Final answer:
During endotracheal tube removal, the patient should be instructed to take a deep breath and exhale or cough to help clear the airway and reduce the risk of aspiration.
Step-by-step explanation:
When removing an endotracheal tube, it is important to ask the patient to take a deep breath and exhale or to cough during the actual removal of the tube. This facilitates the expulsion of any secretions that may have accumulated and helps to clear the airway as the tube is being withdrawn. Moreover, this action reduces the risk of aspiration, which can occur if secretions enter the lungs when the protective barrier of the tube is removed.