Nursing Fundamentals
4 MAXE
NF Foundations of Professional Nursing Practice
CARING · COMPETENCE · COMPASSION
FUNDAMENTALS
Fundamentals of Nursing — Exam 4
N A S O G A ST R I C T U B E S , E N T E R A L N U T R I T I O N & T U B E F E E D I N G — CO M P L E T E R E V I E W
INSTITUTION Nursing Fundamentals Program COURSE CODE NURS 101 — Fundamentals
PROGRAM Associate / Bachelor of Science in Nursing ACADEMIC YEAR
EXAM TITLE Exam 4 — Fundamentals of Nursing TOTAL QUESTIONS 25 Questions (Complete — All Items)
COURSE TITLE Fundamentals of Nursing FORMAT Multiple Choice — Select the Single Best
Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question.
▸ Every concept from the provided NG tube and enteral nutrition study material has been converted into a complete question
with 4 answer choices, correct answer, and clinical rationale.
NG TUBES, ENTERAL FEEDING & COMPLICATIONS — ALL Questions 1 – 25
CONTENT (Complete)
1. A nasogastric (NG) tube is best defined as:
A. A surgically placed tube directly into the jejunum.
B. A flexible tube inserted through the nose, down the esophagus, and into the stomach — used for short-term feeding,
decompression, medication administration, or gastric lavage.
C. A tube inserted through the mouth into the trachea.
D. A permanent feeding tube placed through the abdominal wall.
CORRECT ANSWER B — NG tube = nasogastric route. It is for short-term use (typically <4-6 weeks). The tube travels: nares
→ nasopharynx → oropharynx → esophagus → stomach.
RATIONALE Indications: feeding (functional GI tract but cannot ingest orally — stroke, head/neck cancer), decompression
(GI obstruction, ileus), medication administration (dysphagia), and gastric lavage (poisoning/overdose).
2. Which NG tube type is a single-lumen tube used for feeding or drainage?
A. Salem Sump tube.
B. Levin tube.
C. Dobhoff tube.
D. PEG tube.
CORRECT ANSWER B — Levin = single-lumen (feeding or drainage). Salem Sump = double-lumen (decompression with
blue pigtail air vent). Dobhoff = small-bore, weighted tip for feeding. PEG = percutaneous endoscopic
gastrostomy (not an NG tube).
RATIONALE Polyurethane and silicone tubes are more durable and flexible, often used for longer-term NG placements.
The blue pigtail on the Salem Sump serves as an air vent to prevent suction-induced damage to the gastric
mucosa.
, 3. All of the following are contraindications for NG tube placement EXCEPT:
A. Facial or skull fractures (risk of intracranial placement).
B. Esophageal varices (rupture risk).
C. History of esophageal strictures.
D. Inability to ingest food orally with a functional GI tract — this is actually an INDICATION for NG tube placement.
CORRECT ANSWER D — Inability to eat with a functional GI tract is precisely WHY an NG tube is placed for enteral
nutrition. The other options are contraindications.
RATIONALE Additional contraindications: impaired gag reflex (aspiration risk), recent nasal or upper GI surgery,
anticoagulation (bleeding risk). Always assess patient history thoroughly before insertion.
4. The NG tube is measured for insertion by marking the tube from:
A. Nose to chin to xiphoid process.
B. Nose to earlobe to xiphoid process (NEX measurement).
C. Mouth to umbilicus.
D. Chin to sternal notch.
CORRECT ANSWER B — NEX: Nose → Earlobe → Xiphoid process. This approximates the distance from the nares to the
stomach. Mark the tube at the measured point.
RATIONALE The patient should be positioned in semi-Fowler's position during insertion. Explain the procedure, gather
equipment (NG tube, lubricant, gloves, tape, stethoscope, pH strips, saline/water, syringe), and establish a
communication signal for distress.
5. The GOLD STANDARD for confirming initial NG tube placement before use is:
A. Auscultation of a rush of air over the stomach when air is injected.
B. Chest X-ray (radiographic confirmation).
C. Observing for bubbling when the tube end is submerged in water.
D. Checking the external length marking only.
CORRECT ANSWER B — Chest X-ray is the ONLY definitive method to verify correct NG tube placement before initial use.
NEVER rely on auscultation alone — bowel sounds can be transmitted to the chest, mimicking gastric
placement.
RATIONALE Bedside verification methods: pH testing of gastric aspirate (pH ≤5.5 typically indicates gastric placement),
observing aspirate appearance (gastric = grassy green, tan, or off-white; respiratory = pale yellow/clear), and
measuring external tube length. These SUPPLEMENT but do not replace X-ray for initial confirmation.
6. Standard (polymeric) enteral formulas are:
A. Used only for patients with renal failure.
B. Complete, balanced formulas containing intact proteins, carbohydrates, and fats — designed for patients with
normal digestive function.
C. Elemental formulas for severe malabsorption.
D. Clear liquids only.
CORRECT ANSWER B — Standard/polymeric formulas require normal digestive function. Specialized formulas are for
specific conditions: renal failure (low protein/electrolytes), diabetes (low carbohydrate),
malabsorption (elemental/semi-elemental).
RATIONALE Feeding methods: Continuous (slow, steady pump rate — best for critically ill/high aspiration risk patients),
Intermittent (larger volumes at set times, mimics meal patterns), Bolus (syringe push of set volume over 15-30
min — highest aspiration risk).
