Fundamentals of Nursing NCLEX
Practice Questions Quiz #7 | 70
Questions
Questions related to Patient Tubes: NGT, Chest, and Tracheostomy
FNDNRS-07-001
Which of the following is not true regarding the types of a nasogastric tube?
A. Cantor tube is a single-lumen long tube with a small inflatable bag at
the distal end.
B. Miller-Abbott tube is a long double-lumen used to drain and
decompress the small intestine.
C. Levin tube is a double-lumen nasogastric tube with an air vent.
D. Sengstaken-Blakemore tube is a three-lumen tube.
Correct Answer: C. Levin tube is a double-lumen nasogastric tube with an air
vent.
A Levin tube is a single lumen nasogastric tube while a Salem sump tube is a
double-lumen nasogastric tube with an air vent. The Levin tube is used primarily
for long-continued gastric drainage and for gavage feeding. It is also used for
diagnostic purposes. Its advantages are that it can be inserted either nasally or
orally and that it is firm enough to be passed into an unconscious patient but
flexible enough so there is little danger of producing injury.
Option A: The Cantor Tub is a 10-foot long, single-lumen tube used for
intestinal decompression. The Cantor tube has a mercury-weighted rubber
tab attached to its perforated tip to help carry the tube through the
stomach and intestine. The mercury is placed in the bag with a syringe and
needle before the tube is inserted nasally by the doctor.
Option B: The Miller-Abbott tube is a 10-foot long double-lumen tube
that is equipped with a small balloon near the metal tip at the distal end of
the tube. One lumen is used for aspiration and irrigation; the other is used
, for inflating the balloon. Air, water, or mercury (4 to 5 ml) accomplishes
inflation. This intestinal tube is used for small bowel suction. The two
openings are independent of each other and are clearly marked.
Option D: Also referred to as a Blakemore tube, this tube is a three-lumen,
esophageal-gastric balloon tube that is used in the treatment of bleeding
esophageal varices. One lumen is used to inflate the esophageal balloon,
one lumen is used to inflate the gastric balloon, and the third lumen is
used for decompression and irrigation of the stomach.
FNDNRS-07-002
A new RN nurse is about to insert a nasogastric tube into a client with Guillain-
Barre Syndrome. To determine the accurate measurement of the length of the
tube to be inserted, the nurse should:
A. Place the tube at the tip of the nose, and measure by extending the tube
to the earlobe and then down to the top of the sternum.
B. Place the tube at the tip of the nose and measure by extending the tube
to the earlobe and then down to the xiphoid process.
C. Place the tube at the tip of the nose, and measure by extending the tube
down to the chin and then down to the top of the xiphoid process.
D. Place the tube at the base of the nose and measure by extending the
tube to the earlobe and then down to the top of the sternum.
Correct Answer: B. Place the tube at the tip of the nose, and measure by
extending the tube to the earlobe and then down to the xiphoid process.
Estimate the length of insertion by measuring the distance from the tip of the
nose, around the ear, and down to just below the left costal margin. This point
can be marked with a piece of tape on the tube. When using the Salem sump NG
tube (Kendall, Mansfield, MA) in adults, the estimated length usually falls
between the second and third preprinted black lines on the tube.
Option A: Apart from the nose-to-ear-to-xiphisternum (NEX) method,
several other methods for determining the length of the tube have been
described. Among the various options, a formula based on gender, weight,
, and nose-to-umbilicus measurement while lying flat was found to be safer
and more accurate in a study by Santos et al.
Option C: While the stomach is a highly distensible structure and
therefore, can vary in length, the empty stomach is generally around 25 cm
long. Thus if one intended to place a tube through the nares and place it in
the middle of the stomach, then approximately 55 cm of the tube should
be inserted.
Option D: There are several methods to estimate the depth that an NG
should be placed. All methods for estimation will have some margin of
error. A common pre-procedure maneuver is to loop the tube over one of
the patient’s ears and place the tip at the patient’s xiphoid process and use
this as an estimate for the length of the tube that should be inserted.
FNDNRS-07-003
A stroke client who was initially on NGT feeding was able to tolerate a soft diet so
the physician ordered the removal of it. The nurse would instruct the client to do
which of the following before he removes the tube?
A. Inhale and exhale simultaneously.
B. Take a long breath and hold it.
C. Do a Valsalva maneuver.
D. Blow the nose.
Correct Answer: B. Take a long breath and hold it.
