A nurse is caring for a client who is receiving intermittent enteral tube feedings. Which of the following factors places the client at risk for aspiration?

A. A residual of 65 mL 1 hr postprandial is within acceptable limits and does not indicate an increased risk for aspiration. B. Being in a high-Fowler's position (sitting upright) during feedings actually reduces the risk of aspiration. C. A history of gastroesophageal reflux disease (GERD) predisposes the client to aspiration, as reflux increases the risk that gastric contents may enter the airway. D. Although a high-osmolarity formula can cause gastrointestinal distress, it is not as directly related to aspiration risk as GERD.