a client with a tracheostomy is experiencing increased secretions and labored breathing what should the nurse do first
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Nursing Elites

ATI LPN

PN ATI Comprehensive Predictor

1. A client with a tracheostomy is experiencing increased secretions and labored breathing. What should the nurse do first?

Correct answer: B

Rationale: The correct answer is to suction the tracheostomy first. When a client with a tracheostomy is experiencing increased secretions and labored breathing, suctioning the tracheostomy is the priority intervention to clear the airway and improve breathing. Administering a bronchodilator (Choice A) may help with breathing but should come after ensuring the airway is clear. Encouraging the client to cough (Choice C) may not be effective in clearing secretions from the tracheostomy. Notifying the provider (Choice D) can be done after ensuring immediate airway clearance.

2. A healthcare provider is reviewing the medical record of a client who has hypertension. Which of the following findings should the provider identify as a risk factor for this condition?

Correct answer: C

Rationale: The correct answer is C: Obesity. Obesity is a significant risk factor for hypertension due to its impact on the cardiovascular system. Obesity can lead to increased blood pressure due to the additional workload placed on the heart and blood vessels. Age alone does not necessarily predispose someone to hypertension, and a family history of hypotension or a personal history of hypotension would not increase the risk of developing hypertension. Family history of hypotension is not a known risk factor for hypertension, and a history of hypotension actually indicates low blood pressure, which is the opposite of hypertension.

3. What guides behavior and decision making based on values and beliefs?

Correct answer: A

Rationale: Morals are the values and beliefs that guide behavior and decision-making. While beliefs are part of the equation, morals specifically dictate how individuals act and make choices. Ethics, on the other hand, refer to a system of moral principles governing conduct. Autonomy, although important, is not directly related to the values and beliefs that guide behavior and decision making.

4. What are common signs of hypoglycemia?

Correct answer: A

Rationale: The correct signs of hypoglycemia include shakiness or tremors, sweating, and hunger. These symptoms indicate low blood sugar levels. Confusion or irritability are more associated with severe hypoglycemia, while the immediate treatment for hypoglycemia involves providing a source of glucose to raise blood sugar levels quickly.

5. What are the key factors in assessing a patient's fall risk?

Correct answer: A

Rationale: The correct answer is A. Assessing the patient's age and mobility are key factors in determining fall risk. Age can affect balance and reaction time, while mobility influences the patient's stability. Choices B, C, and D are important considerations in assessing a patient's fall risk as well, but age and mobility play a more direct role in determining the patient's susceptibility to falls.

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