NSE211 EXAM QUESTIONS WITH
CORRECT ANSWERS
Complications of Enteral Feeding: Diarrhea - Answer- Diarrhea:
Mild - 1-2 x/shift - maintain & determine if any other causes
Moderate - 3-4 x/shift - maintain - re-evaluate in 6 hr
Severe - >4 x/shift - inform & document physician
May need to decrease rate by 50% & monitor* check agency policy*
Complications of Enteral Feeding: Constipation - Answer- Consider stool softeners &
water boluses
Inform physician & document
Causes of Clogged Tubes - Answer- Improper flushing of tubes. Rate of flow could
allow enteral formula to clump & cause a build-up on the sides of the feeding tube.
Medications that are not properly crushed.
Prevention: Fushing with water is easiest way to prevent clogging, flush pre & post
medications can prevent most clogged feeding tubes.
Use 30 to 60cc syringe, avoid small syringes due to high pressure. Flush with warm
water, Carbonated beverage (approximately 5 ml) if pt has normal blood sugar levels.
Medication Administration via NG, OG, J-Tube, or G-Tube - Answer- 1. Verify tube
placement (check hospital policy: usually aspirate)
2. Meds must be crushed (dissolved in 15-30 ml warm water - sterile or tap water
depending on agency policy) or in elixir form
3. Not all meds should be crushed (e.g., long acting or enteric coated meds)
4. Ensure meds are well crushed & dissolved to prevent blocking the tube - some meds
are more difficult than others to adequately crush & dissolve (e.g., capsules with
granules inside). Tube can be blocked if this is not done correctly!
5. May need to stop feeding 1 hour before and after feed if incompatible with feeding
(check with pharmacy, drug book)
6. Never add meds directly to feeding tube - need to stop feed, flush first with 30 ml,
flush with 15-30ml water between meds and flush again with 30-60 ml at end and before
restarting feeding (depending on hospital policy) unless contraindicated by patient
condition (e.g., fluid restriction, inability to tolerate excess volume with large number of
meds)
Enteral Feeds: indications - Answer- Cancer
-critical illness or trauma
- neurological and muscular disorders (EX- stroke, cerebrovascular incident, dementia
etc.)
- GI disorders
, - resp failure with prolongued intubation
-Inadequate oral intake
- continuous feedings
-supine positioning
Gastric decompression - Answer- including maintenance of a decompressed state after
endotracheal intubation, often via the oropharynx. Relief of symptoms and bowel rest in
the setting of small-bowel obstruction. Aspiration of gastric content from recent ingestion
of toxic material. Administration of medication.
Endoscopy - Answer- use of an endoscope allows for direct visualization, specimen
collection, or treatment of the interior of the kidney (nephoscopy), ureter (ureteroscopy),
bladder (cystoscopy), and urethra (cystourethroscopy). Although this procedure may be
accomplished using local anaesthesia, it is more commonly performed using general
anaesthesia or conscious sedation to avoid unnecessary anxiety and trauma for the
patient.
Special considers: signed consent is obtained. If ordered, a bowel prep is completed.
Follow agency policy for preoperative prep and checklist. After patients return, assess
the vital signs and the characteristics of urine, monitor intake and output,, encourage
ingestion of fluids, and observe for fever, dysuria, and pain in the suprapubic region.
barium enema - Answer- is a radiographic (X-ray) examination of the lower
gastrointestinal (GI) tract. The large intestine, including the rectum, is made visible on
X-ray film by filling the colon with a liquid suspension called barium sulfate (barium).
Barium highlights certain areas in the body to create a clearer picture.
During a barium enema exam, an X-ray machine takes pictures of the colon while an
enema tube inserted in the rectum delivers liquid barium. A barium enema is an X-ray
exam that can detect changes or abnormalities in the large intestine (colon). The
procedure is also called a colon X-ray
Colonoscopy: - Answer- an endoscopic examination of the rectum and colon that uses a
long, flexible tube. Bowel must be clean and free of fecal matter. Light sedation
required.
Sigmoidoscopy - Answer- an examination of the interior of the sigmoid colon.
Preparation is similar to that of a colonoscopy. Light sedation required.
stool culture - Answer- is a test on a stool sample to find germs (such as bacteria or a
fungus) that can cause an infection. A sample of stool is added to a substance that
promotes the growth of germs. If no germs grow, the culture is negative. If germs that
can cause infection grow, the culture is positive. Stool culture test results usually take 2
to 3 days. But some cultures for fungus and parasites may take weeks to get results.
