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65 Cards in this Set
- Front
- Back
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What nasogastric tube has a single lumen with sizes ranging from 14-18, and is made of plastic or rubber?
a) gastric sump b) levin tube c) salem sump d) dobbhoff |
b) levin tube
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What is the only definitive way to verify a levin tube's placement?
a) gastric aspirate b) x-ray c) air instillation d) deep palpation |
b) x-ray
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What type of suction is used with the Levin tube?
a) intermittent b) continuous c) low continuous d) high continuous |
a) intermittent
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Why is intermittent suction used with the Levin tube?
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Because it helps prevent erosion or tearing of the stomach lining due to constant adherence of the tube's lumen to the mucosal lining of the stomach
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To prevent reflux of gastric contents through the vent lumen of the gastric sump, the vent lumen is positioned:
a) at heart level b) below heart level c) at waist level d) above waist level |
d) above waist level
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What type of tubes are used for feeding?
a) lavin b) gastric sump c) salem sump d) dobbhoff |
d) dobbhoff or enteraflo are used for feeding
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What additional step is needed if a nasoenteric tube needs to be inserted at the bedside?
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An x-ray is needed to verify placement.
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The length of the nasoenteric tube is determined by measuring the distance from the tip of the nose to the earlobe and from the earlobe to the xiphoid process and by adding ___ inches for NG placement or __ for intestinal placement.
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6 inches for NG
8-10 inches for intestinal |
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What position is the patient placed in, in preparation for insertion of an NG tube?
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Fowlers
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True or False: In choosing the correct nostril for the NG tube, the nurse selects the least patent nostril to allow the other nostril to be better utilized for breathing.
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False: The most patent nostril is selected for the NG tube.
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What is the patient instructed to do as the NG tube is passed through the nasopharynx?
a) relax their stomach muscles b) swallow c) breathe in through their nose d) hold their breath |
b) swallow
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True or False: The presence of an endotracheal tube or the recent removal of an endotracheal tube decreases the risk of inadvertent placement of the NG tube in the lung.
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False: It INCREASES the risk.
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Gastric aspirate is most frequently: Check all that apply
a) green and cloudy b) tan or off white c) bloody or brown d) pale yellow and serous |
a) green and cloudy
b) tan or off white c) bloody or brown |
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Pleural fluid is usually:
a) green and cloudy b) tan or off white c) bloody or brown d) pale yellow and serous |
d) pale yellow and serous
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The pH of gastric aspirate is acidic, ranging from:
a) 1 to 5 b) 3-7 c) 1-2 d) 2-10 |
a) 1-5
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A nurse measures the pH of a patient's NG tube aspirate. The test strip reads 7. Where is the NG tube tip?
a) stomach b) intestins c) lungs d) rectum |
c) lungs
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To facilitate movement of the postpyloric feeding tube into the duodenum, what medication is administered?
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Reglan
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How is the patient positioned to help facilitate advancement of the postpyloric feeding tube into the duodenum?
a) on their left side b) on their right side c) on their stomach d) on their back |
b) on their right side
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True or False: Cola and cranberry juice have historically been recommended as effective, noninvasive means of declogging gastric tubes.
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True!
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A patient with a nasoenteric tube complains of coughing during administration of foods or medications and difficulty clearing the airway. He also presents with tachypnea and a fever. What do you suspect?
a) an infection b) an obstruction c) dislodgement of the tube d) none of the above |
c) dislodgement of the tube, possibly into the lungs
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What might a nurse do prior to removing an NG tube, to ensure that the patient does not experience nausea, vomiting, or distention?
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She/He might clamp the tube for several hours, as a trial.
