Practice Quiz

NCLEX-RN

Category - Physiological

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A nurse is assigned to provide tube feedings to a female client every three to four hours. The nurse understands the importance of using the right techniques when performing the procedure to prevent complications. Which of the following nursing interventions maintains safety during administration of feedings?
  1. The client is placed in semi-Fowler’s position before the feeding.
  2. The nurse aspirates 80 mL of residual amounts and then proceeds with the feeding.
  3. The nurse instructs the client to lie flat on the bed for 15 minutes.
  4. The nurse changes the feeding container every 72 hours.
Explanation
Answer: B - If the nurse aspirates 80 mL of residual amounts, feeding is administered. If the residual amounts are greater than 100 mL, feeding is delayed as large volume aspirates are usually indicative of delayed gastric emptying. The client should be placed in high Fowler’s position. The client should maintain the position for at least 30 minutes. The nurse should change the feeding container every 24 hours.
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