Nursing Jurisprudence and Ethics for Texas Nurses Practice Exam

According to BON Position Statement 15.24 Engaging in Reinsertion of Permanently Placed Feeding Tubes, under which condition would it be within the scope of practice for a nurse to replace a gastrostomy tube?

1. The tube has been in place for 8-12 weeks, the facility policy allows replacement of a tube with a specific physician's order, and the nurse has not completed the required skills check-off.

2. The tube has been in place for 8-12 weeks, the nurse has a physician's order to replace the tube, and the nurse has completed specific competency training to safely replace the tube.

3. The tube has been in place for 4-6 weeks and the nurse observed a supervisor completed the procedure.

4. The tube has been in place 4-6 weeks and the nurse has been determined to be competent in reinserting permanently placed tubes that have an established fistulous tract.

The correct answer is: The tube has been in place for 8-12 weeks, the facility policy allows replacement of a tube with a specific physician's order, and the nurse has not completed the required skills check-off.

According to BON Position Statement 15.24, a nurse can replace a gastrostomy tube if it has been in place for 8-12 weeks, the facility policy allows replacement with a specific physician's order, and the nurse has not completed the required skills check-off. This is because the nurse has not yet gained the necessary competency to safely replace the tube. Choice B is incorrect because the nurse must complete competency training even if there is a physician's order. Choice C is incorrect because the nurse should personally complete the procedure, not just observe a supervisor. Choice D is incorrect because a nurse must have established competency in replacing permanently placed tubes, not just have a single competence evaluation.