Editing Nursing Skills and Procedures – RN Practice Questions (section)

==Question 8==
A registered nurse is preparing to administer the first feeding through a newly inserted small-bore nasogastric tube. Which method of verifying placement is required before the initial use?
# Auscultating over the epigastrium while injecting 30 mL of air.
# Aspirating gastric contents and testing the pH.
# Reviewing the radiographic report confirming tube position.
# Asking the client to speak and observing for coughing.

'''Answer:''' 3 (C). Reviewing the radiographic report confirming tube position.

''Rationale:'' Radiographic confirmation is the gold standard and is required before the first use of a blindly inserted small-bore feeding tube, because these tubes can enter the airway without producing symptoms, particularly in sedated or neurologically impaired clients. Option 1 is unreliable and is no longer accepted practice. Option 2 is an appropriate adjunct before subsequent feedings but is not sufficient initially and is unreliable when acid-suppressing medications are given. Option 4 misses silent malposition.