A nurse is preparing to insert a nasogastric tube in a client. Which of the following actions should the nurse take?

A. Encourage client to swallow while advancing tube: Swallowing helps guide the nasogastric tube past the oropharynx and into the esophagus, reducing the risk of airway placement. Sips of water or swallowing motions facilitate smooth passage and improve client comfort during insertion. B. Place client in semi-Fowler's position in bed: The recommended position for NG tube insertion is high Fowler’s (sitting upright at 90°) to reduce aspiration risk and allow easier passage of the tube. Semi-Fowler’s does not provide optimal alignment for insertion. C. Measure the length of the tube from client's nose to shoulder: Proper measurement requires determining the distance from the nose to the earlobe to the xiphoid process, ensuring the tube reaches the stomach. Nose-to-shoulder measurement is incorrect and could result in improper placement. D. Advance tube during client's inspiration: Advancing the tube during inspiration does not facilitate passage into the esophagus and may increase the risk of airway entry. Coordinating advancement with swallowing is the safe, evidence-based method.