A nurse is reinforcing teaching with a newly licensed nurse about tracheostomy care for a toddler. Which of the following instructions should the nurse include in the teaching?

Secure the tracheostomy ties so that fingers cannot fit between the ties and the neck.

Suction for 20 seconds.

Clean secretions from the tube using hydrogen peroxide.

Set the vacuum pressure at 120 mmHg for suctioning.

Answer and Explanation

The Correct Answer is D

A) Secure the tracheostomy ties so that fingers cannot fit between the ties and the neck. The ties should be secure but loose enough to fit one finger between the ties and the neck to prevent skin breakdown and maintain comfort.
B) Suction for 20 seconds. Suctioning for 20 seconds is too long and may cause hypoxia. Suction should not exceed 5 to 10 seconds.
C) Clean secretions from the tube using hydrogen peroxide. Hydrogen peroxide can irritate the delicate tissues and is not recommended. Saline or prescribed cleaning agents are preferred.
D) Set the vacuum pressure at 120 mmHg for suctioning. For a toddler, suction pressure should typically be between 80 and 120 mmHg to prevent mucosal damage.

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Correct Answer is D

Explanation

A. Loop the tubing of the chest tube on the client's bed: Looping can create kinks or blockages, impeding drainage and increasing the risk of complications.
B. Place the chest tube drainage system above the level of the client's heart: This would prevent gravity drainage, leading to fluid accumulation in the pleural space.
C. Strip the client's chest tube every 2 hrs: Stripping can create high negative pressure, damaging lung tissue.
D. Tape the connections on the client's chest tube: Securing all connections with tape helps maintain a closed system and prevents air leaks.

A. Start slowly and increase volume over several sessions. B. Be much more vigorous in increasing increments. C. Do regular deep-breathing exercises instead. D. Use another device because this one might be faulty.

Correct Answer is A

Explanation

A. Start slowly and increase volume over several sessions: Gradually increasing lung volume improves compliance and helps clients build confidence with the device.
B. Be much more vigorous in increasing increments: Rapid or forceful attempts can cause hyperventilation or dizziness and are not recommended.
C. Do regular deep-breathing exercises instead: Deep breathing can be helpful but does not replace the targeted lung expansion benefits of the incentive spirometer.
D. Use another device because this one might be faulty: Device failure is rare; user education is usually more effective.

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A nurse is reinforcing teaching with a newly licensed nurse about tracheostomy care for a toddler. Which of the following instructions should the nurse include in the teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assisting with the care of a client who has a chest tube. Which of the following actions should the nurse take?

Correct Answer is D

Explanation

A nurse is reinforcing teaching with a client who is having difficulty using an incentive spirometer. Which of the following instructions should the nurse include in the teaching?

Correct Answer is A

Explanation

Which of the following is not considered an adventitious lung sound upon auscultation:

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