the nurse has inserted a nasogastric tube to the level of the oropharynx and has repositioned the clients head in a flexed forward position the client
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Nursing Elites

ATI RN

Gastrointestinal System Nursing Exam Questions

1. The nurse has inserted a nasogastric tube to the level of the oropharynx and has repositioned the client’s head in a flexed-forward position. The client has been asked to begin swallowing. The nurse starts slowly to advance the nasogastric tube with each swallow. The client begins to cough, gag, and choke. Which nursing action would least likely result in proper tube insertion and promote client relaxation?

Correct answer: A

Rationale: As the nasogastric tube is passed through the oropharynx, the gag reflex is stimulated, which may cause coughing, gagging, or choking. Instead of passing through to the esophagus, the nasogastric tube may coil around itself in the oropharynx, or it may enter the larynx and obstruct the airway, pulling the tube back slightly will remove it from the larynx; advancing the tube might position it in the trachea. Swallowing closes the epiglottis over the trachea and helps move the tube into the esophagus. Slow breathing helps the client relax to reduce the gag response. The nurse should check the back of the client’s throat to note if the tube has coiled. The tube may be advanced after the client relaxes.

2. After an abdominal resection for colon cancer, Madeline returns to her room with a Jackson-Pratt drain in place. The purpose of the drain is to:

Correct answer: D

Rationale: The purpose of the Jackson-Pratt drain is to prevent the accumulation of drainage in the wound after an abdominal resection.

3. A patient with chronic alcohol abuse is admitted with liver failure. You closely monitor the patient’s blood pressure because of which change that is associated with the liver failure?

Correct answer: C

Rationale: Abnormal peripheral vasodilation is a change associated with liver failure that requires close monitoring of the patient's blood pressure.

4. A client has been diagnosed with gastroesophageal reflux disease. The nurse interprets that the client has dysfunction of which of the following parts of the digestive system?

Correct answer: C

Rationale: The lower esophageal sphincter is a functional sphincter that normally remains closed except when food or fluids are swallowed. If relaxation of this sphincter occurs, the client could experience symptoms of gastroesophageal reflux disease.

5. Your patient with peritonitis is NPO and complaining of thirst. What is your priority?

Correct answer: C

Rationale: Providing frequent mouth care is the priority for a patient with peritonitis who is NPO and complaining of thirst.

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