Evolve HESI Practice Exam

What is the most accurate method to determine proper placement of a nasogastric tube?

1. Auscultation of bowel sounds

2. Measuring the tube length

3. Examining a chest x-ray obtained after insertion

4. Aspirating gastric contents

The correct answer is: Examining a chest x-ray obtained after insertion

The most accurate method to confirm the proper placement of a nasogastric tube is through examining a chest x-ray obtained after insertion. A chest x-ray provides a visual confirmation that the tube is correctly positioned within the stomach, as it allows for direct observation of the tube's location in relation to the anatomical structures of the upper gastrointestinal tract. While other methods such as auscultation of bowel sounds, measuring tube length, and aspirating gastric contents can provide some indications of placement, they are less definitive. Auscultation may indicate air entering the stomach, but it does not confirm placement in the stomach versus the lungs. Measuring the tube length can give an estimate of proper placement but is not foolproof due to variations in anatomy among individuals. Aspirating gastric contents can suggest that the tube is in the stomach, but it does not provide visual confirmation and may not yield contents in every situation depending on the characteristics of the fluid, the contents of the stomach, or the position of the patient. Therefore, examination of a chest x-ray proves to be the most reliable method for ensuring accurate placement of a nasogastric tube.