2026/2027
Senior Diet Expert Practice
Questions and Clinical Nutrition
Review for Gerontological Nutrition
Exams 2026/2027 Version
Question 1:
A nurse is inserting a nasogastric (NG) tube in an adult client. During insertion, the
client suddenly begins coughing and shows signs of respiratory distress. What is the
nurse’s priority action?
A. Advance the tube quickly into the stomach
B. Remove the tube completely and notify the provider
C. Leave the tube in place and assess oxygen saturation
D. Withdraw the tube slightly and pause the procedure
Correct Answer: D. Withdraw the tube slightly and pause the procedure
Rationale: Coughing and respiratory distress during NG tube insertion suggest
possible placement into the trachea. The nurse should immediately withdraw the tube
slightly and pause to prevent further airway compromise. Advancing the tube could
worsen placement into the bronchus. Full removal is unnecessary unless distress
persists. Oxygen assessment is important but not the first action.
Question 2:
A post-anesthesia care unit (PACU) nurse transfers a client to the surgical ward. What
is the nurse’s first priority assessment?
A. Check surgical dressing for bleeding
B. Assess vital signs
C. Assess airway patency
D. Inspect IV site
Correct Answer: C. Assess airway patency
Rationale: Airway is always the highest priority following surgery due to risks of
obstruction, sedation effects, or aspiration. Vital signs, dressings, and IV lines are
secondary to ensuring a patent airway.
,2026/2027
Question 3:
Which position is most appropriate for administering a cleansing enema?
A. Supine
B. Left Sims’ position
C. Right Sims’ position
D. High Fowler’s position
Correct Answer: B. Left Sims’ position
Rationale: The left Sims’ position allows gravity to assist the flow of solution through
the sigmoid colon and descending colon, improving retention and effectiveness of the
enema.
Question 4:
What position should a client be placed in before insertion of a nasogastric tube?
A. Low Fowler’s
B. Supine flat
C. High Fowler’s
D. Prone
Correct Answer: C. High Fowler’s
Rationale: High Fowler’s position reduces aspiration risk and facilitates passage of
the NG tube through the esophagus.
Question 5:
Before administering medication via NG tube, which actions should the nurse take?
(Select all that apply)
A. Check gastric residual volume
B. Verify pH of aspirate
C. Maintain suction during administration
D. Stop suction temporarily
E. Flush tube before and after medication
Correct Answer: A, B, D, E
,2026/2027
Rationale: Checking residual, confirming acidic pH, stopping suction, and flushing
ensures correct placement and medication absorption. Suction should be paused to
prevent medication removal.
Question 6:
A client receiving NG suction requires medication administration. What should the
nurse do?
A. Administer medication and leave suction running
B. Stop suction for 30–60 minutes after medication
C. Increase suction briefly after medication
D. Place client supine for absorption
Correct Answer: B. Stop suction for 30–60 minutes after medication
Rationale: Suction would remove medication before absorption. Holding suction
allows proper drug absorption.
Question 7:
An NG tube aspirate has a pH of 7.5. What is the nurse’s best action?
A. Document correct placement
B. Retest immediately
C. Notify provider for radiographic confirmation
D. Reinsert tube deeper
Correct Answer: C. Notify provider for radiographic confirmation
Rationale: Gastric pH should be acidic (≤3.5). A pH of 7.5 suggests respiratory
placement. X-ray confirmation is required.
Question 8:
How is correct NG tube insertion length determined?
A. Nose to ear to xiphoid process
B. Nose to chin to sternum
C. Ear to nose only
D. Nose to abdomen midpoint
Correct Answer: A. Nose to ear to xiphoid process
, 2026/2027
Rationale: This measurement ensures placement into the stomach rather than the
lungs.
Question 9:
Which NG drainage finding 24 hours post-gastric surgery requires immediate
reporting?
A. Greenish drainage
B. Light yellow drainage
C. Dark red drainage
D. Brownish drainage
Correct Answer: C. Dark red drainage
Rationale: Bright or dark red drainage suggests active bleeding and must be reported
immediately.
Question 10:
A client with prolonged diarrhea is assessed. Which findings are expected? (Select all
that apply)
A. Hypotension
B. Poor skin turgor
C. Hyperthermia
D. Peripheral edema
E. Tachycardia
Correct Answer: A, B, C, E
Rationale: Diarrhea causes dehydration leading to hypotension, tachycardia, fever,
and poor skin turgor. Edema is not expected.
Question 11:
During enema administration, the client reports cramping. What should the nurse do?
