# Transportation has arrived for a client being discharged with a new tracheostomy. The sole home caregiver cannot correctly demonstrate suctioning. Which action should the nurse take?

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> language: en  
> subject: Continuity of Care  
> category: MOC

## Question

Transportation has arrived for a client being discharged with a new tracheostomy. The sole home caregiver cannot correctly demonstrate suctioning. Which action should the nurse take?

## Option

1. Document the completed teaching and continue discharge with written instructions
2. Ask transport staff to review suctioning with the caregiver during the ride
3. Advise the caregiver to call emergency services if secretions accumulate
4. Pause discharge and contact the provider and case manager for a safe plan **✔ Correct answer**

**Correct answer: 4**

## Explanation

Discharge is unsafe when the sole caregiver cannot perform essential airway care. Pause discharge, alert the provider and case manager, and establish a plan that includes verified competency and needed support. Written instructions or emergency services do not substitute for safe transition planning.

## In-depth explanation

Quick answer
Pause discharge and coordinate a safe plan that verifies the caregiver can provide essential tracheostomy care.

Why this is correct
A client with a new tracheostomy depends on competent airway care after leaving the hospital. Failed return demonstration shows that the current plan cannot safely meet that need, so the interprofessional team must revise support, teaching, or disposition before discharge.

Easy analogy or mental picture
Discharge is like transferring a relay baton: the next caregiver must be able to hold it before the hospital lets go. The analogy represents verified transfer of care, but it does not replace individualized assessment of equipment, services, and the client's own abilities.

Memory hook
Unsafe discharge gap: pause, coordinate, verify, then transition.

NCLEX decision rule
When the only available caregiver cannot demonstrate an essential life-sustaining skill, do not rely on paperwork or emergency rescue; stop the transition and build a plan that can safely meet the need.

Why the other choices are wrong
Written instructions do not prove hands-on competency. Transport staff are not substitutes for an established home-care plan. Emergency services are a rescue response, not a routine strategy for expected airway needs.References

- [1]NCSBN: 2026 NCLEX-RN Test PlanNational Council of State Boards of Nursing

- [2]IDEAL Discharge Planning Overview, Process, and ChecklistAgency for Healthcare Research and Quality

- [3]Teach-BackAgency for Healthcare Research and Quality

## Clinical scenario

Clinical Practice Guide
For Crash triage breathing priority, compare the complete cue pattern with the client's current stability, ordered data, and expected nursing scope.

Caution
Do not choose an action from one isolated cue when the full scenario changes priority or safety.

## Key concepts

- **Triage** — Sorting clients by urgency and threat to life or function.
- **Absent Breath Sounds** — A cue that may indicate severe lung or pleural compromise.
- **Dyspnea** — Difficult or labored breathing.

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