Which of the following clients should the nurse identify as being at increased risk for developing ventilator-associated pneumonia (VAP)? Select all that apply.

A client who is postoperative and has received local anesthesia

A massive stroke client who has dysphagia

A client who has myasthenia gravis

A client who has AIDS

A client who has a closed head injury and is receiving mechanical ventilation

A client who was vaccinated for pneumococcus and influenza 6 months ago