ATI RN Comprehensive Predictor Exam 2: Tracheostomy & Trach Care (NCLEX) 70 Questions and Answers 2025

ATI RN Comprehensive Predictor Exam 2: Tracheostomy & Trach Care (NCLEX) 70 Questions and Answers 2025 following an airway procedure is to assess the client's respiratory status; this requires auscultation of the lungs. 5. The client who is concerned about getting a tracheostomy says, "I will be ugly, with a hole in my neck." What is the nurse's best response? A. "But you know you need this to breathe, right?" B. Do you have a pretty scarf or a large loose collar that you could place over it?" C. "Your family and friends probably won't even care." D. "It won't take you long to learn to manage." - B Suggesting strategies to cover the tracheostomy recognizes client concerns and explores options for dealing with the effects of the procedure. 6. The older adult client with degenerative arthritis is admitted for tracheostomy surgery. What is the best communication method for this client during the postoperative period? A. Computer keyboard B. Magic slate C. Picture board D. Pen and paper - C A picture board does not require very much dexterity for communication. Dexterity can be limited to the extent the client finds comfortable. 7. Respirations of the sedated client with a new tracheostomy have become noisy, and the ventilator alarms indicate high peak pressures. The ventilator tube is clear. What is the best immediate action by the nurse? A. Humidifying the oxygen source B. Increasing oxygenation C. Removing the inner cannula of the tracheostomy D. Suctioning the client - D Suctioning the client will likely result in clear lung sounds and lower peak pressure, and the appearance of the sputum will indicate whether bleeding is a concern. 8. A client with a tracheostomy is at increased risk for aspiration. Which nursing intervention(s) will reduce this risk? SELECT ALL THAT APPLY. A. Encourage frequent sipping from a cup B. Encourage water with meals C. Inflate the tracheostomy cuff during meals D. Maintain the client upright for 30 minutes after eating E. Provide small, frequent meals F. Teach the client to "tuck" the chin down in the forward position to swallow - DEF At least 30 minutes is required for thinner liquids in the stomach to be thickened in combination with stomach contents and/or removed from the stomach; this reduces the chance of aspiration. Eating requires significant time and energy. When the client becomes tired, he is more likely to aspirate. Shorter and more frequent intervals of eating tire the client less and reduce the chance of aspiration. Tucking the chin downward helps to open the upper esophageal sphincter. 9. A new graduate RN discovers that her client, who had a tracheostomy placed the previous day, has completely dislodged both the obturator and the tracheostomy tube. Which action should the nurse take first? A. Auscultate the client's breath sounds while applying a nasal cannula B. Direct someone to call the Rapid Response Team while using a resuscitation bag and facemask C. Apply a 100% non-rebreather mask while administering high-flow oxygen D. Replace the obturator while inserting the tracheostomy tube - B Because a fresh tracheostomy stoma will collapse, the client will lose his airway patency, which will require the nurse to ventilate the client through the mouth and nose while waiting for assistance to re-cannulate the client. Directing someone else to call the Rapid Response Team allows the nurse to provide immediate care required by the client. 10. The client is being discharged home with a tracheostomy. Which statement by the client indicates the need for further teaching about tracheostomy care? A. "I can only take baths, no showers." B. "I can put normal saline in my tracheostomy to keep the secretions from getting thick." C. "I should put cotton or foam over the tracheostomy hole." D. "I will have to learn to suction myself." - A The client does not understand that he can shower with the use of a shower shield over the tracheostomy tube to prevent water from entering the airway. Additional teaching is necessary.