A. Increase flow rate
B. Clamp tubing temporarily
C. Continue without interruption
D. Discontinue procedure immediately
Correct Answer: B. Clamp tubing temporarily
Senior Diet Expert Practice
Questions and Clinical Nutrition
Review for Gerontological Nutrition
Exams 2026/2027 Version
Question 1:
A nurse is inserting a nasogastric (NG) tube in an adult client. During insertion, the
client suddenly begins coughing and shows signs of respiratory distress. What is the
nurse’s priority action?
A. Advance the tube quickly into the stomach
B. Remove the tube completely and notify the provider
C. Leave the tube in place and assess oxygen saturation
D. Withdraw the tube slightly and pause the procedure
Correct Answer: D. Withdraw the tube slightly and pause the procedure
Rationale: Coughing and respiratory distress during NG tube insertion suggest
possible placement into the trachea. The nurse should immediately withdraw the tube
slightly and pause to prevent further airway compromise. Advancing the tube could
worsen placement into the bronchus. Full removal is unnecessary unless distress
persists. Oxygen assessment is important but not the first action.
Question 2:
A post-anesthesia care unit (PACU) nurse transfers a client to the surgical ward. What
is the nurse’s first priority assessment?
A. Check surgical dressing for bleeding
B. Assess vital signs
C. Assess airway patency
D. Inspect IV site
Correct Answer: C. Assess airway patency
Rationale: Airway is always the highest priority following surgery due to risks of
obstruction, sedation effects, or aspiration. Vital signs, dressings, and IV lines are
secondary to ensuring a patent airway.
,2026/2027
Question 3:
Which position is most appropriate for administering a cleansing enema?
A. Supine
B. Left Sims’ position
C. Right Sims’ position
D. High Fowler’s position
Correct Answer: B. Left Sims’ position
Rationale: The left Sims’ position allows gravity to assist the flow of solution through
the sigmoid colon and descending colon, improving retention and effectiveness of the
enema.
Question 4:
What position should a client be placed in before insertion of a nasogastric tube?
A. Low Fowler’s
B. Supine flat
C. High Fowler’s
D. Prone
Correct Answer: C. High Fowler’s
Rationale: High Fowler’s position reduces aspiration risk and facilitates passage of
the NG tube through the esophagus.
Question 5:
Before administering medication via NG tube, which actions should the nurse take?
(Select all that apply)
A. Check gastric residual volume
B. Verify pH of aspirate
C. Maintain suction during administration
D. Stop suction temporarily
E. Flush tube before and after medication
Correct Answer: A, B, D, E
,2026/2027
Rationale: Checking residual, confirming acidic pH, stopping suction, and flushing
ensures correct placement and medication absorption. Suction should be paused to
prevent medication removal.
Question 6:
A client receiving NG suction requires medication administration. What should the
nurse do?
A. Administer medication and leave suction running
B. Stop suction for 30–60 minutes after medication
C. Increase suction briefly after medication
D. Place client supine for absorption
Correct Answer: B. Stop suction for 30–60 minutes after medication
Rationale: Suction would remove medication before absorption. Holding suction
allows proper drug absorption.
Question 7:
An NG tube aspirate has a pH of 7.5. What is the nurse’s best action?
A. Document correct placement
B. Retest immediately
C. Notify provider for radiographic confirmation
D. Reinsert tube deeper
Correct Answer: C. Notify provider for radiographic confirmation
Rationale: Gastric pH should be acidic (≤3.5). A pH of 7.5 suggests respiratory
placement. X-ray confirmation is required.
Question 8:
How is correct NG tube insertion length determined?
A. Nose to ear to xiphoid process
B. Nose to chin to sternum
C. Ear to nose only
D. Nose to abdomen midpoint
Correct Answer: A. Nose to ear to xiphoid process
, 2026/2027
Rationale: This measurement ensures placement into the stomach rather than the
lungs.
Question 9:
Which NG drainage finding 24 hours post-gastric surgery requires immediate
reporting?
A. Greenish drainage
B. Light yellow drainage
C. Dark red drainage
D. Brownish drainage
Correct Answer: C. Dark red drainage
Rationale: Bright or dark red drainage suggests active bleeding and must be reported
immediately.
Question 10:
A client with prolonged diarrhea is assessed. Which findings are expected? (Select all
that apply)
A. Hypotension
B. Poor skin turgor
C. Hyperthermia
D. Peripheral edema
E. Tachycardia
Correct Answer: A, B, C, E
Rationale: Diarrhea causes dehydration leading to hypotension, tachycardia, fever,
and poor skin turgor. Edema is not expected.
Question 11:
During enema administration, the client reports cramping. What should the nurse do?
A. Increase flow rate
B. Clamp tubing temporarily
C. Continue without interruption
D. Discontinue procedure immediately
Correct Answer: B. Clamp tubing temporarily
