During NG tube placement, after guiding the tube past the nasopharynx, what should the patient do to facilitate advancement?

• A. Tell client to flex neck forward and swallow
• B. Extend neck back
• C. Ask patient to swallow with head upright
• D. Breath-hold while advancing

Answer: (A)

Swallowing with the neck flexed forward helps guide the tube into the esophagus when advancing after it passes the nasopharynx. Flexing the neck (chin toward the chest) aligns the pharynx with the esophagus, and the act of swallowing moves the epiglottis to protect the airway while the esophagus opens, allowing the tube to slip into the correct passage rather than into the airway.

Extending the neck back changes the alignment in a way that can favor entry toward the larynx, not the esophagus, making misplacement more likely. Swallowing with the head upright offers less optimal alignment for guiding the tube, and breath-holding during advancement can disrupt coordination and airway protection.