Feeding routes

Correct answer: B. To understand gastric emptying and signs of intolerance

Explanation: Tolerance monitoring looks for symptoms such as nausea, vomiting, abdominal distension, pain, diarrhoea, constipation, and delayed gastric emptying. Residual-volume practices must follow current institutional policy because a number alone should not determine feeding. Assessment helps adjust rate, volume, position, formula, and medical management while reducing aspiration risk.

Correct answer: A. Because nutrition is given directly through the venous route

Explanation: Parenteral nutrition enters the bloodstream through a catheter and bypasses the normal protective barriers of the gastrointestinal tract. Any contamination can therefore cause a serious bloodstream infection. Strict hand hygiene, aseptic preparation, catheter care, proper storage and close monitoring of fever or line changes are essential.

Correct answer: D. Give hygienic, appropriately prepared, nutritionally suitable feed

Explanation: Enteral feeding requires a prescribed formula or appropriately prepared feed with adequate energy, protein, fluid, and micronutrients. Strict hygiene, correct consistency, safe storage, proper tube position, appropriate administration rate, and flushing help prevent infection, blockage, aspiration, and undernutrition. The feed and route must be selected by qualified professionals according to the patient’s condition rather than by texture or taste alone.

Correct answer: A. Inadequate nutrition, aspiration, infection, or intolerance may occur

Explanation: Choosing an unsuitable feeding route can prevent the patient from receiving adequate energy and nutrients. It may also cause aspiration into the lungs, infection, gastrointestinal intolerance, vomiting, or other complications. Therefore, route selection must consider swallowing ability, gut function, nutritional needs, and patient safety.

Correct answer: A. To provide safe, tolerated, and adequate nutrition to the patient

Explanation: The purpose of feeding-route management is to meet the patient’s nutritional and fluid requirements safely. The selected route should be tolerated, appropriate for the patient’s condition, and monitored for complications such as aspiration, infection, intolerance, or inadequate intake. Appearance or cost is not the primary goal.

Correct answer: A. To decide by considering patient safety, nutrition goals, tolerance, and complications together

Explanation: A feeding route should not be changed suddenly without assessing the complete clinical picture. A multidisciplinary team can review swallowing, gastrointestinal function, nutritional targets, hydration, current tolerance, risks, and possible complications. Shared discussion supports a safer, more suitable, and better-monitored decision.

Correct answer: A. Both determine how nutrition can be delivered safely

Explanation: Route selection requires assessment of two different functions. Safe swallowing determines whether oral feeding can be used without aspiration, while a functioning gastrointestinal tract determines whether enteral feeding can be digested and absorbed. Considering both findings helps choose oral, enteral, or parenteral support safely. Therefore, option A is correct.

Correct answer: B. Enteral tube feeding

Explanation: Unsafe swallowing makes ordinary oral feeding hazardous because food or liquid may enter the airway and cause aspiration. If the gastrointestinal tract is functioning, enteral tube feeding can provide nutrients directly to the stomach or intestine while bypassing unsafe swallowing. It is generally preferred over parenteral nutrition when the gut can be used, so option B is correct.

Correct answer: C. Because it uses the venous route and requires complex monitoring

Explanation: When the intestine works, enteral feeding is usually preferred because it uses the gastrointestinal tract and is physiologically more natural. Parenteral nutrition enters the bloodstream and can cause catheter infection, glucose disturbance, and fluid or electrolyte problems, so it requires careful specialist monitoring. Thus, option C is correct.

Correct answer: D. Nasogastric feeding ends in the stomach, whereas nasojejunal feeding ends in the jejunum

Explanation: The names identify the tube’s final destination. A nasogastric tube passes through the nose and ends in the stomach, whereas a nasojejunal tube passes beyond the stomach and ends in the jejunum, a part of the small intestine. The destination affects clinical use and tolerance, so option D is correct.

Correct answer: A. It can provide a stable enteral route into the stomach

Explanation: A gastrostomy creates a tube opening directly into the stomach. When enteral support is expected for a prolonged period and oral intake is unsafe or inadequate, this route can be more stable and comfortable than leaving a tube through the nose for a long time. It still requires professional care and monitoring. Therefore, option A is correct.

Correct answer: B. When nutrition needs to be delivered directly into the small intestine

Explanation: Jejunostomy provides access directly to the jejunum, which is part of the small intestine. It may be considered when feeding into the stomach is unsuitable, such as in selected cases involving gastric problems or a high aspiration risk. The route remains enteral because the intestine is used. Therefore, option B is correct.

Correct answer: C. The feed may enter the wrong place

Explanation: A nasogastric tube can be misplaced in the airway or may move from its intended position. If feed is given without confirming placement according to institutional clinical practice, it may enter the lungs instead of the stomach, causing choking, aspiration, pneumonia, or severe injury. Therefore, option C represents the serious safety risk.

