and placing it in the other nostril is not a standard practice before administering medication. This action is unnecessary and could cause discomfort or complications for the patient. The focus should be on verifying the tube’s placement and ensuring it is functioning correctly.
Choice D Reason:
Testing the stomach contents for a pH indicating acidity is a reliable method to confirm the nasogastric tube’s placement. Gastric contents typically have a pH of 1 to 5, indicating the tube is in the stomach. This step helps ensure the safe administration of medications.
Choice E Reason:
Turning off the suction to the nasogastric tube is necessary before administering medications. Suction can interfere with the absorption of the medication and may cause the medication to be removed from the stomach before it has a chance to take effect. Therefore, it is important to turn off the suction temporarily during medication administration.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason:
Decrease protein intake: This is not typically recommended for clients with Cushing’s disease. Protein is essential for maintaining muscle mass and overall health. Clients with Cushing’s disease often experience muscle weakness and wasting, so adequate protein intake is crucial to help counteract these effects. Therefore, decreasing protein intake would not be beneficial.
Choice B Reason:
Restrict sodium intake: Clients with Cushing’s disease often suffer from hypertension (high blood pressure) due to the excess cortisol in their bodies. High sodium intake can exacerbate this condition by increasing blood pressure even further. Therefore, it is crucial to restrict sodium intake to help manage hypertension and reduce the risk of cardiovascular complications. Foods high in sodium include processed foods, canned soups, and salty snacks. The recommended daily sodium intake for most adults is less than 2,300 milligrams, but for those with hypertension, it is often advised to consume even less.

Choice C Reason:
Limit intake of potassium-rich foods: This is not a standard recommendation for clients with Cushing’s disease. In fact, potassium is often beneficial as it can help counteract the effects of sodium and lower blood pressure. Potassium-rich foods include bananas, oranges, spinach, and sweet potatoes. Limiting these foods would not be advantageous and could potentially worsen hypertension.
Choice D Reason:
Increase carbohydrate intake: Increasing carbohydrate intake is not typically recommended for clients with Cushing’s disease. Excess cortisol can lead to increased blood sugar levels and a higher risk of developing diabetes. Therefore, it is important to manage carbohydrate intake carefully to avoid spikes in blood sugar. Instead, a balanced diet with a focus on complex carbohydrates, lean proteins, and healthy fats is recommended.
Correct Answer is A
Explanation
Choice A reason:
Baclofen is primarily used to treat muscle symptoms caused by multiple sclerosis, including muscle spasms, stiffness, and pain1. It acts on the spinal cord nerves to decrease the number and severity of muscle spasms, thereby improving muscle movement2. The effectiveness of baclofen in managing multiple sclerosis symptoms is best evaluated by assessing the reduction in muscle spasms.

Choice B reason:
While mood and affect are important aspects of a patient’s overall well-being, they are not the primary indicators of baclofen’s effectiveness. Baclofen does not have a direct impact on mood and affect, as its main function is to relieve muscle spasms and improve muscle movement.
Choice C reason:
Appetite is not a primary concern when evaluating the effectiveness of baclofen. This medication is not known to significantly affect appetite. The main therapeutic goal of baclofen is to reduce muscle spasms and improve mobility in patients with multiple sclerosis.
Choice D reason:
Sleep pattern, although important for overall health, is not the primary measure of baclofen’s effectiveness. Baclofen’s primary role is to alleviate muscle spasms and improve muscle function. While it may have some impact on sleep due to its muscle-relaxing properties, this is not the main criterion for evaluating its effectiveness.
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