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Nursing QUESTION #9282
Question 1
A nurse is caring for a patient with a nasogastric tube (Ryle's tube). Which method is the most reliable to confirm correct placement before feeding?
  • Auscultation of air insufflation over the epigastrium
  • Checking the pH of aspirate (pH ≤ 5.5 confirms gastric placement)✔️
  • Observing for bubbles when tube tip is placed in water
  • Measuring the external length of tube
Correct Answer Explanation

Confirming NG tube placement is a critical patient safety practice. Reliability of each method:

MethodReliabilityNotes
Auscultation (air insufflation)UnreliableAir sounds can transmit from lung to epigastrium — caused multiple fatal incidents
pH testing of aspirateMost reliable at bedsideGastric pH ≤ 5.5 confirms gastric placement
Bubbling in waterUnreliableCannot differentiate gastric from pulmonary placement
X-ray confirmationGold standardUsed when aspirate cannot be obtained

The National Patient Safety Agency (NPSA) recommends pH testing as the first-line bedside method. X-ray remains the gold standard when pH is inconclusive.