Feeding

Feeding items are usually aspiration- and safety-priority questions: the stem describes a stroke, post-extubation, or dysphagic client, and the “tell” is choosing the action that protects the airway. The right answer hinges on a swallowing screen before the first oral intake, an upright 90° chin-tuck position, and stopping intake at the first cough, wet voice, or pocketing — not on which food is offered. For tube feeders, a newly placed tube is confirmed by X-ray (the gold standard); pH testing of aspirate is the accepted bedside check, while the discredited auscultation/air-bolus method is not acceptable (some older banks still list auscultation — pick X-ray or pH).

The classic trap is confusing feeding (the route and act of delivering intake) with nutrition (whether the nutrients themselves are adequate, tracked via albumin/prealbumin), hydration (fluid balance and I&O), or comfort (physical and emotional ease). Don’t reflexively hold a feeding for a single mildly high residual; return aspirated residual to the stomach to preserve electrolytes (current critical-care guidance won’t hold for a GRV under 500 mL, though many exam banks still teach a lower 250 mL cutoff). Hook: with feeding, position before food.