Which of the following precautions can be implemented to minimize the risk of developing VAP? I. employing the minimal leak technique for cuff care II. instituting noninvasive positive pressure ventilation when indicated III. avoiding placing the patient in the supine position IV. suctioning the patient only PRN

A. I, II only
B. II, III only
C. II, III, IV only
D. I, III, IV only

ANS: B
A. Incorrect response: See explanation B.
B. Correct response: Despite the recommendation to avoid placing the patient in the supine position, and to apply using the semirecumbent position, clinicians often maintain patients in the supine position during mechanical ventilation. Noninvasive positive pressure ventilation should be considered in all eligible patients with no contraindications because it has been shown to reduce the need for intubation, prevent VAP, and improve outcome. Also, unnecessary blood transfusions need to be avoided. Lung-protective mechanical ventilation strategies need to be implemented along with timely weaning and extubation practices.
C. Incorrect response: See explanation B.
D. Incorrect response: See explanation B.?