NCLEX NGT EXAM WITH
COMPLETE SOLUTION
Of the patients listed below, which would be a candidate for nasoenteric feeding tube
placement?
a. Post-motor vehicle accident victim with a broken nose and jaw
b. Patient with a bleeding ulcer and possible esophageal varices
c. Elderly patient with a diagnosis of failure to thrive and an inability to chew
d. Patient with an esophageal tumor - Answer ANS: C
Enteral nutrition, commonly called tube feeding, is the administration of nutrients
through the gastrointestinal tract when a patient cannot ingest, chew, or swallow, but
can digest and absorb nutrients. Nasoenteric tubes are contraindicated in patients with
facial trauma, prolonged bleeding, and upper gastrointestinal (GI) blockage (as is seen
in cases of solid cancer).
The nurse has just inserted a nasogastric (NG) feeding tube into a patient. What should
the nurse do to definitely ascertain that the tube is in the stomach or in the intestine?
a. Test the pH of the contents.
b. Use a carbon dioxide sensor.
c. Lower the head of the bed to 15 degrees.
d. Obtain an order for a chest radiograph. - Answer ANS: D
The most reliable method of feeding tube verification is a chest radiograph (chest x-ray).
Gastric and intestinal pH measurements have been shown to differentiate tube
placement, with the stomach having a lower pH than the intestines. This helps to ensure
that the tube is beyond the pylorus, theoretically reducing the risk for aspiration. This
method is helpful before and after radiological confirmation. Carbon dioxide sensors are
helpful in determining tube placement between the stomach and the lung. A small
plastic piece with an embedded yellow sensor is attached to the end of the feeding tube;
the sensor changes color when carbon dioxide is present. Investigators have shown
that this reduces the incidence of inadvertent pulmonary placement. This method is
helpful before and after radiological confirmation. Elevation of the head of the bed to a
minimum of 30 degrees is a simple method used to keep the risk for aspiration at a
minimum. The nurse is instrumental in achieving this goal. This method does not
ascertain placement but may be useful in preventing aspiration.
The nurse is checking gastric residual on a patient who has a continuously running tube
,feeding. She finds that the patient has a 600-mL residual volume. How should the nurse
respond?
a. Stop the tube feeding.
b. Slow the tube feeding.
c. Continue the tube feeding at the same rate.
d. Increase the rate of the tube feeding. - Answer ANS: A
Tube feedings are stopped if the patient has high gastric residual (more than 500 mL).
Before insertion of a nasogastric (NG) tube, of which finding should the physician be
notified?
a. Patent nares
b. Absent bowel sounds
c. Evident gag reflex
d. Impaired swallowing - Answer ANS: B
Absent bowel sounds may indicate decreased or absent peristalsis and increased risk
for aspiration.
An appropriate technique for nasogastric (NG) tube insertion is for the nurse to:
a. position the patient supine.
b. apply oil-based lubricant to the plastic tube.
c. advance the tube while the patient swallows.
d. measure the tube length from the nose to the sternum. - Answer ANS: C
Encourage the patient to swallow by giving small sips of water or ice chips.
Which technique is appropriate for the nurse to implement during nasogastric (NG) tube
insertion?
a. Use sterile gloves.
b. Have the patient mouth-breathe.
c. Advance the tube quickly when the patient coughs.
d. Bend the patient's head backward after the tube is through the nasopharynx. -
Answer ANS: B
Emphasize the need to mouth-breathe and swallow during the procedure.
, The nurse has inserted a nasogastric (NG) feeding tube. The feeding tube has a stylet in
place to aid insertion. What should the nurse do once the tube is in place?
a. Remove the stylet immediately.
b. Reinsert the stylet if the radiograph determines incorrect placement.
c. Fasten the end of the NG tube to the patient's gown using tape and a safety pin.
d. Leave the stylet in place and obtain a chest/abdomen radiograph. - Answer ANS: D
Leave the stylet in place (if used) until correct position has been verified by x-ray film.
The nurse is caring for a patient who is receiving continuous tube feedings. What must
the nurse do to care for this patient?
a. Verify tube position every 4 to 6 hours.
b. Obtain a radiograph every 4 to 12 hours.
c. Instill air into the stomach via the tube and listen for bubbles.
d. Do not worry about tube placement because the tube has already been determined to
be in the right place. - Answer ANS: A
After initial radio graphic verification that a tube is positioned in the desired site (either
the stomach or the small intestine), the nurse is responsible for ensuring that the tube
has remained in the intended position before administering formula or medications
through the tube.
The home health nurse evaluates the provision of intermittent tube feedings by the
patient's family member. The nurse notes that additional teaching is required when she
notices that the family member:
a. keeps the formula refrigerated between feedings.
b. keeps the feeding tube capped between feedings.
c. begins the feeding before checking tube placement.
d. irrigates the tube with 30 to 60 mL of water before and after feedings. - Answer ANS:
C
For intermittent tube-fed patients, test placement immediately before each feeding and
before each administration of medication.
