The nurse is caring for four clients on a step-down intensive care unit. The client at the highest risk for developing nosocomial pneumonia is the one who（）
A. has a respiratory infection.
B. is intubated and on a ventilator.
C. has pleural chest tubes.
D. is receiving feedings through a jejunostomy tube.
参考答案：B
解析：
When clients are on mechanical ventilation, the artificial airway impairs the gag and cough reflexes that help keep organisms out of the lower respiratory tract. The artifical airway also prevents the upper respiratory system from humidifying and heating air to enhance mucociliary clearance. Manipulations of the artificial airway sometimes allow secretions into the lower airways. With standard procedures the other choices wouldn’t be at high risk.