The nurse recognizes that, immediately before a tracheostomy cuff deflation, the patient should:
be monitored for respiratory rate
have the cuff pressure checked
have the pharynx suctioned
be administered extra oxygen
The Correct Answer is C
A. Be monitored for respiratory rate: Important for ongoing assessment but not directly related to the deflation process.
B. Have the cuff pressure checked: Necessary during care but not immediately before deflation.
C. Have the pharynx suctioned: Suctioning clears secretions that could be aspirated when the cuff is deflated.
D. Be administered extra oxygen: Beneficial but not a direct prerequisite for cuff deflation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Oxygen diffuses across the alveolar membrane into the blood: This is the primary function of the respiratory system, ensuring oxygenation of blood.
B. The alveoli have cilia that help remove foreign particles: Cilia are present in the respiratory tract, but not in the alveoli.
C. The diaphragm controls respiration: The diaphragm assists with breathing but does not "control" respiration, which is regulated by the brainstem.
D. The bronchioles contain macrophages that phagocytize inhaled bacteria: Macrophages are found in alveoli, not the bronchioles.
Correct Answer is B
Explanation
A) Trendelenburg. This position involves tilting the patient with the head lower than the body and can worsen respiratory distress.
B) Tripod. The tripod position maximizes lung expansion by allowing the diaphragm to move freely, improving oxygenation.
C) Supine. The supine position can impair lung expansion and worsen respiratory distress.
D) Low-Fowler's Position. This position may provide minimal respiratory relief but is not as effective as the tripod position.
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