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What can be done to prevent dumping symdrome?
a) start with 400-500 mL per feeding b) start with a concerntrated solution c) start with a weak solution d) start by administrating 4-5 mL over 8-10 hours |
c) start with a weak solution: increase the concentration over several days to help alleviate dumping syndrome
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A residual volume of ___ or more is considered cause for consern in a patient with a nasoenteric tube.
a) 100 b) 200 c) 300 d) 400 |
b) 200
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The patient with a feeding tube should have the head of their bed elevated:
a) 15 degrees b) 20 degrees c) 30-45 degrees d) 90-180 degress :) |
c) 30-45 degrees
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How often should an open system formula be replaced with fresh formula?
a) every 1 hour b) every 4 hours c) every 8 hours d) every 24 hours |
b) every 4 hours
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What should you do if aspiration is suspected? Check all that apply:
a) stop the tube feed b) suction the pharynx and trachea c) lower the head of the bed d) place the patient on their right side e) call the MD |
All of the above!
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Lemon juice and vinegar can be given to:
a) acidify stomach contents b) alkali stomach contents c) neutralize alkali stomach contents |
c) neutralize alkali stomach contents
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Tagamet, Pepcid, Axid and Zantac are examples of:
a) H2 receptor antagonists b) Antibiotics c) Proton pump inhibitors of gastric acid d) Prostaglandin E1 analog |
a) H2 receptor antagonists
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Nexium, Prevacid, Prilosec, Protonix and AcipHex are all examples of:
a) H2 receptor antagonists b) proton pump inhibitors of gastric acid c) prostaglandin E1 analogs |
b) proton pump inhibitors of gastric acid
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Cytotec and Carafate are examples of:
a) H2 receptor antagonists b) proton pump inhibitors of gastric acid c) prostaglandin E1 analogs |
prostaglandin E1 analogs
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In general, how does a prostaglandin E1 analog help treat peptic ulcer disease and gastritis?
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It helps protect the gastric mucosa from agents that cause ulcers.
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In general, how does an H2 receptor antagonist treat peptic ulcer disease and gastritis?
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It decreases the amount of HCL produced by the stomach by blocking the action of histamine
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Peptic ulcers commonly result from infection with the gram-negative bacteri:
a) E-coli b) Staphlococcus Aureus c) Ebola d) H. pylori |
d) H. pylori
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How are the following substances related:
stress, milk, caffeinated beverages, smoking, alcohol, spicy foods. |
They all increase HCL secretion.
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People with what blood type are genetically predispositioned to peptic ulcers?
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Type O
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Presence of severe peptic ulcers, extreme gastric hyperacidity, and gastrin-secreting benign or malignant tumors of the pancreas collectively suggest what syndrome?
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Zollinger-Ellison syndrome(ZES)
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As a rule, the patient with an ulcer complains of what type of pain?
a) dull b) sharp c) intense d) lingering |
a) dull
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True or False: Ulcer pain is usually relieved by eating.
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True! The food neutralizes the acid.
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Many meds ending in "prazole" are:
a) H2 antagonists b) proton pump inhibitors c) antibiotics d) Acid reducers |
b) proton pump inhibitors:
Example: Omeprazole Lansoprazole Rabeprazole Pantoprazole Esomeprazole |
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Many drugs ending in "tidine" are:
a) H2 antagonists b) proton pump inhibitors c) antibiotics d) Acid reducers |
a) H2 antagonists
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How does smoking affect the small intestine?
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It decreases the secretion of bicarbonate from the pancreas into the duodenum.
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True or False: A patient with a peptic ulcer usually complain of pain 20-30 minutes after consuming a meal.
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False: They typically experience pain 2 hours after eating. Remember food alleviates pain.
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A patient that is hemmorhaging is placed in what position to prevent hypotension?
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Recumbent with the legs elevated.
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A patient with an ulcer who experiences sudden, severe upper abdominal pain, vomiting, fainting, extreme tender/rigid abdomen, hypotension and tachycardia may have experienced what?
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perforation: the erosion of the ulcer through the gastric serosa into the peritoneal cavity without warning :(
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A residual volume of more than ___ mL strongly suggest obstruction.
a) 100 b) 200 c) 300 d) 400 |
d) 400
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A patient who underwent bariatric surgery is recommended to eat ___ meals per day totalling ___ to ___ calories.