Correct answer: D. To reduce reflux and aspiration risk

Explanation: Keeping the head and upper body appropriately elevated uses gravity to reduce the movement of gastric contents back toward the oesophagus and airway. This can reduce reflux and lower the chance that feed will be aspirated into the lungs. Positioning does not change the feed itself, so option D is correct, subject to clinical instructions.

Correct answer: A. A rate that is too fast can cause nausea, vomiting, abdominal distension, or diarrhoea

Explanation: The stomach and intestine have a limited ability to receive and process feed at one time. If the rate is too high, gastrointestinal intolerance may produce nausea, vomiting, abdominal distension, cramps, or diarrhoea; vomiting may also increase aspiration risk. The rate is therefore advanced gradually according to tolerance, making option A correct.

Correct answer: B. Bolus feeding is given in set amounts at intervals, whereas continuous feeding is given slowly over an extended period

Explanation: Bolus feeding resembles meals: a prescribed volume is delivered at particular intervals, usually over a relatively short period. Continuous feeding uses a pump or controlled system to deliver smaller amounts steadily over many hours. The distinction is the timing and rate of delivery, not whether nutrition is provided. Hence, option B is correct.

Correct answer: C. Feed intolerance and vomiting

Explanation: A large bolus delivered too rapidly can overdistend the stomach and exceed gastrointestinal tolerance. The patient may develop nausea, fullness, abdominal distension, cramping, feed intolerance, or vomiting; vomiting can also increase aspiration risk. Rapid delivery does not guarantee better absorption, and constipation is not the usual immediate effect. Thus, option C is correct.

Correct answer: D. Keeping the tube clear and preventing blockage

Explanation: Flushing the tube with the prescribed fluid at appropriate times helps clear residual formula and medicines from its lumen. It reduces the chance of blockage, supports delivery of the full prescribed dose, and helps maintain tube patency. The amount and timing must follow clinical instructions, so option D is correct.

Correct answer: A. To reduce tube blockage and medicine–feed mixing problems

Explanation: Medicines should not be mixed casually with enteral formula because interactions, altered drug absorption, incompatibility, or tube blockage may occur. Following the prescribed procedure and flushing as directed separates medicines from the feed and helps deliver the correct dose safely. Therefore, option A is correct; exact practice should follow professional instructions.

Correct answer: A. Thick feed may flow poorly and block the tube

Explanation: A smaller tube offers greater resistance to flow, and a thick or poorly prepared formula may move slowly or become lodged inside it. This can cause incomplete delivery, difficult flushing, and blockage. Formula consistency, tube diameter, and preparation method must therefore be compatible and prescribed by professionals. Option A is correct.

Correct answer: C. Reviewing feed rate, volume, hygiene, medicines, and tolerance

Explanation: Diarrhoea during enteral feeding has multiple possible causes, including excessive rate or volume, formula composition, contamination, medicines such as antibiotics, infection, or underlying illness. A proper assessment reviews the complete feeding process, hydration, medicines, hygiene, and patient tolerance before corrective action is taken. Therefore, option C is correct.

Correct answer: D. The risk of contamination and infection

Explanation: Prepared enteral formula can support microbial growth if it is left exposed or stored beyond the recommended time and temperature. Contaminated feed may cause gastrointestinal illness, diarrhoea, or systemic infection in a vulnerable patient. Safe preparation, covered storage, hand hygiene, and adherence to handling limits are essential. Thus, option D is correct.

Correct answer: A. Infection through the venous route can become serious

Explanation: Parenteral nutrition enters the bloodstream through a vascular catheter, bypassing many natural protective barriers. If aseptic technique is ignored, microorganisms can enter the line and cause bloodstream infection, sepsis, or other life-threatening complications. Strict hand hygiene, sterile equipment, and professional monitoring are therefore essential. Option A is correct.

Correct answer: B. Because nutrition is delivered through a vein in controlled amounts

Explanation: Parenteral nutrition delivers water, glucose, amino acids, electrolytes, and other nutrients directly into the circulation. Incorrect amounts or rapid changes can cause dehydration, fluid overload, or electrolyte disturbances affecting the heart, muscles, and nervous system. Clinical observation and laboratory tests are therefore necessary. Option B is correct.

Correct answer: C. When longer-term and higher-level nutrition support is needed

Explanation: Central venous parenteral nutrition may be selected when nutrition support is required for a longer period or when a concentrated solution is needed to meet high nutritional demands. It is an advanced therapy with risks such as catheter infection, thrombosis, and metabolic disturbance, so specialist assessment and close monitoring are essential. Option C is correct.