ATI Leadership Proctored Exam 70 Questions & Answers Graded A 2023.

ATI LEADERSHIP PROCTORED EXAM
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.Aknursekiskpreparingktokadministerkankenteralkfeeding.kInkwhichkorderkwillktheknursekim
plement the steps, starting with the first one?
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1. Elevate head of bed to at least 30 degrees.
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2. Check for gastric residual volume.
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3. Flush tubing with 30 mL of water.
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4.Verify tube placement. k k



5. Initiate feeding. k



a. 4, 2, 1, 5, 3
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b. 2, 4, 1, 3, 5
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c. 1, 4, 2, 3, 5
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d. 2, 1, 4, 5, 3
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ANS: C k


The steps for an enteral feeding are as follows: Place patient in high-
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Fowler’s position or elevate head of bed to at least 30 (preferably 45) degrees; veri
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fy tubeplacement; check for gastric residual volume; flush tubing with 30 mL of
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water;and initiate feeding.
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24. The patient is admitted with facial trauma, including a broken nose, and has
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a history of esophageal reflux and of aspiration pneumonia. With which tube willthe
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nurse most likely administer the feeding?
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a. Nasogastric tube k




b. Jejunostomy tube k



c. Nasointestinal tube k



d. Percutaneous endoscopic gastrostomy (PEG) tube k k k k

,ANS: B k


Patients with gastroparesis or esophageal reflux or with a history of aspiration pneu
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monia may require placement of tubes beyond the stomach into the intestine.The jeju
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nostomy tube is the only tube in the list that is beyond the stomach and isnot contrain
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dicated by facial trauma. The nasogastric tube and the PEG tube are placed in the sto
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mach, and placement could lead to aspiration. The nasointestinal tube and the nasoga
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stric tube may be contraindicated by facial trauma and the broken nose.
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25. The nurse is preparing to insert a nasogastric tube in a patient who is semic
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onscious. To determine the length of the tube needed to be inserted, how
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should the nurse measure the tube?
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a. From the tip of the nose to the earlobe
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b. From the tip of the earlobe to the xiphoid process
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c. From the tip of the earlobe to the nose to the xiphoid process
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d. From the tip of the nose to the earlobe to the xiphoid process
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ANS: D k


Measure distance from the tip of the nose to the earlobe to the xiphoid process ofth
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e sternum. This approximates the distance from the nose to the stomach in 98%of p
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atients. For duodenal or jejunal placement, an additional 20 to 30 cm is required.
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26. Before giving the patient an intermittent gastric tube feeding, what should then
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urse do? k



a. Make sure that the tube is secured to the gown with a safety pin.
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b. Inject air into the stomach via the tube and auscultate.
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, c. Have the tube feeding at room temperature.
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d. Check to make sure pH is at least 5. k k k k k k k k




ANS: C k


Be sure that the formula is at room temperature. Cold formula causes gastric cra
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mping and discomfort because the mouth and the esophagus do not warm the li
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quid. Do not use safety pins. Safety pins can become unfastened and may cause
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harm to the patient. Auscultation is no longer considered a reliablemethod for v
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erification of tube placement because a tube inadvertently placedin the lungs, p
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harynx, or esophagus transmits sound similar to that of air entering the stomach
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. Gastric fluid of patient who has fasted for at least 4 hours usually has a pH of 1
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to 4, especially when the patient is not receiving gastric-acid inhibitor.
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27.A small-bore feeding tube is placed. Which technique will the nurse use to k k k k k k k k k k k


best verify tube placement? k k k



a. X-ray

b. pH testing k



c. Auscultation
d. Aspiration of contents k k




ANS: A k


At present, the most reliable method for verification of placement of small-
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kbore feeding tubes is x-
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ray examination. Aspiration of contents and pH testingare not infallible. The nur
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se would need a more precise indicator to help differentiate the source of tube fe
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eding aspirate. Auscultation is no longer considered a reliable method for verifi
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cation of tube placement because a tubeinadvertently placed in the lungs, phary
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nx, or esophagus transmits sound similar to that of air entering the stomach.
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28. The nurse is concerned about pulmonary aspiration when providing
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the patient with an intermittent tube feeding. Which action is the priority?
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a. Observe the color of gastric contents. k k k k k