Enteral Feeding And Aspiration Precautions - NCLEX Rn

1. Which assessment finding suggests intolerance that can increase aspiration risk during enteral feeding?

   Abdominal distention with nausea or vomiting. These indicate delayed gastric emptying, increasing reflux and aspiration potential.

2. Which feeding tube placement is associated with the lowest aspiration risk compared with gastric tubes?

   Post-pyloric (duodenal/jejunal) tube placement. Small bowel feeding bypasses stomach, reducing reflux and gastric residual volumes.

3. What is the priority action if a patient vomits while receiving enteral nutrition?

   Stop feeding immediately and assess airway; suction PRN. Immediate cessation prevents further aspiration, with suction aiding airway clearance.

4. Which dosage form should not be crushed for administration through an enteral feeding tube?

   Enteric-coated or extended-release tablets/capsules. Crushing alters absorption rates, potentially causing toxicity or inefficacy.

5. For how long should the head of bed remain elevated after an intermittent bolus enteral feeding?

   At least $30$–$60$ minutes after the feeding. Elevation allows time for gastric emptying, minimizing reflux and aspiration after bolus.

6. Which statement best describes why checking gastric residual volume alone does not prevent aspiration?

   Aspiration can occur even with low or absent residuals. Residuals do not correlate directly with reflux risk, as silent aspiration can still occur.

7. What bedside finding is most reliable for ongoing NG tube placement checks before feeding?

   Gastric aspirate pH testing per facility policy. pH ≤5.5 indicates gastric acidity, reliably distinguishing from respiratory or intestinal placement.

8. Which patient finding is the clearest sign of possible aspiration during tube feeding?

   New cough or respiratory distress during feeding. These symptoms indicate possible formula entry into airways, requiring immediate intervention.

9. What action is the priority if a patient shows coughing and desaturation during an enteral feeding?

   Stop the feeding and assess airway and breathing. Prioritizing ABCs ensures patient stability before further assessment or interventions.

10. Which oral care practice helps reduce aspiration pneumonia risk in tube-fed patients?

    Regular oral hygiene to reduce oropharyngeal colonization. Reducing oral bacteria decreases microaspiration risk into lungs during feeding.

11. What is the correct action before administering medications through an enteral feeding tube?

    Stop feeding and flush tube with water per policy. Pausing clears tube, preventing interactions between formula and medications.

12. Which method is unsafe and should not be used to verify NG tube placement at the bedside?

    Auscultation of injected air ("whoosh test"). Air insufflation sounds can mislead, as they may occur even with tube in lungs or esophagus.

13. What is the preferred method to verify initial placement of a newly inserted NG feeding tube?

    Radiographic confirmation (x-ray) before first use. X-ray confirms tube tip location in stomach, preventing misplacement risks like lung insertion.

14. What is the correct action between each medication given via an enteral feeding tube?

    Flush with water between medications. Flushing prevents drug interactions and tube clogging from residue buildup.

15. What is the priority nursing action if tube feeding formula is found in the patient's mouth?

    Stop feeding; place patient upright; suction as needed. This prevents further aspiration while clearing airway and improving oxygenation.

16. Which patient condition is a high-risk factor for aspiration with enteral feeding?

    Decreased level of consciousness or impaired gag reflex. Impaired reflexes hinder airway protection, elevating silent aspiration likelihood.

17. What is the correct action if an NG tube becomes displaced and external length has changed?

    Hold feeding and re-verify placement before use. Reverification ensures correct positioning before resuming to avoid complications.

18. Which medication class increases aspiration risk by reducing protective airway reflexes?

    Sedatives and opioids. These depress cough and gag reflexes, impairing airway protection during feeding.

19. What is the priority intervention to reduce aspiration risk for a patient receiving continuous tube feeding?

    Maintain head-of-bed elevation $30$–$45$ degrees. Consistent elevation minimizes reflux in continuous feeding where residuals accumulate.

20. What is the recommended head-of-bed position to reduce aspiration risk during enteral feeding?

    Elevate head of bed $30$–$45$ degrees. Semi-Fowler's position promotes gastric emptying and reduces gastroesophageal reflux.

21. Which nursing practice reduces bacterial contamination and aspiration pneumonia risk with tube feeding?

    Use clean technique and change administration set per policy. Sterile handling limits bacterial growth in formula, decreasing pneumonia incidence.

22. What is the correct response if a patient receiving tube feeds develops new crackles and fever?

    Suspect aspiration; stop feeds and notify provider promptly. These signs suggest pneumonia from aspiration, requiring prompt medical evaluation.

23. What is the correct action if an enteral tube becomes clogged during medication administration?

    Attempt warm water flush; avoid force; follow protocol. Gentle methods prevent tube damage or dislodgement while resolving occlusion.

24. What is the safest method to administer a bolus feeding to reduce aspiration risk?

    Slow gravity method with patient upright. Controlled rate and positioning mimic natural eating, reducing gastric overload.

25. What is the correct nursing action if a patient must be placed supine for a procedure during feeding?

    Pause feeding and keep HOB elevated when possible. Pausing reduces reflux risk during supine positioning, maintaining elevation when feasible.

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