Which evaluation indicates that placement of a nasogastric or enteric tube is correct?
a. Nasointestinal aspirate with a pH of less than 6
b. Pleural fluid pH of less than 6
COMPLETE SOLUTION
Of the patients listed below, which would be a candidate for nasoenteric feeding tube
placement?
a. Post-motor vehicle accident victim with a broken nose and jaw
b. Patient with a bleeding ulcer and possible esophageal varices
c. Elderly patient with a diagnosis of failure to thrive and an inability to chew
d. Patient with an esophageal tumor - Answer ANS: C
Enteral nutrition, commonly called tube feeding, is the administration of nutrients
through the gastrointestinal tract when a patient cannot ingest, chew, or swallow, but
can digest and absorb nutrients. Nasoenteric tubes are contraindicated in patients with
facial trauma, prolonged bleeding, and upper gastrointestinal (GI) blockage (as is seen
in cases of solid cancer).
The nurse has just inserted a nasogastric (NG) feeding tube into a patient. What should
the nurse do to definitely ascertain that the tube is in the stomach or in the intestine?
a. Test the pH of the contents.
b. Use a carbon dioxide sensor.
c. Lower the head of the bed to 15 degrees.
d. Obtain an order for a chest radiograph. - Answer ANS: D
The most reliable method of feeding tube verification is a chest radiograph (chest x-ray).
Gastric and intestinal pH measurements have been shown to differentiate tube
placement, with the stomach having a lower pH than the intestines. This helps to ensure
that the tube is beyond the pylorus, theoretically reducing the risk for aspiration. This
method is helpful before and after radiological confirmation. Carbon dioxide sensors are
helpful in determining tube placement between the stomach and the lung. A small
plastic piece with an embedded yellow sensor is attached to the end of the feeding tube;
the sensor changes color when carbon dioxide is present. Investigators have shown
that this reduces the incidence of inadvertent pulmonary placement. This method is
helpful before and after radiological confirmation. Elevation of the head of the bed to a
minimum of 30 degrees is a simple method used to keep the risk for aspiration at a
minimum. The nurse is instrumental in achieving this goal. This method does not
ascertain placement but may be useful in preventing aspiration.
The nurse is checking gastric residual on a patient who has a continuously running tube
,feeding. She finds that the patient has a 600-mL residual volume. How should the nurse
respond?
a. Stop the tube feeding.
b. Slow the tube feeding.
c. Continue the tube feeding at the same rate.
d. Increase the rate of the tube feeding. - Answer ANS: A
Tube feedings are stopped if the patient has high gastric residual (more than 500 mL).
Before insertion of a nasogastric (NG) tube, of which finding should the physician be
notified?
a. Patent nares
b. Absent bowel sounds
c. Evident gag reflex
d. Impaired swallowing - Answer ANS: B
Absent bowel sounds may indicate decreased or absent peristalsis and increased risk
for aspiration.
An appropriate technique for nasogastric (NG) tube insertion is for the nurse to:
a. position the patient supine.
b. apply oil-based lubricant to the plastic tube.
c. advance the tube while the patient swallows.
d. measure the tube length from the nose to the sternum. - Answer ANS: C
Encourage the patient to swallow by giving small sips of water or ice chips.
Which technique is appropriate for the nurse to implement during nasogastric (NG) tube
insertion?
a. Use sterile gloves.
b. Have the patient mouth-breathe.
c. Advance the tube quickly when the patient coughs.
d. Bend the patient's head backward after the tube is through the nasopharynx. -
Answer ANS: B
Emphasize the need to mouth-breathe and swallow during the procedure.
, The nurse has inserted a nasogastric (NG) feeding tube. The feeding tube has a stylet in
place to aid insertion. What should the nurse do once the tube is in place?
a. Remove the stylet immediately.
b. Reinsert the stylet if the radiograph determines incorrect placement.
c. Fasten the end of the NG tube to the patient's gown using tape and a safety pin.
d. Leave the stylet in place and obtain a chest/abdomen radiograph. - Answer ANS: D
Leave the stylet in place (if used) until correct position has been verified by x-ray film.
The nurse is caring for a patient who is receiving continuous tube feedings. What must
the nurse do to care for this patient?
a. Verify tube position every 4 to 6 hours.
b. Obtain a radiograph every 4 to 12 hours.
c. Instill air into the stomach via the tube and listen for bubbles.
d. Do not worry about tube placement because the tube has already been determined to
be in the right place. - Answer ANS: A
After initial radio graphic verification that a tube is positioned in the desired site (either
the stomach or the small intestine), the nurse is responsible for ensuring that the tube
has remained in the intended position before administering formula or medications
through the tube.
The home health nurse evaluates the provision of intermittent tube feedings by the
patient's family member. The nurse notes that additional teaching is required when she
notices that the family member:
a. keeps the formula refrigerated between feedings.
b. keeps the feeding tube capped between feedings.
c. begins the feeding before checking tube placement.
d. irrigates the tube with 30 to 60 mL of water before and after feedings. - Answer ANS:
C
For intermittent tube-fed patients, test placement immediately before each feeding and
before each administration of medication.
Which evaluation indicates that placement of a nasogastric or enteric tube is correct?
a. Nasointestinal aspirate with a pH of less than 6
b. Pleural fluid pH of less than 6