Holding the breath closes the glottis hence it will be easier to withdraw the tube
through the esophagus into the nose, and this method will also prevent
aspiration. An NG tube should be removed if it is no longer required. The process
of removal is usually very quick. Prior to removing an NG tube, verify physician
orders. If the NG tube was ordered to remove gastric content, the physician’s
order may state to “trial” clamping the tube for a number of hours to see if the
patient tolerates its removal. During the trial, the patient should not experience
any nausea, vomiting, or abdominal distension.
Option A: Instruct the patient to take a deep breath and hold it. This
prevents aspiration; holding the breath closes the glottis. Kink the NG tube
, near the naris and gently pull out the tube in a swift, steady motion,
wrapping it in your hand as it is being pulled out. Dispose of tube in
garbage bag.
Option C: The Valsalva maneuver is a breathing technique that can be
used to unclog ears, restore heart rhythm or diagnose an autonomic
nervous system (ANS). To perform the Valsalva maneuver, the patient
should close his mouth, pinch the nose shut and press the air out like
blowing up a balloon.
Option D: Blowing the nose is a way of clearing out mucus that has
collected debris and pollutants from the atmosphere. Most of the time,
people blow their nose because of excess mucus production – a cold,
nasal allergy, hay fever, or other conditions.
FNDNRS-07-004
The nurse is preparing to give bolus enteral feedings via a nasogastric tube to a
comatose client. Which of the following actions is an inappropriate practice by
the nurse?
A. If bowel sounds are absent, hold the feeding and notify the physician.
B. Assess tube placement by aspirating gastric content and check the PH
level.
C. Warm the feeding to room temperature to prevent the occurrence of
diarrhea and cramps.
D. Elevate the head of the bed to 45 degrees and maintain for 30 minutes
after installation of feeding.
Correct Answer: D. Elevate the head of the bed to 45 degrees and maintain
for 30 minutes after instillation of feeding.
If the client is comatose, place in a high-Fowler’s which is at a 90-degree level.
Position client upright or in full Fowler’s position if possible. Place a clean towel
over the client’s chest. Full Fowler’s position assists the client to swallow, for
optimal neck-stomach alignment and promotes peristalsis.
Option A: Inject 30 mL of air into the stomach and listen with the
stethoscope for the “whoosh” of air into the stomach. The small diameter
Practice Questions Quiz #7 | 70
Questions
Questions related to Patient Tubes: NGT, Chest, and Tracheostomy
FNDNRS-07-001
Which of the following is not true regarding the types of a nasogastric tube?
A. Cantor tube is a single-lumen long tube with a small inflatable bag at
the distal end.
B. Miller-Abbott tube is a long double-lumen used to drain and
decompress the small intestine.
C. Levin tube is a double-lumen nasogastric tube with an air vent.
D. Sengstaken-Blakemore tube is a three-lumen tube.
Correct Answer: C. Levin tube is a double-lumen nasogastric tube with an air
vent.
A Levin tube is a single lumen nasogastric tube while a Salem sump tube is a
double-lumen nasogastric tube with an air vent. The Levin tube is used primarily
for long-continued gastric drainage and for gavage feeding. It is also used for
diagnostic purposes. Its advantages are that it can be inserted either nasally or
orally and that it is firm enough to be passed into an unconscious patient but
flexible enough so there is little danger of producing injury.
Option A: The Cantor Tub is a 10-foot long, single-lumen tube used for
intestinal decompression. The Cantor tube has a mercury-weighted rubber
tab attached to its perforated tip to help carry the tube through the
stomach and intestine. The mercury is placed in the bag with a syringe and
needle before the tube is inserted nasally by the doctor.
Option B: The Miller-Abbott tube is a 10-foot long double-lumen tube
that is equipped with a small balloon near the metal tip at the distal end of
the tube. One lumen is used for aspiration and irrigation; the other is used
, for inflating the balloon. Air, water, or mercury (4 to 5 ml) accomplishes
inflation. This intestinal tube is used for small bowel suction. The two
openings are independent of each other and are clearly marked.
Option D: Also referred to as a Blakemore tube, this tube is a three-lumen,
esophageal-gastric balloon tube that is used in the treatment of bleeding
esophageal varices. One lumen is used to inflate the esophageal balloon,
one lumen is used to inflate the gastric balloon, and the third lumen is
used for decompression and irrigation of the stomach.
