what is the first action a nurse should take when a patients nasogastric ng tube becomes clogged
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HESI LPN

HESI PN Exit Exam 2023

1. What is the first action a healthcare professional should take when a patient’s nasogastric (NG) tube becomes clogged?

Correct answer: C

Rationale: When a patient's nasogastric (NG) tube becomes clogged, the first action to take is to attempt to aspirate the clog with a syringe. This is a standard and initial step to clear the blockage in the tube. Flushing the tube with water (Choice A) may not address the specific clog; repositioning the patient (Choice B) is not directly related to clearing the tube. Administering a medication to dissolve the clog (Choice D) should only be considered after simpler methods like aspiration have been attempted.

2. When caring for a client with colostomy, which topical skin preparation should the PN apply around the stoma?

Correct answer: D

Rationale: The correct answer is 'Stomadhesive.' Stomadhesive is a protective barrier used around the stoma to prevent skin irritation and to secure the colostomy bag. This preparation helps to maintain skin integrity and prevent complications such as skin breakdown. Antiseptic cream (Choice A) is not typically used around the stoma as it can irritate the skin. Petroleum jelly (Choice B) is also not recommended as it can interfere with the adhesive properties of the colostomy appliance. Cornstarch (Choice C) is not suitable for application around the stoma as it can promote moisture and lead to skin irritation.

3. A female Native American client who is receiving chemotherapy places a native artifact, an Indian medicine wheel, in her hospital room. The HCP removes the medicine wheel and tells the client, 'This type of thing does not belong in the hospital.' Which intervention should the PN implement?

Correct answer: B

Rationale: Acting as the client's advocate is the most appropriate intervention in this situation. Removing a culturally significant artifact without considering the client's beliefs and emotional needs can be distressing. By advocating for the client, the PN can ensure that the client's cultural practices are respected, which is crucial for her emotional and spiritual well-being during treatment. Choice A is incorrect because while chemotherapy adherence is important, it is not the most immediate concern in this scenario. The client's cultural needs and well-being take precedence. Choice C is incorrect because consulting with a Native American healer might not be necessary at this point and could delay addressing the immediate issue of advocating for the client's rights. Choice D is incorrect because simply reporting the client's feelings of culture shock to the HCP does not actively address the situation or advocate for the client's rights and cultural needs.

4. An adult client is undergoing weekly external radiation treatments for breast cancer. Upon arrival at the outpatient clinic for a scheduled treatment, the client reports increasing fatigue to the PN who is taking the client's vital signs. What action should the PN implement?

Correct answer: D

Rationale: When a client undergoing radiation therapy reports increasing fatigue, it is essential to address this common side effect. Educating the client on the importance of rest and sleep can help manage fatigue and promote recovery. Contacting the healthcare provider or charge nurse immediately may not be necessary unless fatigue is severe and other symptoms are present. Rescheduling the treatment or monitoring vital signs more frequently is not the priority in this situation.

5. A client reports being able to swallow only small bites of solid food and liquids for the last 3 months. The PN should assess the client for what additional information?

Correct answer: C

Rationale: The correct answer is C: History of alcohol or tobacco use. A history of alcohol or tobacco use is significant as both are risk factors for esophageal cancer or other esophageal disorders that could cause difficulty swallowing (dysphagia). This information helps in evaluating the underlying cause of the symptom. Choices A, B, and D are less relevant in this context. While a past traumatic injury to the neck could potentially cause swallowing difficulties, given the chronic nature of the symptom in this case, it is more important to focus on potential risk factors associated with esophageal disorders like alcohol and tobacco use. Daily consumption of hot beverages and daily dietary intake of roughage are less likely to be directly related to the client's current swallowing issue.

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