4 MAXE
NF Foundations of Professional Nursing Practice
CARING · COMPETENCE · COMPASSION
FUNDAMENTALS
Fundamentals of Nursing — Exam 4
N A S O G A ST R I C T U B E S , E N T E R A L N U T R I T I O N & T U B E F E E D I N G — CO M P L E T E R E V I E W
INSTITUTION Nursing Fundamentals Program COURSE CODE NURS 101 — Fundamentals
PROGRAM Associate / Bachelor of Science in Nursing ACADEMIC YEAR
EXAM TITLE Exam 4 — Fundamentals of Nursing TOTAL QUESTIONS 25 Questions (Complete — All Items)
COURSE TITLE Fundamentals of Nursing FORMAT Multiple Choice — Select the Single Best
Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question.
▸ Every concept from the provided NG tube and enteral nutrition study material has been converted into a complete question
with 4 answer choices, correct answer, and clinical rationale.
NG TUBES, ENTERAL FEEDING & COMPLICATIONS — ALL Questions 1 – 25
CONTENT (Complete)
1. A nasogastric (NG) tube is best defined as:
A. A surgically placed tube directly into the jejunum.
B. A flexible tube inserted through the nose, down the esophagus, and into the stomach — used for short-term feeding,
decompression, medication administration, or gastric lavage.
C. A tube inserted through the mouth into the trachea.
D. A permanent feeding tube placed through the abdominal wall.
CORRECT ANSWER B — NG tube = nasogastric route. It is for short-term use (typically <4-6 weeks). The tube travels: nares
→ nasopharynx → oropharynx → esophagus → stomach.
RATIONALE Indications: feeding (functional GI tract but cannot ingest orally — stroke, head/neck cancer), decompression
(GI obstruction, ileus), medication administration (dysphagia), and gastric lavage (poisoning/overdose).
2. Which NG tube type is a single-lumen tube used for feeding or drainage?
A. Salem Sump tube.
B. Levin tube.
C. Dobhoff tube.
D. PEG tube.
CORRECT ANSWER B — Levin = single-lumen (feeding or drainage). Salem Sump = double-lumen (decompression with
blue pigtail air vent). Dobhoff = small-bore, weighted tip for feeding. PEG = percutaneous endoscopic
gastrostomy (not an NG tube).
RATIONALE Polyurethane and silicone tubes are more durable and flexible, often used for longer-term NG placements.
The blue pigtail on the Salem Sump serves as an air vent to prevent suction-induced damage to the gastric
mucosa.
, 3. All of the following are contraindications for NG tube placement EXCEPT:
A. Facial or skull fractures (risk of intracranial placement).
B. Esophageal varices (rupture risk).
C. History of esophageal strictures.
D. Inability to ingest food orally with a functional GI tract — this is actually an INDICATION for NG tube placement.
CORRECT ANSWER D — Inability to eat with a functional GI tract is precisely WHY an NG tube is placed for enteral
nutrition. The other options are contraindications.
RATIONALE Additional contraindications: impaired gag reflex (aspiration risk), recent nasal or upper GI surgery,
anticoagulation (bleeding risk). Always assess patient history thoroughly before insertion.
4. The NG tube is measured for insertion by marking the tube from:
A. Nose to chin to xiphoid process.
B. Nose to earlobe to xiphoid process (NEX measurement).
C. Mouth to umbilicus.
D. Chin to sternal notch.
CORRECT ANSWER B — NEX: Nose → Earlobe → Xiphoid process. This approximates the distance from the nares to the
stomach. Mark the tube at the measured point.
RATIONALE The patient should be positioned in semi-Fowler's position during insertion. Explain the procedure, gather
equipment (NG tube, lubricant, gloves, tape, stethoscope, pH strips, saline/water, syringe), and establish a
communication signal for distress.
5. The GOLD STANDARD for confirming initial NG tube placement before use is:
A. Auscultation of a rush of air over the stomach when air is injected.
B. Chest X-ray (radiographic confirmation).
C. Observing for bubbling when the tube end is submerged in water.
D. Checking the external length marking only.
CORRECT ANSWER B — Chest X-ray is the ONLY definitive method to verify correct NG tube placement before initial use.
NEVER rely on auscultation alone — bowel sounds can be transmitted to the chest, mimicking gastric
placement.
RATIONALE Bedside verification methods: pH testing of gastric aspirate (pH ≤5.5 typically indicates gastric placement),
observing aspirate appearance (gastric = grassy green, tan, or off-white; respiratory = pale yellow/clear), and
measuring external tube length. These SUPPLEMENT but do not replace X-ray for initial confirmation.
6. Standard (polymeric) enteral formulas are:
A. Used only for patients with renal failure.
B. Complete, balanced formulas containing intact proteins, carbohydrates, and fats — designed for patients with
normal digestive function.
C. Elemental formulas for severe malabsorption.
D. Clear liquids only.
CORRECT ANSWER B — Standard/polymeric formulas require normal digestive function. Specialized formulas are for
specific conditions: renal failure (low protein/electrolytes), diabetes (low carbohydrate),
malabsorption (elemental/semi-elemental).
RATIONALE Feeding methods: Continuous (slow, steady pump rate — best for critically ill/high aspiration risk patients),
Intermittent (larger volumes at set times, mimics meal patterns), Bolus (syringe push of set volume over 15-30
min — highest aspiration risk).
