# A client receives nutrition and several medications through an enteral access device. Complete the safe medication-administration plan.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=546626&lang=en  
> language: en  
> subject: Nutrition and Oral Hydration  
> category: BCC

## Question

A client receives nutrition and several medications through an enteral access device. Complete the safe medication-administration plan.

Before medication delivery, the nurse should ::선택::mix all medications with the formulaverify tube position and patency according to policyassume the tube is usable because nutrition is runningremove the tube. Each suitable medication is then ::선택::combined with the other medicationsadded to the nutrition bagadministered separately in an appropriate formulationgiven without reviewing compatibility. The enteric-coated tablet is ::선택::crushed finely with the immediate-release tabletdissolved in hot waterplaced whole into the tubenot crushed; an appropriate alternative is obtained, and the tube is ::선택::flushed with the ordered water before, between, and after medicationsflushed only if resistance occursleft unflushed during continuous nutritionfilled with carbonated beverage after all drugs.

## Explanation

The nurse first confirms tube position and patency according to the device and organizational policy. Each medication is reviewed for suitability and administered separately; medications should not be mixed together or placed directly into the nutrition formula. Enteric-coated and modified-release products are not crushed, so an appropriate alternative must be obtained. Ordered water flushes before the first medication, between medications, and after the last medication reduce incompatibility and tube obstruction. Drug-specific feeding interruptions should follow the medication order and pharmacy guidance rather than a single universal hold time.

## In-depth explanation

Correct Answer
Verify the tube, give each suitable medication separately, obtain an alternative to the enteric-coated product, and flush before, between, and after.

Why It Fits
These steps protect tube patency, preserve dosage-form safety, and reduce medication-formula incompatibility.

Clinical Picture
Continuous enteral nutrition and multiple dosage forms increase the risk of clogging, altered absorption, and unsafe crushing.

Memory Link
Verify, separate, never crush protected forms, and flush in between.

NCLEX Rule
Enteral medications are individually assessed and administered through a verified patent tube using compatible formulations and ordered flushes.

Why the Alternatives Fail
Combining drugs, crushing an enteric-coated tablet, adding medication to formula, or skipping flushes creates preventable dosing and tube complications.

Sources
1ASPEN Enteral Nutrition Clinical Resources
2ASPEN Safe Practices Update Questions
3NCSBN 2026 NCLEX-RN Test Plan

## Clinical scenario

Medical unit
A client with a small-bore feeding tube receives continuous enteral nutrition. Morning medications include a liquid medication, an immediate-release tablet that may be crushed, and an enteric-coated tablet. The tube has not yet been assessed during this medication pass.

## Key concepts

- **Enteral access device** — A tube that provides access to the gastrointestinal tract for nutrition, hydration, or medication.
- **Enteric-coated tablet** — A dosage form designed to resist dissolution in the stomach and generally unsafe to crush.
- **Tube patency** — The condition in which the enteral tube remains open and permits safe flow.

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