NHI Patient Care and Procedures 4 — Questions and Answers
Question 1: A patient with a nasogastric tube is receiving tube feedings. Before administering the feeding, the FIRST action is:
- Flush the tube with 60 mL of water
- Check tube placement by aspirating gastric contents (Correct answer)
- Prime the feeding bag tubing
- Position the patient in Trendelenburg
Correct answer: Check tube placement by aspirating gastric contents
Tube placement must be verified before each feeding to ensure the tube has not migrated and to prevent aspiration.
Question 2: Which finding should be reported IMMEDIATELY when monitoring a patient's wound drain output?
- Serosanguineous drainage for the first 24 hours
- Sudden decrease in drainage output
- Bright red drainage increasing over one hour (Correct answer)
- Small amount of serous fluid
Correct answer: Bright red drainage increasing over one hour
Bright red drainage that is increasing in volume indicates active arterial bleeding and requires immediate reporting.
Question 3: The correct technique for performing passive range-of-motion (PROM) exercises is:
- Move joints until the patient reports pain, then push 10% further
- Support each joint and move it through its full pain-free range (Correct answer)
- Ask the patient to resist movement to build strength
- Perform exercises only on the unaffected side
Correct answer: Support each joint and move it through its full pain-free range
PROM requires supporting each joint above and below and moving it smoothly through its comfortable range without forcing movement.
Question 4: A patient's blood pressure reading is 158/96 mmHg. How should this be documented?
- 158 over 96
- 158/96 (Correct answer)
- Systolic 96, Diastolic 158
- 96/158
Correct answer: 158/96
Blood pressure is documented as systolic/diastolic (158/96), with the higher systolic reading listed first.
Question 5: When a patient needs a bedpan, which action ensures privacy AND safety?
- Leave the room immediately after placing the bedpan
- Close the curtain, raise the side rail, and keep the call light within reach (Correct answer)
- Lower all four side rails for easier access
- Place bedpan and return in 20 minutes
Correct answer: Close the curtain, raise the side rail, and keep the call light within reach
Closing the curtain preserves dignity while raising the side rail and providing the call light ensures safety while the patient is using the bedpan.
Question 6: A post-surgical patient has a PCA (patient-controlled analgesia) pump. The healthcare worker's role is to:
- Press the button every hour on behalf of the patient
- Monitor the patient's pain, sedation, and respiratory status (Correct answer)
- Increase the programmed dose if the patient complains
- Administer additional IV pain medication alongside the PCA
Correct answer: Monitor the patient's pain, sedation, and respiratory status
Healthcare workers monitor for oversedation, respiratory depression, and pain control effectiveness; only the patient should press the PCA button.
Question 7: Which laboratory value indicates that a patient may be dehydrated?
- Serum sodium 138 mEq/L
- BUN 28 mg/dL and creatinine 1.8 mg/dL (Correct answer)
- Hemoglobin 14 g/dL
- Blood glucose 95 mg/dL
Correct answer: BUN 28 mg/dL and creatinine 1.8 mg/dL
Elevated BUN and creatinine levels suggest decreased renal perfusion often caused by dehydration and reduced circulatory volume.
NHI Patient Care and Procedures 4
A patient with a nasogastric tube is receiving tube feedings.
Before administering the feeding, the FIRST action is: