Feeding routes

Correct answer: A. The healthcare team

Explanation: The healthcare team selects the tube-feeding method after assessing the patient’s diagnosis, gastrointestinal function, nutritional requirements, consciousness, swallowing risk, expected duration, tolerance, and prescribed rate or volume. Nurses, doctors, dietitians, and other trained professionals may contribute according to their roles; an unqualified person should not decide independently.

Correct answer: A. Get swallowing assessed

Explanation: Repeatedly feeling that food is sticking in the throat may indicate dysphagia or another swallowing problem. The patient should not simply be given harder food or ignored. A trained health professional should assess swallowing safety and recommend suitable textures or an alternative feeding route to reduce choking and aspiration risk.

Correct answer: A. Amount, rate, hygiene, and patient response

Explanation: Safe tube feeding requires attention to the prescribed amount and rate, cleanliness of the feed and equipment, and the patient’s response. Monitoring for discomfort, vomiting, abdominal distension, coughing, or breathing difficulty helps identify intolerance or aspiration early. Therefore, all four elements in option A are relevant.

Correct answer: A. Safety of oral intake and total nutritional adequacy

Explanation: When oral and tube feeding are combined, the team must first confirm that oral intake is safe, especially for swallowing, and then calculate whether the combined intake supplies enough energy, protein, fluids, and other nutrients. Tube feeding should be adjusted only according to assessment and professional advice.

Correct answer: A. Supplementary oral nutrition

Explanation: If chewing and swallowing are safe and the digestive tract can be used, supplementary oral nutrition is generally considered before invasive tube or intravenous methods. Energy-dense foods, fortified meals, or prescribed oral nutrition supplements can increase intake. The exact plan must be individualized by the health team.

Correct answer: B. Enteral tube feeding

Explanation: An unconscious patient who cannot protect the airway should not receive ordinary oral food because swallowing and aspiration risks are serious. If the gastrointestinal tract is functioning, nutrition can often be delivered through an appropriately placed enteral tube, with confirmation and monitoring by trained professionals.

Correct answer: D. Parenteral route

Explanation: Parenteral nutrition supplies nutrients through the bloodstream, usually through an intravenous access, and therefore bypasses the stomach and intestines. It may be considered when the gastrointestinal tract cannot be used adequately. Because it carries risks such as infection and metabolic imbalance, it requires medical supervision.

Correct answer: B. Gastrostomy

Explanation: A gastrostomy provides access directly into the stomach through an opening in the abdominal wall and may be selected when enteral feeding is expected to continue for a prolonged period. The decision depends on medical assessment, expected duration, patient condition, and informed professional care.

Correct answer: C. Jejunum of the small intestine

Explanation: In a jejunostomy, a feeding tube is surgically placed through the abdominal wall directly into the jejunum, which is the middle section of the small intestine. Liquid nutrition therefore bypasses the mouth and stomach and is delivered into the small intestine for digestion and absorption. Thus, option C is correct.

Correct answer: D. To prevent tube blockage

Explanation: Straining removes lumps, seeds, fibres, and other coarse particles that could lodge inside a narrow feeding tube. A smooth and uniform feed helps reduce blockage and supports controlled delivery. Preparation must still follow the prescribed formula, hygiene standards, and professional instructions.

Correct answer: A. Safety of chewing and swallowing

Explanation: Before oral feeding, the patient’s ability to chew, control food, and swallow safely should be assessed. This helps identify dysphagia and the risk of choking or aspiration. If oral feeding is unsafe, texture modification or enteral support may be required instead of simply offering ordinary food.

Correct answer: B. When the patient can swallow but has difficulty chewing

Explanation: A patient who can swallow safely but has difficulty chewing may receive a soft, minced, mashed, or otherwise texture-modified oral diet. The modification supports adequate intake while reducing chewing effort. If swallowing itself is unsafe, oral feeding should not be selected without specialist assessment.

Correct answer: C. Strict hygiene

Explanation: Parenteral nutrition enters the bloodstream through venous access, so contamination can cause serious bloodstream infection. Strict hand hygiene, aseptic catheter care, clean preparation, correct storage, and careful monitoring are essential. This route must be managed by trained professionals according to institutional protocols.

Correct answer: D. To reduce reflux and aspiration risk

Explanation: Elevating the head and upper body during tube feeding, and for the period recommended afterward, uses gravity to reduce reflux and the chance that stomach contents will enter the airway. It is an important safety measure, although positioning must follow the patient’s condition and the health team’s instructions.

Correct answer: A. Enteral uses the digestive tract and parenteral uses a vein

Explanation: Enteral nutrition uses the gastrointestinal tract, either through the mouth or through a tube leading to the stomach or intestine. Parenteral nutrition is infused into a vein and bypasses the gastrointestinal tract. The choice depends on gut function, safety, clinical need, and professional assessment.

Correct answer: B. Enteral feeding through a tube

Explanation: Stroke-related dysphagia can make ordinary oral food unsafe because food may enter the airway. When the gastrointestinal tract is functioning, enteral feeding through an appropriately selected tube can provide nutrition while swallowing is assessed or rehabilitated. The route must be prescribed and monitored by the health team.

Correct answer: C. One who cannot swallow safely

Explanation: Taste and enjoyment are important aspects of eating, but they cannot override swallowing safety. A patient who cannot swallow safely is at risk of choking and aspiration if oral food is given merely for taste. Such a patient needs specialist assessment and, when appropriate, a safer modified or alternative route.

Correct answer: B. Nasogastric tube

Explanation: A nasogastric tube is commonly used when enteral feeding is needed for a relatively short period and the stomach can be used. It passes through the nose into the stomach. Suitability depends on clinical assessment, and placement, formula, rate, and monitoring must follow professional instructions.

Correct answer: C. Gastrostomy or jejunostomy

Explanation: For prolonged enteral nutrition, a gastrostomy or jejunostomy can provide a more stable access directly to the stomach or jejunum than a nasal tube. The choice depends on anatomy, aspiration risk, expected duration, and medical condition. It must be made and managed by the appropriate health team.

Correct answer: D. Inform the health worker immediately

Explanation: Coughing and breathing difficulty after tube feeding may signal aspiration, reflux, tube displacement, or intolerance and can become an emergency. Feeding should not be increased or the symptoms concealed. The feed should be handled according to protocol and the health worker informed immediately for assessment and safe action.

Correct answer: A. Because it is given through a vein and can be complex

Explanation: Parenteral nutrition is infused into a vein and requires careful control of nutrients, fluid balance, glucose, electrolytes, and infection prevention. Complications can be serious, so the regimen must be prescribed, administered, and monitored by a qualified health team rather than treated as ordinary feeding.

Correct answer: A. Both can use the digestive tract

Explanation: Nasogastric feeding carries nutrition through a tube passed through the nose into the stomach, whereas gastrostomy feeding delivers nutrition through a tube inserted through the abdominal wall into the stomach. Both are forms of enteral feeding because they use the gastrointestinal tract, unlike intravenous or parenteral nutrition. Therefore, option A is correct.

Correct answer: A. Unstrained lumps or fibres in the feed

Explanation: Unstrained lumps, seeds, or fibrous particles can lodge inside a narrow feeding tube and accumulate, causing repeated occlusion. Adequate flushing and giving medicines in liquid or properly dissolved form generally reduce blockage risk. Feed should be smooth, uniform, hygienically prepared, and given at the prescribed rate.

Correct answer: A. When the patient swallows safely but eats too little regular food

Explanation: An oral nutritional supplement is appropriate when the patient can swallow safely but ordinary meals do not provide enough energy, protein, or other nutrients. The supplement adds nutrition through the mouth and may help meet requirements. It is not a substitute for assessing swallowing safety or digestive function, and a patient who cannot swallow safely may need another route prescribed by the health team.

Correct answer: C. Parenteral route and skin application

Explanation: The incorrect match is option C because parenteral nutrition is delivered into the bloodstream, usually through a peripheral or central vein; it is not applied to the skin. Oral feeding uses the mouth, enteral feeding uses the gastrointestinal tract, and a nasogastric tube passes through the nose into the stomach. These route definitions make C unambiguous.