,1. A client receiving tube feedings is experiencing diarrhea. The nurse and healthcare provider
suspect dumping syndrome. What intervention is most appropriate?
A) Stop the tube feed and aspirate stomach contents
B) Increase the hourly feed rate so it finishes earlier
C) Keep the client in semi-Fowler position for 1 hour after feedings
D) Administer fluid replacement by IV
Correct Answer: Keep the client in semi-Fowler position for 1 hour after feedings
Rationale: In dumping syndrome, high-osmolality feeds cause rapid fluid shifts into the
intestine. Keeping the client in semi-Fowler position slows gastric emptying and helps manage
symptoms . Stopping feeds or increasing the rate is inappropriate, and IV fluids address the
consequence, not the cause.
2. A nurse is admitting a client to the postsurgical unit following a gastrostomy. Which potential
postoperative complication should the nurse prioritize?
A) Premature removal of the G tube
B) Bowel perforation
C) Constipation
D) Development of peptic ulcer disease
Correct Answer: Premature removal of the G tube
Rationale: The primary postoperative complication of a gastrostomy is premature removal of
the tube, which can lead to site closure and need for reinsertion . The nurse should secure the
tube and monitor for dislodgement. Bowel perforation is a risk during insertion, not afterward.
,3. A nurse is providing care for a client with late-stage Alzheimer disease who has just returned
to the unit to begin supplemental feedings through an NG tube. Which assessment addresses
the client's most significant potential complication?
A) Frequent assessment of abdominal girth
B) Assessment for hemorrhage from the nasal insertion site
C) Frequent lung auscultation
D) Vigilant monitoring of bowel movement frequency and character
Correct Answer: Frequent lung auscultation
Rationale: Aspiration is the most significant potential complication of NG tube feeding in a client
with late-stage Alzheimer disease due to impaired swallowing and gag reflexes . Frequent lung
auscultation allows early detection of aspiration pneumonia.
4. A nurse is caring for a client who has a nasogastric tube that has been in place for 2 days.
Before administering a scheduled feeding, the nurse should:
A) Ensure the client has recently voided
B) Administer 30-45 mL of water to confirm placement
C) Position the client upright
D) Perform a focused gastrointestinal assessment
Correct Answer: Position the client upright
Rationale: Positioning the client upright (at least 30-45 degrees) before and after an NG tube
feeding reduces the risk of aspiration . Water boluses are insufficient for verifying tube
placement, and x-ray confirmation is recommended.
, 5. A client's enteral feedings have been determined to be too concentrated based on the
development of dumping syndrome. What physiologic phenomenon caused this complication?
A) Increased gastric secretion of HCl and gastrin due to high osmolality
B) Entry of large amounts of water into the small intestine due to osmotic pressure
C) Mucosal irritation of the stomach and small intestine by the high concentration
D) Acid-base imbalance resulting from the high volume of solutes in the feed
Correct Answer: Entry of large amounts of water into the small intestine due to osmotic
pressure
Rationale: Highly concentrated enteral feedings draw water into the intestinal lumen via
osmosis, causing rapid gastric emptying and dumping syndrome symptoms . This fluid shift leads
to diarrhea, cramping, and hypotension.
6. A client with dysphagia is scheduled for PEG tube insertion and asks the nurse how the tube
will stay in place. What is the nurse's best response?
A) Adhesive holds a flange in place against the abdominal skin
B) A stitch holds the tube in place externally
C) The tube is stitched to the abdominal skin externally and the stomach wall internally
D) Internal and external fixation bolsters secure the tube against the stomach wall
Correct Answer: Internal and external fixation bolsters secure the tube against the stomach wall
Rationale: A PEG tube is secured using internal and external fixation bolsters that sandwich the
stomach and abdominal wall . This prevents the tube from dislodging and maintains proper
position for feeding and decompression.
suspect dumping syndrome. What intervention is most appropriate?
A) Stop the tube feed and aspirate stomach contents
B) Increase the hourly feed rate so it finishes earlier
C) Keep the client in semi-Fowler position for 1 hour after feedings
D) Administer fluid replacement by IV
Correct Answer: Keep the client in semi-Fowler position for 1 hour after feedings
Rationale: In dumping syndrome, high-osmolality feeds cause rapid fluid shifts into the
intestine. Keeping the client in semi-Fowler position slows gastric emptying and helps manage
symptoms . Stopping feeds or increasing the rate is inappropriate, and IV fluids address the
consequence, not the cause.
2. A nurse is admitting a client to the postsurgical unit following a gastrostomy. Which potential
postoperative complication should the nurse prioritize?
A) Premature removal of the G tube
B) Bowel perforation
C) Constipation
D) Development of peptic ulcer disease
Correct Answer: Premature removal of the G tube
Rationale: The primary postoperative complication of a gastrostomy is premature removal of
the tube, which can lead to site closure and need for reinsertion . The nurse should secure the
tube and monitor for dislodgement. Bowel perforation is a risk during insertion, not afterward.
,3. A nurse is providing care for a client with late-stage Alzheimer disease who has just returned
to the unit to begin supplemental feedings through an NG tube. Which assessment addresses
the client's most significant potential complication?
A) Frequent assessment of abdominal girth
B) Assessment for hemorrhage from the nasal insertion site
C) Frequent lung auscultation
D) Vigilant monitoring of bowel movement frequency and character
Correct Answer: Frequent lung auscultation
Rationale: Aspiration is the most significant potential complication of NG tube feeding in a client
with late-stage Alzheimer disease due to impaired swallowing and gag reflexes . Frequent lung
auscultation allows early detection of aspiration pneumonia.
4. A nurse is caring for a client who has a nasogastric tube that has been in place for 2 days.
Before administering a scheduled feeding, the nurse should:
A) Ensure the client has recently voided
B) Administer 30-45 mL of water to confirm placement
C) Position the client upright
D) Perform a focused gastrointestinal assessment
Correct Answer: Position the client upright
Rationale: Positioning the client upright (at least 30-45 degrees) before and after an NG tube
feeding reduces the risk of aspiration . Water boluses are insufficient for verifying tube
placement, and x-ray confirmation is recommended.
, 5. A client's enteral feedings have been determined to be too concentrated based on the
development of dumping syndrome. What physiologic phenomenon caused this complication?
A) Increased gastric secretion of HCl and gastrin due to high osmolality
B) Entry of large amounts of water into the small intestine due to osmotic pressure
C) Mucosal irritation of the stomach and small intestine by the high concentration
D) Acid-base imbalance resulting from the high volume of solutes in the feed
Correct Answer: Entry of large amounts of water into the small intestine due to osmotic
pressure
Rationale: Highly concentrated enteral feedings draw water into the intestinal lumen via
osmosis, causing rapid gastric emptying and dumping syndrome symptoms . This fluid shift leads
to diarrhea, cramping, and hypotension.
6. A client with dysphagia is scheduled for PEG tube insertion and asks the nurse how the tube
will stay in place. What is the nurse's best response?
A) Adhesive holds a flange in place against the abdominal skin
B) A stitch holds the tube in place externally
C) The tube is stitched to the abdominal skin externally and the stomach wall internally
D) Internal and external fixation bolsters secure the tube against the stomach wall
Correct Answer: Internal and external fixation bolsters secure the tube against the stomach wall
Rationale: A PEG tube is secured using internal and external fixation bolsters that sandwich the
stomach and abdominal wall . This prevents the tube from dislodging and maintains proper
position for feeding and decompression.
