You are preparing to give an enteral feeding through a nasogastric tube. Place the steps in the correct order.

Correct Answer: A

Rationale: Correct Answer: A - Assess for bowel sounds. Rationale: 1. Assessing for bowel sounds is the initial step to ensure proper placement before administering enteral feeding. 2. Bowel sounds indicate the tube is in the gastrointestinal tract, reducing the risk of aspiration. 3. This step precedes tube placement confirmation (auscultation and pH check), flushing, and reflushing. Summary: - Auscultating tube placement and checking pH (B) should follow assessing bowel sounds. - Flushing the tube with water (C) and reflushing (D) occur after confirming proper tube placement.

Correct Answer: C

Rationale: The correct answer is C: Administer oxygen throughout the seizure. Oxygen administration is crucial during a seizure to maintain oxygenation and prevent hypoxia. Hypoxia can exacerbate brain damage in clients experiencing seizures. Administering oxygen helps ensure adequate oxygen supply to the brain and other vital organs, reducing the risk of injury. A: Initiate precautions by restraining the client - Restraint can increase the risk of injury and worsen the seizure. B: Observe the client throughout the seizure - While important, simply observing the client does not actively prevent injury during the seizure. D: Administer an analgesic during the seizure - Analgesics are not indicated during a seizure and may not address the risk for injury. Administering oxygen is the most appropriate intervention to minimize the risk for injury during a seizure in a client with pancreatitis and alcohol withdrawal.

Correct Answer: B

Rationale: The correct answer is B: Pepsin. Pepsin is an enzyme produced in the stomach that breaks down proteins into smaller peptides. It is activated by the acidic environment in the stomach. Bile (A) is produced in the liver and stored in the gallbladder, not active in the stomach. Gastrin (C) is a hormone that stimulates gastric acid secretion but is not a digestive substance. Maltase (D) is an enzyme produced in the small intestine that breaks down maltose into glucose, not active in the stomach. Thus, the only substance active or activated in the stomach is Pepsin.

Correct Answer: A

Rationale: Step-by-step rationale for why option A is correct: 1. Gastrostomy tube is inserted directly into the stomach, bypassing the esophagus, reducing irritation to nasal and esophageal mucosa. 2. NG tube goes through the nose, potentially causing irritation and discomfort to the mucosa. 3. In severe protein-calorie malnutrition, preservation of mucosal integrity is crucial for nutrient absorption. 4. Hence, choosing a gastrostomy tube minimizes additional stress on already compromised mucosa. Summary of why other options are incorrect: - Option B: The sensory experience of eating is unrelated to the nutritional benefits of tube feeding. - Option C: Aspiration risk is not directly affected by the type of tube used but rather by proper feeding techniques and patient positioning. - Option D: All feeding tubes require periodic checking for placement to prevent complications, including gastrostomy tubes.

Correct Answer: B

Rationale: The correct answer is B: IV replacement of fluid and electrolytes. When a patient has been vomiting for several days, they are at risk of dehydration and electrolyte imbalance. Intravenous fluids are necessary to rehydrate the patient and restore electrolyte balance. Oral administration of broth and tea (choice A) may not be sufficient for severe dehydration. Administration of parenteral antiemetics (choice C) may help control vomiting but does not address the dehydration and electrolyte imbalance. Insertion of a nasogastric (NG) tube for suction (choice D) may be considered if the patient has severe gastric distention or ileus, but the priority is to address fluid and electrolyte imbalances first.