NORCET Exams Preparation Series - Day 3 ( NG Tube Feeding )

NORCET Nursing Foundation – NG Tube Feeding

Test 01 • 50 MCQs • 50 Marks • 30 Minutes

Conceptual + Clinical + Case-Based + Scenario-Based Questions

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Q1. What is the primary purpose of a nasogastric (NG) tube in enteral feeding?

A. To deliver nutrition directly into the gastrointestinal tract B. To deliver medication directly into a vein C. To provide oxygen to the lungs D. To drain urine from the bladder

Answer: A. To deliver nutrition directly into the gastrointestinal tract
An NG tube can be used to provide enteral nutrition when oral intake is inadequate or not possible and the gastrointestinal tract is functional.

Q2. An NG tube is inserted through which route?

A. Nose to stomach B. Mouth to intestine C. Nose to bladder D. Ear to stomach

Answer: A. Nose to stomach
A nasogastric tube is passed through the nose, down the pharynx and esophagus, and into the stomach.

Q3. Which is an important indication for NG tube feeding?

A. A patient who cannot safely meet nutritional needs orally but has a functioning GI tract B. A patient who can eat normally C. A patient with normal nutrition D. A patient who refuses all nursing assessment

Answer: A. A patient who cannot safely meet nutritional needs orally but has a functioning GI tract
Enteral feeding is appropriate when the GI tract is functional but oral intake is inadequate or unsafe.

Q4. Which method is commonly used to confirm initial NG tube placement before feeding?

A. Radiographic confirmation according to institutional protocol B. Asking the patient if the tube feels correct C. Observing the color of the tube D. Checking the patient's pulse only

Answer: A. Radiographic confirmation according to institutional protocol
Initial placement of an NG tube should be confirmed using an appropriate validated method, commonly radiography, before it is used for feeding when required by protocol.

Q5. Why is correct NG tube placement critical before feeding?

A. Incorrect placement can result in aspiration or respiratory complications B. It increases appetite C. It prevents all infections D. It increases blood pressure

Answer: A. Incorrect placement can result in aspiration or respiratory complications
If the tube enters the respiratory tract instead of the gastrointestinal tract, feeding can cause serious pulmonary complications.

Q6. Which assessment is particularly important before starting an NG feeding?

A. Verify tube placement and assess the patient's condition B. Check hair color C. Check visual acuity only D. Check shoe size

Answer: A. Verify tube placement and assess the patient's condition
Before feeding, the nurse should verify appropriate tube position using the approved method and assess tolerance and relevant clinical factors.

Q7. What is the best position for a patient receiving enteral feeding through an NG tube?

A. Head of bed elevated, generally 30–45 degrees unless contraindicated B. Completely flat C. Prone D. Trendelenburg position

Answer: A. Head of bed elevated, generally 30–45 degrees unless contraindicated
Elevating the head of the bed helps reduce the risk of regurgitation and aspiration during enteral feeding.

Q8. How long should the head of the bed generally remain elevated after an intermittent tube feeding?

A. According to institutional protocol, commonly at least 30–60 minutes B. No time at all C. Only 1 minute D. Only before the feeding

Answer: A. According to institutional protocol, commonly at least 30–60 minutes
Keeping the patient appropriately elevated after feeding helps reduce reflux and aspiration risk. Follow the facility's protocol.

Q9. Which complication is most concerning during NG tube feeding?

A. Aspiration B. Mild hunger C. Dry skin D. Increased hair growth

Answer: A. Aspiration
Aspiration of gastric contents or enteral formula into the lungs can cause severe respiratory complications, including aspiration pneumonia.

Q10. A patient receiving NG feeding suddenly begins coughing and develops respiratory distress. What should the nurse do first?

A. Stop the feeding and assess the patient immediately B. Increase the feeding rate C. Continue feeding until the bag is empty D. Place the patient flat

Answer: A. Stop the feeding and assess the patient immediately
Sudden coughing and respiratory distress may indicate aspiration or another acute complication. Feeding should be stopped and the patient assessed promptly.

Q11. Which sign may suggest aspiration during enteral feeding?

A. Coughing, choking or respiratory distress B. Improved appetite C. Normal breathing D. Increased urine output

Answer: A. Coughing, choking or respiratory distress
Coughing, choking, oxygen desaturation and respiratory distress can be warning signs of aspiration and require immediate assessment.

Q12. What is the purpose of flushing an NG feeding tube with water according to protocol?

A. To help maintain tube patency B. To increase gastric acid production C. To sterilize the stomach D. To stop digestion

Answer: A. To help maintain tube patency
Appropriate water flushing helps prevent clogging and maintains tube patency. The volume and type of water should follow institutional policy and patient-specific requirements.

Q13. When is flushing of an NG feeding tube commonly performed?

