NCLEX RN: 8 QUESTIONS AND ANSWERS PRACTICE EXAM 2022

NCLEX RN: 8 QUESTIONS AND ANSWERS PRACTICE
EXAM 2022
Which observation by the RN requires intervention during the care of a student RN to a pt w/
continuous NG tube feeding?


1.) Before refilling the next feeding, the RN aspirates gastric fluid to check for proper
placement. 2.) Student RN admins 2 meds @ a time, then flushes properly w/ H2O
3.) Maintain pt in semi-fowler's position @ all time
4.) Before refilling the next feeding the student RN checks & measures gastric residue - CORRECT
ANSWER 2 => Risk for NGT meds clumping & interaction
=> Give 1 med @ a time
-Do NOT want it to block


Explanations:
1 = true; pit on gastric strip to check pH
3 = true; @ all times 30 degrees; 45-60
degrees 4 = true; check to see of pt is
absorbing feedings


Identify the 10 Steps involved in Tube feeding/Gastric Gavage - CORRECT ANSWER 1.) Check bowel
sounds (use stethoscope), & begin feeding when GI peristalsis returns
=> pt pulls up & has NO peristalsis movement, then NO NG feedings


2.) Place pt in High-fowler position
=> 90 degrees

,NCLEX RN: 8 QUESTIONS AND ANSWERS PRACTICE
EXAM 2022
-Semi-fowler's 45-60 degrees


3.) Place towel over chest
=> want to be clean & neat


4.) Check gastric tube placement
=> w/ gastric acidity <5 pH


5.) Connect feeding tube to funnel or large syringe


6.) Check gastric residual to assess absorption & pt tolerance, return residual
=> amount of previous feeding the is still in stomach
-100 mL => poor gastric emptying & feedings w/held
--talk to HCP


7.) Poor feeding into tilted funnel & unclamp tubing to allow feeding to flow by gravity
=> to prevent splash


8.) Regulate flow by raising or lowing container
=> Feeding too QUICKLY causes:
-> diarrhea,
-> gastric distention
-> Pain


=> feeding too SLOWLY causes possible:
-> obstruction of flow of the NG tube


9.) After feeding, irrigate tube w/ warm H2O & clamp tube

,NCLEX RN: 8 QUESTIONS AND ANSWERS PRACTICE
EXAM 2022
10.) Apply small dressing over tube opening, coil tube (to prevent pulling) & attach to dressing may
cover w/ an abd. binder
=> keep HOB ELEVATED 30 degrees for @ least 1 hr after feeding
- Keep HOB 30 degrees @ ALL times of on continuous


(10 Steps involved in Tube feeding/Gastric Gavage) 2.) The RN should place the pt in what position? -
CORRECT ANSWER High-Fowler's 90 degrees
=> or semi-fowlers 45-60 degrees



(10 Steps involved in Tube feeding/Gastric Gavage) 4.) What should the pH be of the gastric content
from the NG tube? - CORRECT ANSWER pH <5


(10 Steps involved in Tube feeding/Gastric Gavage) 8.) When the RN is regulating the flow by raising or
lowering the container, feedings that are TOO QUICKLY causes what 3 things? - CORRECT ANSWER 1.)
Diarrhea
2.) Gastric distention
3.) Pain


(10 Steps involved in Tube feeding/Gastric Gavage) 8.) When the RN is regulating the flow by raising
or lowering the container, feedings that are TOO SLOWLY causes what 1 thing? - CORRECT ANSWER
1.) Obstruction of flow of the NG tube



(10 Steps involved in Tube feeding/Gastric Gavage) 10.) When the RN applies small dressings
over the tube opening, coil the tube, & attach to dressing may cover w/ an a.)


=> Keep HOB b.) @ c.) degrees for @ least d.) after feeding
-keep HOB @ 30 degrees @ ALL times if on e.) - CORRECT ANSWER a.) Abdominal
binder b.) Elevated
c.) 30 degrees
d.) 1 hr
e.) Continuous



The RN double dosed this pt on vancomycin & the pt is @ the oliguric phase of AKI. Which will the RN
expect to observe?

, NCLEX RN: 8 QUESTIONS AND ANSWERS PRACTICE
EXAM 2022

1.) Urine output of
1mL/kg/hr 2.) K+ = 5.9
3.) Creatinine = 1.1
4.) BUN = 16 - CORRECT ANSWER 2 => Expected in AKI => Hyperkalemia
* oliguric phase = 2nd stage


Explanations:
1 = 70 kg = 150-160 lbs normal; in AKI <0.5
mL/kg/hr 3 = normal 0.6-1.2; w/ AKI see
INCREASE creatinine 4 = normal 10-20; w/ AKI
INCREASE BUN


This is an abrupt deterioration of the renal system, may be a reversible syndrome - CORRECT ANSWER
Acute Renal Failure


Name 3 types of Acute Renal Failure - CORRECT ANSWER 1.)
Prerenal 2.) Intrarenal
3.) Postrenal


(3 types of Acute Renal Failure) a.) is the interference w/ renal perfusion
=> b.) blood to kidney to filter & deprives kidneys c.) - CORRECT ANSWER A.)
Prerenal b.) Decrease blood
c.) Nutrients


(3 types of Acute Renal Failure) List the 4 causes for Prerenal - CORRECT ANSWER 1.)
Hemorrhage 2.) Hypovolemia
3.) DECREASE CO
4.) DECREASE renal perfusion


(3 types of Acute Renal Failure) a.) is the damage to the parenchyma (damage to the nephrons)