FNDNRS-07-002
A new RN nurse is about to insert a nasogastric tube into a client with Guillain-
Barre Syndrome. To determine the accurate measurement of the length of the
tube to be inserted, the nurse should:
A. Place the tube at the tip of the nose, and measure by extending the tube
to the earlobe and then down to the top of the sternum.
B. Place the tube at the tip of the nose and measure by extending the tube
to the earlobe and then down to the xiphoid process.
C. Place the tube at the tip of the nose, and measure by extending the tube
down to the chin and then down to the top of the xiphoid process.
D. Place the tube at the base of the nose and measure by extending the
tube to the earlobe and then down to the top of the sternum.
Correct Answer: B. Place the tube at the tip of the nose, and measure by
extending the tube to the earlobe and then down to the xiphoid process.
Estimate the length of insertion by measuring the distance from the tip of the
nose, around the ear, and down to just below the left costal margin. This point
can be marked with a piece of tape on the tube. When using the Salem sump NG
tube (Kendall, Mansfield, MA) in adults, the estimated length usually falls
between the second and third preprinted black lines on the tube.
Option A: Apart from the nose-to-ear-to-xiphisternum (NEX) method,
several other methods for determining the length of the tube have been
described. Among the various options, a formula based on gender, weight,
, and nose-to-umbilicus measurement while lying flat was found to be safer
and more accurate in a study by Santos et al.
Option C: While the stomach is a highly distensible structure and
therefore, can vary in length, the empty stomach is generally around 25 cm
long. Thus if one intended to place a tube through the nares and place it in
the middle of the stomach, then approximately 55 cm of the tube should
be inserted.
Option D: There are several methods to estimate the depth that an NG
should be placed. All methods for estimation will have some margin of
error. A common pre-procedure maneuver is to loop the tube over one of
the patient’s ears and place the tip at the patient’s xiphoid process and use
this as an estimate for the length of the tube that should be inserted.
FNDNRS-07-003
A stroke client who was initially on NGT feeding was able to tolerate a soft diet so
the physician ordered the removal of it. The nurse would instruct the client to do
which of the following before he removes the tube?
A. Inhale and exhale simultaneously.
B. Take a long breath and hold it.
C. Do a Valsalva maneuver.
D. Blow the nose.
Correct Answer: B. Take a long breath and hold it.
Holding the breath closes the glottis hence it will be easier to withdraw the tube
through the esophagus into the nose, and this method will also prevent
aspiration. An NG tube should be removed if it is no longer required. The process
of removal is usually very quick. Prior to removing an NG tube, verify physician
orders. If the NG tube was ordered to remove gastric content, the physician’s
order may state to “trial” clamping the tube for a number of hours to see if the
patient tolerates its removal. During the trial, the patient should not experience
any nausea, vomiting, or abdominal distension.
Option A: Instruct the patient to take a deep breath and hold it. This
prevents aspiration; holding the breath closes the glottis. Kink the NG tube
, near the naris and gently pull out the tube in a swift, steady motion,
wrapping it in your hand as it is being pulled out. Dispose of tube in
garbage bag.
Option C: The Valsalva maneuver is a breathing technique that can be
used to unclog ears, restore heart rhythm or diagnose an autonomic
nervous system (ANS). To perform the Valsalva maneuver, the patient
should close his mouth, pinch the nose shut and press the air out like
blowing up a balloon.
Option D: Blowing the nose is a way of clearing out mucus that has
collected debris and pollutants from the atmosphere. Most of the time,
people blow their nose because of excess mucus production – a cold,
nasal allergy, hay fever, or other conditions.
FNDNRS-07-004
The nurse is preparing to give bolus enteral feedings via a nasogastric tube to a
comatose client. Which of the following actions is an inappropriate practice by
the nurse?
A. If bowel sounds are absent, hold the feeding and notify the physician.
B. Assess tube placement by aspirating gastric content and check the PH
level.
C. Warm the feeding to room temperature to prevent the occurrence of
diarrhea and cramps.
D. Elevate the head of the bed to 45 degrees and maintain for 30 minutes
after installation of feeding.
Correct Answer: D. Elevate the head of the bed to 45 degrees and maintain
for 30 minutes after instillation of feeding.
If the client is comatose, place in a high-Fowler’s which is at a 90-degree level.
Position client upright or in full Fowler’s position if possible. Place a clean towel
over the client’s chest. Full Fowler’s position assists the client to swallow, for
optimal neck-stomach alignment and promotes peristalsis.
Option A: Inject 30 mL of air into the stomach and listen with the
stethoscope for the “whoosh” of air into the stomach. The small diameter