A. Before and after feeding or medication administration according to protocol B. Only once per month C. Never D. Only when the patient is asleep

Answer: A. Before and after feeding or medication administration according to protocol
Regular flushing helps maintain patency and prevents formula or medication from remaining inside the tube.

Q14. A feeding tube becomes clogged. What should the nurse avoid?

A. Forcing fluid through the tube with excessive pressure B. Following the facility's unclogging protocol C. Assessing the cause of blockage D. Seeking assistance when required

Answer: A. Forcing fluid through the tube with excessive pressure
Excessive pressure can damage the tube or cause other complications. Use approved methods for managing tube obstruction.

Q15. Which item should generally NOT be mixed directly into enteral feeding formula unless specifically prescribed?

A. Crushed medications B. Prescribed formula C. Water used for flushing D. Nothing additional

Answer: A. Crushed medications
Medications should generally be administered separately through the tube when appropriate, because mixing drugs into formula can cause incompatibility, altered absorption or tube blockage.

Q16. Which medication should NOT be crushed for administration through an NG tube?

A. An extended-release tablet B. A medication specifically approved for crushing C. A liquid medication D. A medication with appropriate tube instructions

Answer: A. An extended-release tablet
Modified-release, extended-release and some enteric-coated medications should not be crushed because doing so can alter drug release or absorption.

Q17. Before administering medication through an NG tube, the nurse should first:

A. Verify tube placement and check medication compatibility B. Mix all medications together C. Add medications directly to the formula D. Clamp the tube permanently

Answer: A. Verify tube placement and check medication compatibility
Safe enteral medication administration requires appropriate tube assessment, medication review and adherence to institutional guidelines.

Q18. Which finding may indicate feeding intolerance?

A. Persistent vomiting, abdominal distension or severe diarrhea B. Normal bowel sounds C. Comfortable patient D. Stable vital signs

Answer: A. Persistent vomiting, abdominal distension or severe diarrhea
GI symptoms such as vomiting, significant abdominal distension or severe diarrhea may indicate poor tolerance and require assessment.

Q19. A patient develops repeated vomiting during tube feeding. What is the nurse's priority?

A. Stop the feeding and assess the patient B. Increase the feeding rate C. Place the patient flat D. Ignore the vomiting

Answer: A. Stop the feeding and assess the patient
Repeated vomiting increases aspiration risk. Stop the feeding, maintain appropriate positioning and assess the patient according to clinical protocol.

Q20. What is a major advantage of enteral nutrition over parenteral nutrition when the GI tract is functional?

A. It uses the gastrointestinal tract and generally has fewer central-line-related complications B. It always requires a central venous catheter C. It bypasses the digestive tract D. It eliminates all infection risk

Answer: A. It uses the gastrointestinal tract and generally has fewer central-line-related complications
When the GI tract is functional, enteral nutrition is generally preferred because it supports GI function and avoids many risks associated with intravenous nutrition.

Q21. Which patient may be an appropriate candidate for NG feeding?

A. A patient with impaired swallowing but a functioning GI tract B. A patient with complete intestinal obstruction C. A patient with severe uncontrolled GI bleeding without evaluation D. A patient with no indication for nutritional support

Answer: A. A patient with impaired swallowing but a functioning GI tract
Patients who cannot safely swallow but have a functioning gastrointestinal tract may receive enteral nutrition through an appropriate feeding tube.

Q22. Which condition may make gastric feeding inappropriate or require specialist evaluation?

A. Complete intestinal obstruction B. Mild thirst C. Normal digestion D. Stable appetite

Answer: A. Complete intestinal obstruction
Mechanical intestinal obstruction can prevent safe enteral feeding and requires appropriate medical assessment.

Q23. A patient with dysphagia is prescribed NG feeding. Which is the most important safety concern?

A. Aspiration prevention and correct tube placement B. Increasing the feeding speed C. Keeping the patient flat D. Skipping placement checks

Answer: A. Aspiration prevention and correct tube placement
Dysphagia increases aspiration risk. Correct tube placement, appropriate positioning and careful monitoring are essential.

Q24. What should the nurse do if the patient coughs severely during NG tube insertion?

A. Stop advancement and assess the patient B. Force the tube forward C. Continue rapidly without assessment D. Immediately start feeding

Answer: A. Stop advancement and assess the patient
Severe coughing can occur if the tube approaches or enters the airway. The tube should not be forced, and the patient should be assessed immediately.

Q25. Which action can help reduce discomfort during NG tube insertion?

A. Explain the procedure and use appropriate lubrication B. Insert without explanation C. Use force D. Avoid patient cooperation

Answer: A. Explain the procedure and use appropriate lubrication
Patient education, cooperation, appropriate lubrication and gentle technique can reduce discomfort and trauma.

Q26. Which method should NOT be relied upon as the sole method of confirming NG tube placement?

