NG And Urinary Catheter Care - NCLEX Pn

1. What is the correct action if an NG tube is not draining while ordered to low intermittent suction?

   Assess for kinks/occlusion and irrigate only if ordered per policy. Kinks or occlusions impede drainage; irrigation requires orders to avoid risks like perforation or infection.

2. Which routine nursing measure helps prevent nasal mucosa breakdown with an NG tube?

   Provide frequent nares and oral care; secure tube to reduce friction. Regular care maintains skin integrity, while securing minimizes movement that could cause erosion or pressure ulcers.

3. What is the appropriate nursing action before administering medication through an NG tube?

   Verify placement and flush with water per facility policy. Verification ensures correct placement to prevent complications, and flushing maintains patency and compatibility.

4. Which finding most strongly suggests a catheter is obstructed and requires prompt assessment?

   No urine output with bladder distention or suprapubic discomfort. Absent output with distention indicates blockage, risking bladder overdistension or hydronephrosis if untreated.

5. What is the correct position of the urinary drainage bag relative to the bladder?

   Below bladder level at all times, off the floor. Positioning below the bladder promotes gravity drainage and prevents urine reflux, reducing infection risk.

6. What is the primary purpose of a nasogastric (NG) tube used for gastric decompression?

   Remove gastric contents and relieve abdominal distention. NG tubes for decompression evacuate accumulated gas and fluid from the stomach to prevent or alleviate distention and associated complications.

7. What is the correct action if a catheter disconnects from the drainage tubing accidentally?

   Disinfect and reconnect using aseptic technique; do not touch ends. Aseptic reconnection prevents bacterial contamination and maintains the closed system's integrity.

8. Which action best prevents catheter-associated urinary tract infection (CAUTI)?

   Maintain a closed drainage system with unobstructed urine flow. A closed system minimizes bacterial entry, and unobstructed flow prevents stasis that promotes infection.

9. Which medication form should be avoided for administration via NG tube when possible?

   Enteric-coated or extended-release tablets. These forms are designed for timed release and crushing alters pharmacokinetics, potentially causing overdose or inefficacy.

10. What is the first nursing action if urine is not draining into the bag after Foley insertion?

    Check for dependent loops/kinks and ensure bag is below bladder level. Loops or kinks obstruct flow, and proper bag positioning ensures gravity-assisted drainage.

11. What is the correct immediate action if an NG tube becomes dislodged from the nares?

    Stop use and reinsert per order; do not advance a displaced tube. Advancing a displaced tube risks misplacement or perforation; reinsertion ensures proper positioning under controlled conditions.

12. What is the most reliable bedside method to verify initial NG tube placement before use?

    Radiographic confirmation (x-ray). X-ray provides definitive visualization of tube position in the stomach, ruling out esophageal or pulmonary misplacement.

13. What is the priority nursing assessment for an NG tube connected to suction?

    Patency and correct functioning of suction with ordered settings. Ensuring patency and proper suction prevents complications like obstruction or inadequate decompression.

14. Which bedside finding best supports that an NG tube is in the stomach after placement?

    Aspirate with acidic pH consistent with gastric contents. Gastric aspirate typically has a low pH due to hydrochloric acid, distinguishing it from respiratory or intestinal placement.

15. Which step is required before collecting a sterile urine specimen from an indwelling catheter?

    Clamp briefly, disinfect sampling port, then aspirate with sterile syringe. Clamping allows urine accumulation, and aseptic aspiration from the port maintains specimen sterility.

16. Identify the correct technique for routine perineal care with an indwelling catheter.

    Cleanse meatus and catheter with soap and water; no routine irrigation. Daily cleansing removes bacteria without introducing irrigants that could cause irritation or infection.

17. What is the best nursing action to reduce aspiration during intermittent tube feeding?

    Keep head of bed elevated during feeding and for prescribed time after. Elevation reduces reflux of feeding formula into the esophagus, minimizing aspiration pneumonia risk.

18. Which complication is most concerning with NG suction and requires close monitoring?

    Fluid and electrolyte imbalance. Continuous suction can lead to excessive loss of fluids and electrolytes, potentially causing dehydration or metabolic alkalosis.

19. What is the indication for inserting an indwelling urinary (Foley) catheter?

    Acute urinary retention or need for accurate hourly urine output. Indwelling catheters relieve retention by draining urine and allow precise monitoring in critical conditions.

20. Which post-catheter removal assessment is the priority for urinary elimination?

    Time to first void and signs of urinary retention. Monitoring voiding detects retention early, preventing complications like infection or bladder dysfunction.

21. Which patient position is best to reduce aspiration risk during NG tube insertion?

    High Fowler position (upright, head flexed slightly forward). This position facilitates swallowing and directs the tube toward the esophagus while minimizing the risk of aspiration into the airway.

22. Identify the immediate action if a patient develops coughing, choking, or cyanosis during NG insertion.

    Stop insertion and remove the tube. These symptoms indicate possible tracheal placement, requiring immediate removal to prevent respiratory compromise.

23. What is the correct action if a patient reports pain and urine leakage around a Foley catheter?

    Assess for obstruction or bladder spasms; do not increase balloon volume. Pain and leakage suggest issues like blockage causing pressure; increasing volume risks bladder injury.

24. Identify the key assessment to perform before each intermittent NG feeding.

    Check for signs of intolerance (nausea, distention, residual per policy). Assessing tolerance prevents overfeeding and complications like aspiration or gastrointestinal distress.

25. Identify the correct technique when removing an indwelling urinary catheter.

    Deflate balloon completely, then withdraw catheter smoothly. Complete deflation prevents urethral trauma, and smooth withdrawal minimizes discomfort and injury.

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