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For a client who is unresponsive following a cerebrovascular accident (CVA), the safest and most appropriate approach to feeding would be bolus enteral feeding through a gastrostomy tube. This method allows for nutrition to be directly delivered into the stomach, which is essential for clients who may have difficulty swallowing or are at risk for aspiration due to their unresponsive state.

Bolus feeding can provide adequate nutrition while minimizing the risk of complications that can arise from oral or nasogastric feeding. Enteral feeding via a gastrostomy tube is particularly suitable for long-term nutritional support when oral intake is not possible or safe, as it bypasses the risk of aspiration that comes with oral feeding and the potential for misplacement associated with nasogastric tubes.

In contrast, oral feeding is not suitable for an unresponsive client since they cannot safely swallow, which greatly increases the risk of aspiration. Similarly, while nasogastric tube feeding could be considered in some situations, it often requires a level of alertness and cooperation from the patient to ensure correct placement, and there's still a risk of aspiration. Parenteral nutrition involves delivering nutrients intravenously and is typically used when there is a complete inability to digest or absorb food through the gastrointestinal tract