The nurse has provided oral feeding safety education for a client with dysphagia. Which statement by the client indicates an understanding of the education?

Rationale:

• Chest tightness is correct for Blank 1 because this symptom may indicate a potentially life-threatening condition such as cardiac or respiratory compromise. Using the ABC priority framework, physiological stability and possible airway, breathing, or circulation issues must be addressed first.
• Anxiety is correct for Blank 2 because once immediate physiological threats are assessed, psychological distress should be evaluated. Anxiety can contribute to physical symptoms and may worsen chest discomfort.
• No appetite is correct for Blank 3 because while important, it is not an immediate threat to physiological stability. Appetite changes can be addressed after ruling out serious causes of chest tightness and evaluating anxiety.

Rationale:
A. Advancing the NG tube slowly is standard practice, but if the client begins coughing, continuing to advance—even slowly—can cause the tube to enter the airway, increasing the risk of aspiration or trauma.

B. Removing the NG tube completely is not always necessary unless there are signs of severe distress, respiratory compromise, or incorrect placement. Immediate removal may be premature in this situation.

C. Advancing the NG tube rapidly is unsafe. Rapid advancement can cause the tube to enter the trachea or lungs, leading to coughing, gagging, aspiration, or injury to the respiratory tract.

D. Withdrawing the NG tube slightly is the correct action when the client begins coughing. Coughing indicates that the tube may have entered the airway or is irritating the pharynx. Pulling the tube back slightly allows the nurse to reposition and redirect the tube into the esophagus safely before continuing advancement, reducing the risk of aspiration or trauma.