A. Air insufflation with auscultation B. Approved pH testing when appropriate C. Radiographic confirmation when indicated D. Institutional validated placement protocol

Answer: A. Air insufflation with auscultation
The traditional "whoosh" or air-bolus auscultation method is unreliable and should not be used as the sole method to confirm tube placement.

Q27. Why may gastric aspirate pH be checked?

A. As part of an approved method for assessing gastric tube placement B. To measure blood pressure C. To diagnose every gastric disease D. To determine body temperature

Answer: A. As part of an approved method for assessing gastric tube placement
pH testing of aspirated gastric contents can contribute to placement assessment when used according to validated institutional protocols.

Q28. A nurse cannot verify NG tube placement before feeding. What should the nurse do?

A. Do not start feeding until placement is appropriately verified B. Start feeding anyway C. Increase the feeding rate D. Assume the tube is correctly placed

Answer: A. Do not start feeding until placement is appropriately verified
Feeding through a tube with unconfirmed placement can cause serious harm, including aspiration. Follow the approved verification process.

Q29. What is the purpose of checking gastric residual volume when required by a specific protocol?

A. To assess gastric emptying and feeding tolerance B. To diagnose diabetes C. To measure blood pressure D. To determine oxygen saturation

Answer: A. To assess gastric emptying and feeding tolerance
Residual assessment, when indicated by institutional protocol, can provide information about gastric emptying and tolerance. Routine checks are not required in every patient.

Q30. A patient has repeated high gastric residuals according to the facility's protocol. What should the nurse do?

A. Assess the patient and follow the enteral feeding protocol B. Automatically double the feeding rate C. Ignore the finding D. Remove the tube immediately without assessment

Answer: A. Assess the patient and follow the enteral feeding protocol
High residuals should be interpreted along with symptoms and the patient's clinical condition. Follow the specific institutional protocol.

Q31. Which complication can occur from prolonged NG tube use?

A. Nasal or pharyngeal irritation B. Permanent immunity C. Increased bone growth D. Improved hearing

Answer: A. Nasal or pharyngeal irritation
Prolonged NG tube placement can cause local irritation, discomfort, pressure injury and other complications.

Q32. Which nursing intervention helps protect the nostril of a patient with an NG tube?

A. Inspect the skin regularly and maintain appropriate securement B. Tighten the tube continuously C. Ignore skin condition D. Remove all fixation

Answer: A. Inspect the skin regularly and maintain appropriate securement
Regular skin assessment and proper securement help prevent pressure injury and accidental tube displacement.

Q33. A patient accidentally pulls out an NG feeding tube. What is the nurse's priority?

A. Stop feeding and assess the patient before any tube replacement or further use B. Immediately continue feeding C. Ignore the event D. Give another feeding orally without assessment

Answer: A. Stop feeding and assess the patient before any tube replacement or further use
Accidental tube displacement can compromise safety. The patient should be assessed and the tube replaced and reverified according to clinical protocol before use.

Q34. Which observation may indicate tube displacement?

A. Change in external tube length or new respiratory symptoms B. Stable patient with unchanged tube position C. Normal feeding tolerance D. Intact securement

Answer: A. Change in external tube length or new respiratory symptoms
Changes in tube position, coughing, respiratory symptoms or other unexpected findings may suggest displacement and require reassessment.

Q35. Which type of formula is appropriate for enteral feeding?

A. A prescribed enteral formula appropriate for the patient's nutritional needs B. Any homemade liquid without assessment C. Carbonated soft drink D. Unprescribed concentrated solution

Answer: A. A prescribed enteral formula appropriate for the patient's nutritional needs
The formula should be selected according to the patient's nutritional requirements, medical condition and prescribed feeding plan.

Q36. Which factor is important when calculating an enteral feeding schedule?

A. Prescribed volume, concentration and rate B. Patient's shoe size C. Room temperature only D. Hair length

Answer: A. Prescribed volume, concentration and rate
Safe feeding depends on the prescribed formula, total volume, caloric concentration and administration rate.

Q37. A feeding order says 240 mL is to be administered over 2 hours. What is the hourly rate?

A. 60 mL/hour B. 100 mL/hour C. 120 mL/hour D. 240 mL/hour

Answer: C. 120 mL/hour
Rate = Total volume ÷ Time = 240 mL ÷ 2 hours = 120 mL/hour.

Q38. A patient is prescribed 500 mL of enteral formula over 4 hours. What is the rate?

A. 100 mL/hour B. 125 mL/hour C. 150 mL/hour D. 200 mL/hour

Answer: B. 125 mL/hour
Rate = 500 mL ÷ 4 hours = 125 mL/hour.

Q39. Which nursing action helps reduce the risk of aspiration during continuous NG feeding?

