NSG 323 Exam 3 Study Guide
Questions with All Actual Answers
2025-2026 Updated.
what is enteral and parental nutrition? - Answer two alternate ways in which we can get
nutrition into patients
enteral nutrition (EN) - Answer aka tube feeding
admin of liquified food or formula through tube, catheter, or stoma directly into GI tract,
bypassing oral cavity
what is different about EN? - Answer pts w/ EN HAVE a functioning GI tract but they are
unable to orally intake (enough) food
indications for EN - Answer indications for EN:
-anorexia
-oral surgery; orofacial fractures
-extensive burns or critical condition
-decreased LOC
-chemo (causes issues w/ swallowing, excessive saliva pro)
contraindications for EN - Answer since tube goes directly into GI tract, can't have any
obstruction there such as
-GI obstruction
-prolonged ileus
-severe d/v
-enterocutaneous fistula
types of EN - Answer 4 diff types of tubing:
1. Nasogastric - in through nose and into stomach
2. Nasoduodenal/ nasojejunal - in through nose and into duodenum (bypasses stomach and
goes straight to first part of small intestine)
1&2 used for short term
,3. Esophagostomy - incision on side of neck, down the esophagus and into stomach
4. Gastrostomy/ Jejunostomy - incision made into side of thoracic cavity straight into stomach
**pt MUST have intact, unobstructed GI
3&4 can be used long term
what types of EN may be used long term? - Answer stomies
gastrostomy & esophagostomy
what types of EN should be limited to short term use? - Answer naso
nasogastric & nasoduodenal/
nasojejunal
how is EN delivered? - Answer via continuous pump or bolus
how do you est NG tube length? - Answer measure from TIP of NOSE to EAR then down
straight to BELOW XIPHOID process
what is the only way to confirm placement of an NG tube that is 100% accurate? - Answer
Chest XR!
Aside from CXR, what are some other ways to confirm NG tube placement? - Answer 1.
check pH lvl of stomach acid
2. check residuals
3. use capnography to detect CO2 release from tube
4. insert air bolus (NO LONGER REC)- NOT accurate
checking pH lvl of stomach acid - Answer -not a reliable or accurate way to confirm NG tube
placement; esp not for pt on cont EN (bc you would have to stop feeding for at least 1 hr
BEFORE testing)
, -cannot be used to distinguish btwn gastric vs esophageal placement
-general idea is, pH < 5 = acidic so placement likely in stomach vs pH > 6 = basic so placement
may be in lungs, small intest, or elsewhere
checking residuals - Answer can be useful
-general idea is, you aspirate the tube to have gastric acid come up
--if aspirated fluid = yellow, green, brown, tan, saliva like then placement prob in stomach
--if NO residual/aspirated fluid = may mean tube is elsewhere like lungs
-can also check pH of fluid
using capnography to detect CO2 release - Answer detection of CO2 from tube suggests
placement in lungs, NOT stomach
-feeding should be STOPPED and XR done to confirm
what is the purpose of checking gastric vol/residuals? - Answer way of checking if NG tube is
in right place
also:
-helps assess gastric emptying and feeding tolerance
--high residual (> 500 mL) = DELAYED gastric emptying; increases risk of aspiration and
pneumonia
--if stomach too full, feeding may be held or adj to prevent v and asp
--if residuals are HIGH, pt may be unable to tolerate feeding rate of vol; may have to decrease
rate
normal residual = 250 mL
what is bolus feeding in EN? - Answer when you use a syringe to admin a certain amount of
nutrition into NG tube; like giving a bolus
how should the pt be positioned when INSERTING the NG? - Answer HIGH FOWLER's -- 90
degrees, sitting upright
Questions with All Actual Answers
2025-2026 Updated.
what is enteral and parental nutrition? - Answer two alternate ways in which we can get
nutrition into patients
enteral nutrition (EN) - Answer aka tube feeding
admin of liquified food or formula through tube, catheter, or stoma directly into GI tract,
bypassing oral cavity
what is different about EN? - Answer pts w/ EN HAVE a functioning GI tract but they are
unable to orally intake (enough) food
indications for EN - Answer indications for EN:
-anorexia
-oral surgery; orofacial fractures
-extensive burns or critical condition
-decreased LOC
-chemo (causes issues w/ swallowing, excessive saliva pro)
contraindications for EN - Answer since tube goes directly into GI tract, can't have any
obstruction there such as
-GI obstruction
-prolonged ileus
-severe d/v
-enterocutaneous fistula
types of EN - Answer 4 diff types of tubing:
1. Nasogastric - in through nose and into stomach
2. Nasoduodenal/ nasojejunal - in through nose and into duodenum (bypasses stomach and
goes straight to first part of small intestine)
1&2 used for short term
,3. Esophagostomy - incision on side of neck, down the esophagus and into stomach
4. Gastrostomy/ Jejunostomy - incision made into side of thoracic cavity straight into stomach
**pt MUST have intact, unobstructed GI
3&4 can be used long term
what types of EN may be used long term? - Answer stomies
gastrostomy & esophagostomy
what types of EN should be limited to short term use? - Answer naso
nasogastric & nasoduodenal/
nasojejunal
how is EN delivered? - Answer via continuous pump or bolus
how do you est NG tube length? - Answer measure from TIP of NOSE to EAR then down
straight to BELOW XIPHOID process
what is the only way to confirm placement of an NG tube that is 100% accurate? - Answer
Chest XR!
Aside from CXR, what are some other ways to confirm NG tube placement? - Answer 1.
check pH lvl of stomach acid
2. check residuals
3. use capnography to detect CO2 release from tube
4. insert air bolus (NO LONGER REC)- NOT accurate
checking pH lvl of stomach acid - Answer -not a reliable or accurate way to confirm NG tube
placement; esp not for pt on cont EN (bc you would have to stop feeding for at least 1 hr
BEFORE testing)
, -cannot be used to distinguish btwn gastric vs esophageal placement
-general idea is, pH < 5 = acidic so placement likely in stomach vs pH > 6 = basic so placement
may be in lungs, small intest, or elsewhere
checking residuals - Answer can be useful
-general idea is, you aspirate the tube to have gastric acid come up
--if aspirated fluid = yellow, green, brown, tan, saliva like then placement prob in stomach
--if NO residual/aspirated fluid = may mean tube is elsewhere like lungs
-can also check pH of fluid
using capnography to detect CO2 release - Answer detection of CO2 from tube suggests
placement in lungs, NOT stomach
-feeding should be STOPPED and XR done to confirm
what is the purpose of checking gastric vol/residuals? - Answer way of checking if NG tube is
in right place
also:
-helps assess gastric emptying and feeding tolerance
--high residual (> 500 mL) = DELAYED gastric emptying; increases risk of aspiration and
pneumonia
--if stomach too full, feeding may be held or adj to prevent v and asp
--if residuals are HIGH, pt may be unable to tolerate feeding rate of vol; may have to decrease
rate
normal residual = 250 mL
what is bolus feeding in EN? - Answer when you use a syringe to admin a certain amount of
nutrition into NG tube; like giving a bolus
how should the pt be positioned when INSERTING the NG? - Answer HIGH FOWLER's -- 90
degrees, sitting upright
