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60–80 mmHg is too low and may not be effective in clearing secretions.

60–100 mmHg is not the recommended standard range for safe suctioning in pediatric clients.

40–60 mmHg is too low and will not provide adequate suctioning.

Risk for infection is important but not the most urgent; airway patency takes precedence over potential complications.

Risk for skin breakdown is relevant to long-term care but not life-threatening in the immediate postoperative period.

Impaired gas exchange may occur if the airway is not cleared, but ensuring airway clearance comes first in the nursing priority hierarchy (Airway-Breathing-Circulation).

To decrease the likelihood of aspiration of stomach contents is not the function of a fenestrated tube; aspiration prevention is managed with cuffed tracheostomy tubes.

To prevent dislodgement is incorrect; tube security is maintained by ties or holders, not fenestration.

To prevent trauma to the trachea is not the purpose of fenestration; careful technique and appropriate tube size help prevent trauma.

The outer cannula of the tracheostomy tube should remain in place to maintain the airway and is not removed for routine cleaning.

The obturator is only used during the insertion of a tracheostomy tube and is not part of routine cleaning.

The flange secures the tracheostomy tube to the neck and is not removed for cleaning.

Set suction regulator at 150 to 200 mmHg is too high; excessive suction pressure can damage mucosa and cause hypoxemia. The safe range is generally 80–120 mmHg for children and 100–150 mmHg for adults.

Liberally lubricate the end of the suction catheter with a water-soluble solution is not recommended; catheters are usually moistened with sterile saline if needed, not lubricated.

Apply suction while gently rotating and inserting the catheter is incorrect because suction should only be applied during withdrawal, not insertion, to prevent airway trauma.

10–15 seconds; 3 passes is incorrect because 10–15 seconds refers to suctioning duration, not the rest period.

10–15 seconds; 2 passes is incorrect because 10–15 seconds refers to suction time, and limiting to 2 passes is not standard practice.

1–3 minutes; 2 passes is incorrect because up to 3 passes are safe when adequate oxygenation is provided.

Manually occlude the tracheostomy with sterile gauze would obstruct the airway completely and is unsafe.

Press the emergency response button may be necessary if reinsertion is unsuccessful, but it is not the first action.

Place the patient on a facemask delivering 100% oxygen is not effective because the tracheostomy stoma is the patient’s airway, and oxygen delivery via face mask would not ventilate the lungs.

Calling the doctor is not necessary for a normal response like coughing during suctioning.

Checking oxygen saturation is important if distress occurs, but coughing alone is an expected response and does not require stopping the procedure.

Advancing until resistance is met risks damaging the airway mucosa and should be avoided.

Teaching the patient and family what type of drainage is expected and when to report abnormal findings is essential for early detection of infection or complications.

Recognizing and preventing hypoxia is critical for patient safety and effective tracheostomy care.

Suctioning is a vital skill that caregivers must learn to maintain airway patency and prevent obstruction.

Nasotracheal suctioning is used for patients without a tracheostomy to access the lower airway through the nasal passage.

Orotracheal suctioning is also intended for patients without a tracheostomy and is more invasive.

Oropharyngeal suctioning clears secretions from the mouth and throat only, not the trachea, and is insufficient for maintaining a tracheostomy airway.