Normal: No disease-causing bacteria, fungi, parasites, or viruses are present or grow in
the culture
CORRECT ANSWERS
Complications of Enteral Feeding: Diarrhea - Answer- Diarrhea:
Mild - 1-2 x/shift - maintain & determine if any other causes
Moderate - 3-4 x/shift - maintain - re-evaluate in 6 hr
Severe - >4 x/shift - inform & document physician
May need to decrease rate by 50% & monitor* check agency policy*
Complications of Enteral Feeding: Constipation - Answer- Consider stool softeners &
water boluses
Inform physician & document
Causes of Clogged Tubes - Answer- Improper flushing of tubes. Rate of flow could
allow enteral formula to clump & cause a build-up on the sides of the feeding tube.
Medications that are not properly crushed.
Prevention: Fushing with water is easiest way to prevent clogging, flush pre & post
medications can prevent most clogged feeding tubes.
Use 30 to 60cc syringe, avoid small syringes due to high pressure. Flush with warm
water, Carbonated beverage (approximately 5 ml) if pt has normal blood sugar levels.
Medication Administration via NG, OG, J-Tube, or G-Tube - Answer- 1. Verify tube
placement (check hospital policy: usually aspirate)
2. Meds must be crushed (dissolved in 15-30 ml warm water - sterile or tap water
depending on agency policy) or in elixir form
3. Not all meds should be crushed (e.g., long acting or enteric coated meds)
4. Ensure meds are well crushed & dissolved to prevent blocking the tube - some meds
are more difficult than others to adequately crush & dissolve (e.g., capsules with
granules inside). Tube can be blocked if this is not done correctly!
5. May need to stop feeding 1 hour before and after feed if incompatible with feeding
(check with pharmacy, drug book)
6. Never add meds directly to feeding tube - need to stop feed, flush first with 30 ml,
flush with 15-30ml water between meds and flush again with 30-60 ml at end and before
restarting feeding (depending on hospital policy) unless contraindicated by patient
condition (e.g., fluid restriction, inability to tolerate excess volume with large number of
meds)
Enteral Feeds: indications - Answer- Cancer
-critical illness or trauma
- neurological and muscular disorders (EX- stroke, cerebrovascular incident, dementia
etc.)
- GI disorders
, - resp failure with prolongued intubation
-Inadequate oral intake
- continuous feedings
-supine positioning
Gastric decompression - Answer- including maintenance of a decompressed state after
endotracheal intubation, often via the oropharynx. Relief of symptoms and bowel rest in
the setting of small-bowel obstruction. Aspiration of gastric content from recent ingestion
of toxic material. Administration of medication.
Endoscopy - Answer- use of an endoscope allows for direct visualization, specimen
collection, or treatment of the interior of the kidney (nephoscopy), ureter (ureteroscopy),
bladder (cystoscopy), and urethra (cystourethroscopy). Although this procedure may be
accomplished using local anaesthesia, it is more commonly performed using general
anaesthesia or conscious sedation to avoid unnecessary anxiety and trauma for the
patient.
Special considers: signed consent is obtained. If ordered, a bowel prep is completed.
Follow agency policy for preoperative prep and checklist. After patients return, assess
the vital signs and the characteristics of urine, monitor intake and output,, encourage
ingestion of fluids, and observe for fever, dysuria, and pain in the suprapubic region.
barium enema - Answer- is a radiographic (X-ray) examination of the lower
gastrointestinal (GI) tract. The large intestine, including the rectum, is made visible on
X-ray film by filling the colon with a liquid suspension called barium sulfate (barium).
Barium highlights certain areas in the body to create a clearer picture.
During a barium enema exam, an X-ray machine takes pictures of the colon while an
enema tube inserted in the rectum delivers liquid barium. A barium enema is an X-ray
exam that can detect changes or abnormalities in the large intestine (colon). The
procedure is also called a colon X-ray
Colonoscopy: - Answer- an endoscopic examination of the rectum and colon that uses a
long, flexible tube. Bowel must be clean and free of fecal matter. Light sedation
required.
Sigmoidoscopy - Answer- an examination of the interior of the sigmoid colon.
Preparation is similar to that of a colonoscopy. Light sedation required.
stool culture - Answer- is a test on a stool sample to find germs (such as bacteria or a
fungus) that can cause an infection. A sample of stool is added to a substance that
promotes the growth of germs. If no germs grow, the culture is negative. If germs that
can cause infection grow, the culture is positive. Stool culture test results usually take 2
to 3 days. But some cultures for fungus and parasites may take weeks to get results.
Normal: No disease-causing bacteria, fungi, parasites, or viruses are present or grow in
the culture
