During bolus feeding via nasogastric tube, the patient experiences sudden severe vomiting and inability to maintain airway. The appropriate response is to:

• A. Discontinue the administration of the bolus feeding
• B. Continue the administration at the same rate
• C. Pause the feeding to check the tube placement
• D. Flush the tube and resume feeding

Answer: (A)

When a patient receiving a nasogastric tube bolus feeding suddenly vomits severely and cannot maintain the airway, the priority is airway protection. The safest action is to discontinue the bolus feeding immediately. Stopping the feeding removes ongoing gastric contents from entering the stomach, which reduces the risk of aspiration while you address the airway and breathing issues. After stopping, position the patient to help airway protection, suction as needed, and ensure adequate oxygenation and ventilation. Only once the patient is stabilized should you reassess the tube and plan for resuming feeds, if appropriate. Continuing the feeding would worsen the risk of aspiration, and pausing to check tube placement or flushing and restarting does not address the immediate threat to the airway.