Difficulty: Medium
Average Score: 93%
Simulated
While caring for a client who requires a mechanical ventilator for breathing, the high-pressure alarm goes off on the ventilator. What is the first action the nurse should perform?
Correct answer
B
Rationale
A high-pressure alarm suggests obstruction or resistance, so assessing the clientÔÇÖs condition (B) first identifies the cause (e.g., tube kinking, secretions). Disconnecting (A), calling for help (C), or resetting (D) without assessment risks harm or delays resolution.