A nurse is preparing to discharge a patient who is post-operative following a laryngectomy. The nurse should recognize which of the following discharge teaching as the highest priority?

Use of Passy Muir speaking valve.

Phone number of healthcare provider to report complications.

Emergency personal identification that patient is unable to speak.

Ability to perform tracheostomy care.

Answer and Explanation

The Correct Answer is D

Choice A rationale
The use of a Passy Muir speaking valve can be important for communication, but it is not the highest priority for discharge teaching.
Choice B rationale
Having the phone number of the healthcare provider to report complications is important, but it is not the highest priority. The patient needs to know how to prevent and recognize complications first.
Choice C rationale
While having emergency personal identification that the patient is unable to speak is important, it is not the highest priority. The patient’s immediate post-operative needs should be addressed first.
Choice D rationale
The ability to perform tracheostomy care is the highest priority for discharge teaching. This is a new and critical skill that the patient must learn to prevent complications, maintain the airway, and manage their own care at home.

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Correct Answer is C

Explanation

Choice A rationale
PEEP does not decrease trapped oxygen in the alveoli. Instead, it helps to increase the volume of gas remaining in the lungs at the end of expiration, which can improve oxygenation.
Choice B rationale
PEEP does not directly promote independent breathing efforts. It is a mode of mechanical ventilation used to support a patient’s breathing.
Choice C rationale
PEEP keeps the airways and small lung spaces open by increasing the pressure in the lungs at the end of expiration. This can prevent alveolar collapse and improve oxygenation in patients with conditions like ARDS23.
Choice D rationale
While PEEP can be used in the process of weaning a patient off mechanical ventilation, its primary benefit is not facilitating weaning. It is used to improve oxygenation and prevent alveolar collapse.

A. Limit oral fluids to minimize labored breathing. B. Lie in a low Fowler’s position to promote lung expansion. C. Perform hourly incentive spirometry to inflate lungs and mobilize secretions. D. Perform pursed lip breathing to expel trapped carbon dioxide from the alveoli.

Correct Answer is C

Explanation

Choice A rationale
Limiting oral fluids is not the best action for a client with pneumonia and copious tracheobronchial secretions. Adequate hydration can actually help thin and loosen pulmonary secretions, making them easier to expel.
Choice B rationale
While lying in a low Fowler’s position can aid in lung expansion, it is not the priority action in this case. The client has copious tracheobronchial secretions, and the most effective way to mobilize these secretions is through incentive spirometry.
Choice C rationale
Performing hourly incentive spirometry can help inflate the lungs and mobilize secretions, which is particularly beneficial for a client with pneumonia who has copious tracheobronchial secretions. This is the priority action as it directly addresses the client’s issue of labored breathing due to excessive secretions.
Choice D rationale
Pursed lip breathing is a technique used primarily to slow the pace of breathing and can help maintain open airways longer. However, it is not the most effective method for mobilizing tracheobronchial secretions.

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A nurse is preparing to discharge a patient who is post-operative following a laryngectomy. The nurse should recognize which of the following discharge teaching as the highest priority?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client diagnosed with adult respiratory distress syndrome (ARDS) and being treated with positive end expiratory pressure (PEEP). How does PEEP benefit the client?

Correct Answer is C

Explanation

A nurse is caring for a client diagnosed with pneumonia who has labored breathing and copious tracheobronchial secretions. What priority action should the nurse encourage with the client?

Correct Answer is C

Explanation

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