Which statement is most important for the nurse to make when caring for an anxious patient with a new tracheostomy?

"I have cared for patients who were able to have the tracheostomy reversed."

“I understand that you might be apprehensive."

“I will be efficient and give care quickly."

"I will wait until your tracheostomy heals before teaching."

Answer and Explanation

The Correct Answer is B

A. "I have cared for patients who were able to have the tracheostomy reversed. While this may offer hope, it shifts the focus to long-term outcomes rather than addressing the patient's current emotional state. Not all tracheostomies are reversible, and offering this reassurance prematurely may set unrealistic expectations.

B. “I understand that you might be apprehensive." This statement acknowledges the patient's anxiety and fosters trust. Demonstrating empathy helps reduce emotional distress, encourages open communication, and supports emotional adaptation to the tracheostomy.

C. “I will be efficient and give care quickly." Although efficiency is important, this response may come off as dismissive of the patient's emotional needs. It prioritizes task completion over patient-centered care and fails to address the underlying anxiety.

D. "I will wait until your tracheostomy heals before teaching." Teaching should begin early, even in small steps, to help the patient gradually understand and adapt to tracheostomy care. Delaying education may increase fear, uncertainty, and dependence on others for care.

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Correct Answer is A

Explanation

A. White blood cell (WBC) count, arterial blood gases (ABGs):WBC count helps assess the presence and severity of infection, while ABGs evaluate the patient’s oxygenation and gas exchange critical factors in pneumonia. These tests directly reflect respiratory function and the inflammatory response.

B. Complete blood count (CBC), urinalysis:While a CBC includes the WBC count, the rest of the values are not directly helpful in tracking pneumonia progression. A urinalysis assesses kidney and urinary tract health, not respiratory infection, so it is not essential.

C. Electrolytes, serum creatinine:These tests provide information on renal function and electrolyte balance, which may be relevant in complex cases but are not specific indicators of pneumonia status or treatment response.

D. Partial thromboplastin time (PTT), serum potassium:PTT evaluates clotting, and serum potassium assesses electrolyte balance. Neither test provides useful information about the progression or resolution of pneumonia.

A. Barrel chest and polycythemia B. Bronchovesicular lung sounds and bradypnea C. Unequal lung expansion and dyspnea D. Frothy bloody sputum and consolidation

Correct Answer is C

Explanation

A. Barrel chest and polycythemia: These findings are more characteristic of chronic obstructive pulmonary disease, especially emphysema. They reflect long-term adaptations to hypoxia and air trapping, not the acute onset seen in pneumothorax.

B. Bronchovesicular lung sounds and bradypnea: Bronchovesicular sounds are normal in some lung areas, and bradypnea is not a common feature of pneumothorax. Pneumothorax often presents with decreased or absent breath sounds on the affected side and increased respiratory rate due to hypoxia.

C. Unequal lung expansion and dyspnea: Unequal chest expansion occurs because the collapsed lung on the affected side does not inflate properly. Dyspnea results from impaired gas exchange, making this the most accurate sign combination of pneumothorax.

D. Frothy bloody sputum and consolidation: These findings suggest pulmonary edema or pneumonia rather than pneumothorax. Frothy sputum is often seen in left-sided heart failure, and lung consolidation is not a feature of air in the pleural space.

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Which statement is most important for the nurse to make when caring for an anxious patient with a new tracheostomy?

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