A. Maintain appropriate head-of-bed elevation and monitor tolerance B. Keep the patient completely flat C. Increase the rate without an order D. Stop all monitoring

Answer: A. Maintain appropriate head-of-bed elevation and monitor tolerance
Proper positioning and monitoring for intolerance are key strategies to reduce aspiration risk during enteral feeding.

Q40. A patient receiving continuous NG feeding is found lying flat in bed. What should the nurse do?

A. Elevate the head of the bed if not contraindicated and reassess the patient B. Leave the patient flat C. Increase feeding rate D. Remove the feeding pump

Answer: A. Elevate the head of the bed if not contraindicated and reassess the patient
Appropriate head elevation helps reduce aspiration risk during enteral feeding.

Q41. Which finding should be reported during NG feeding?

A. New respiratory distress B. Stable vital signs C. Comfortable patient D. Normal tube position

Answer: A. New respiratory distress
Respiratory distress during tube feeding may indicate aspiration or another serious complication and requires immediate assessment.

Q42. Which action is appropriate when documenting an NG feeding?

A. Document the formula, amount, route, tolerance and relevant assessments B. Document only the patient's name C. Document nothing D. Record an estimated amount without checking

Answer: A. Document the formula, amount, route, tolerance and relevant assessments
Accurate documentation supports continuity of care and provides a record of the feeding and patient response.

Q43. A patient reports nasal soreness from the NG tube. What should the nurse do?

A. Inspect the area and assess tube securement and skin condition B. Ignore the complaint C. Pull the tube out without assessment D. Tighten the tube further

Answer: A. Inspect the area and assess tube securement and skin condition
Nasal soreness may indicate irritation or pressure injury. The site and tube securement should be assessed and managed appropriately.

Q44. Which action is safest when administering multiple medications through an NG tube?

A. Administer compatible medications separately with appropriate flushing between medications B. Mix all medications into one container with formula C. Crush every medication regardless of formulation D. Skip all flushing

Answer: A. Administer compatible medications separately with appropriate flushing between medications
Separating medications and flushing according to protocol helps prevent drug interactions, tube blockage and dosing errors.

Q45. A patient receiving NG feeding develops abdominal distension and discomfort. What should the nurse do first?

A. Stop or pause the feeding as appropriate and assess the patient B. Increase the feeding rate C. Give another feeding immediately D. Ignore the finding

Answer: A. Stop or pause the feeding as appropriate and assess the patient
Abdominal distension and discomfort can indicate feeding intolerance or another GI problem. The patient should be assessed before continuing feeding.

Q46. Which statement about enteral feeding equipment is correct?

A. Equipment should be handled according to infection-prevention and manufacturer guidelines B. Equipment can always be reused indefinitely C. Hand hygiene is unnecessary D. Formula can be left at room temperature indefinitely

Answer: A. Equipment should be handled according to infection-prevention and manufacturer guidelines
Safe enteral feeding requires appropriate hand hygiene, equipment handling, storage and replacement practices.

Q47. Which patient has the highest aspiration risk during NG feeding?

A. A patient with reduced consciousness and impaired protective airway reflexes B. A fully alert patient with normal swallowing C. A patient sitting upright and tolerating feeding D. A patient with normal respiratory status

Answer: A. A patient with reduced consciousness and impaired protective airway reflexes
Reduced consciousness and impaired airway protection significantly increase aspiration risk and require careful positioning and monitoring.

Q48. A patient with an NG tube suddenly develops cyanosis during feeding. What is the priority action?

A. Stop the feeding and initiate immediate assessment and emergency response as indicated B. Continue feeding slowly C. Give another bolus D. Ignore the finding

Answer: A. Stop the feeding and initiate immediate assessment and emergency response as indicated
Cyanosis is a serious sign of possible hypoxemia. Feeding should be stopped and immediate clinical assessment and emergency management should be initiated.

Q49. A nurse is about to start feeding but notices that the external length of the NG tube is significantly different from the documented length. What should the nurse do?

A. Stop and verify tube placement before feeding B. Start feeding immediately C. Ignore the difference D. Increase the feeding rate

Answer: A. Stop and verify tube placement before feeding
A significant change in external tube length may indicate displacement. Feeding should not begin until placement has been appropriately verified.

Q50. Case Scenario: A stroke patient with dysphagia is receiving NG feeding. During feeding, the patient starts coughing, oxygen saturation decreases and the patient becomes breathless. What is the nurse's best immediate action?

A. Stop the feeding, maintain appropriate positioning and assess for aspiration/respiratory compromise B. Increase the feeding rate C. Place the patient flat D. Continue feeding until the prescribed volume is complete

Answer: A. Stop the feeding, maintain appropriate positioning and assess for aspiration/respiratory compromise
This is a classic aspiration-risk scenario. Stop feeding immediately, maintain appropriate positioning, assess airway and breathing, and activate further clinical support according to the patient's condition and institutional protocol.

Test Result