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6 meals per day totalling 600-800 calories
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A patient who underwent bariatric surgery should restrict their total meal size to:
a) 100 mL b) 120 mL c) 240 mL d) 360 mL |
c) 240 mL
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True or False: Patients who underwent bariatric surgery are recommended not to eat and drink at the same time.
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True.
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Medium-length nasoenteric tubes are used for:
a) feeding b) aspiration c) decompression d) emptying |
a) feeding
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True or False:
Most nasoenteric tubes use mercury to carry the tube by gravity to its desired location. |
True!
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Which of the following medications represents the category proton pump inhibitors?
a) Flagyl b) Pepcid c) Carafate d) Prilosec |
d) Prilosec
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What kind of feeding should be administered to a patient who is at risk for diarrhea due to hypertonic feeding solutions?
a) bolus feeding b) cyclic feeding c) continuous feeding d) intermittent feeding |
c) continuous
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When the nurse prepares to give a bolus tube feeding to the patient and determines that the residual gastric content is 150 mL, her best action is to:
a) withhold the tube feeding indefinitely b) give the tube feeding c) reassess the residual gastric content in 1 hour d) notify the physician |
c) reassess the residual gastric content in 1 hour: if the gastric residual exceeds 100 mL 2 hours in a row, the MD should be notified. One observation of a residual gastric content over 100 mL does not have to be reported to the physician.
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The nurse recognizes that the patient with a duodenal ulcer with likely experience:
a) pain 2-3 hours after a meal b) weight loss c) vomiting d) hemorrhage |
a) pain 2-3 hours after a meal
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The physician ordered a nasoenteric feeding tube with a tungsten-weighted tip. The nurse knows to obtain what kind of tube?
a) Dobbhoff b) Levin c) Salem d) Sengstaken-Blakemore |
a) Dobbhoff
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When continuous or intermittent suction is used with a nasogastric tube, the goal is to have the amount of suction in the gastric mucosa reduced to:
a) 30-40 mm Hg b) 60 mm Hg c) 70-80 mm Hg d) 100-120 mm Hg |
a) 30-40 mm Hg
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To confirm placement of a nasogastric tube, the nurse tests the pH of the tube aspirate. The nurse know that tube placement in the lungs is indicated by what pH?
a) 3 b) 5 c) 6 d) 7 |
d) 7
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A nasoenteric-decompression tube can be safely advanced 2-3 inches every:
a) 1 hour b) 2 hours c) 4 hours d) 8 hours |
a) 1 hour
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Symptoms of oliguria, lethargy, and hypothermia in a patient would indicate to the nurse that the patient may be experiencing the initial common potential complication of nasoenteric intubation, which is:
a) cardiac dysrhythmia b) fluid volume deficit c) mucous membrane irritation d) pulmonary complications |
b) fluid volume deficit
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Initial fluid nourishment after a gastrostomy usually consists of:
a) distilled water b) 10% glucose and tap water c) milk d) high-calorie liquids |
b) 10% glucose and tap water
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When administering a bolus gastrostomy feeding, the receptacle should be held no higher than:
a) 9 inches b) 18 inches c) 27 inches d) 36 inches |
b) 18 inches
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The preferred route for infusion of parenteral nutrition is the:
a) brachial vein b) jugular vein c) subclavian vein d) superior vena cava |
c) subclavian vein
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The most common infectious fungal organism for patients receiving parenteral nutrition is:
a) Candida albicans b) klebsiella pneumoniae c) staphylococcus aureus d) staphylococcus epidermidis |
a) candida albicans
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A patient receiving parenteral nutrition is observed as having diuresis, stupor, and lethargy. What are they most likely experiencing?
a) hypoglycemia b) hyperglycemia c) allergic reaction d) hyper-osmolarity |
b) hyperglycemia
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The best time to administer an antacid is:
a) with the meal b) 30 minutes before the meal c) 1-3 hours after the meal d) immediately after the meal |
c) 1-3 hours after the meal
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