Question 1

Which of the following is the correct positioning for a patient after a chest tube has been inserted for a pneumothorax?

Accepted Answer

A) Supine 
B) Side-lying 
C) Semi-Fowler's 
D) High-Fowler's 
A) Supine 
B) Side-lying 
C) Semi-Fowler's 
D) High-Fowler's D

Question 2

For a patient with a pneumothorax,where does the nurse anticipate that the chest tube will be located?

Accepted Answer

A) Second to third intercostal space (apical),anterior 
B) Fifth to sixth intercostal space,posterior 
C) Fifth to sixth intercostal space,lateral 
D) Mediastinal area 
A) Second to third intercostal space (apical),anterior 
B) Fifth to sixth intercostal space,posterior 
C) Fifth to sixth intercostal space,lateral 
D) Mediastinal area A

Question 3

The nurse is caring for a patient who has had a chest tube in place for 2 days.As the nurse begins her shift assessment,she should ensure that what equipment is at the bedside? (Select all that apply. )

Accepted Answer

A) Two rubber-tipped clamps 
B) Plain gauze 4×4 
C) Sterile petroleum gauze 
D) Extra drainage system 
E) A sterile chest tube of the same size as the one inserted in the patient 
A) Two rubber-tipped clamps 
B) Plain gauze 4×4 
C) Sterile petroleum gauze 
D) Extra drainage system 
E) A sterile chest tube of the same size as the one inserted in the patient A,B,C,D

Question 4

Which of the following is an expected outcome of chest tube insertion?

Accepted Answer

A) Mild chest pain is maintained. 
B) Breath sounds are auscultated in all lobes. 
C) Drainage from the pleural cavity increases over time. 
D) Lung expansion is increased beyond the unaffected side. 
A) Mild chest pain is maintained. 
B) Breath sounds are auscultated in all lobes. 
C) Drainage from the pleural cavity increases over time. 
D) Lung expansion is increased beyond the unaffected side.

Question 5

The patient has a chest tube for a pneumothorax.Assessment revealed continuous bubbling in the water-seal chamber.The nurse finds no loose connections.After the chest tube near the patient is clamped,the bubbling stops.The nurse's first action should be to:

Accepted Answer

A) apply pressure to the dressing around the chest tube insertion site. 
B) move the clamp farther down the tube and note whether bubbling resumes. 
C) replace the entire collection tubing and system. 
D) increase suction control until bubbling does not resume when the clamp is removed. 
A) apply pressure to the dressing around the chest tube insertion site. 
B) move the clamp farther down the tube and note whether bubbling resumes. 
C) replace the entire collection tubing and system. 
D) increase suction control until bubbling does not resume when the clamp is removed.

Question 6

During assessment of a patient,the chest tube becomes dislodged.What should the nurse do first?

Accepted Answer

A) Have an assistant apply an occlusive gauze dressing and tape on all four sides. 
B) Clamp the chest tube. 
C) Attempt to gently reinsert the tube. 
D) Apply pressure over the insertion site. 
A) Have an assistant apply an occlusive gauze dressing and tape on all four sides. 
B) Clamp the chest tube. 
C) Attempt to gently reinsert the tube. 
D) Apply pressure over the insertion site.

Question 7

The nurse is caring for a patient who has a chest tube connected to a water seal.The patient is not on a ventilator.Which of the following would the nurse consider normal?

Accepted Answer

A) The fluid level in the water seal rises with inspiration. 
B) The fluid level in the water seal falls with inspiration. 
C) Constant bubbling occurs in the water seal. 
D) The fluid level in the water seal falls with expiration 3 days after insertion. 
A) The fluid level in the water seal rises with inspiration. 
B) The fluid level in the water seal falls with inspiration. 
C) Constant bubbling occurs in the water seal. 
D) The fluid level in the water seal falls with expiration 3 days after insertion.

Question 8

Which of the following represents appropriate technique when providing care for a patient with chest tubes?

Accepted Answer

A) Applying an occlusive dressing over the site 
B) "Stripping" the tube on a regular basis 
C) Assessing the patient hourly after insertion 
D) Keeping excess loops of tubing from hanging over the side of the bed 
A) Applying an occlusive dressing over the site 
B) "Stripping" the tube on a regular basis 
C) Assessing the patient hourly after insertion 
D) Keeping excess loops of tubing from hanging over the side of the bed

Question 9

What does the expected role of the nurse include during chest tube removal?

Accepted Answer

A) Prepares an occlusive dressing. 
B) Performs clipping of the sutures. 
C) Provides support and assessment of the patient. 
D) Removes the chest tube firmly and quickly. 
A) Prepares an occlusive dressing. 
B) Performs clipping of the sutures. 
C) Provides support and assessment of the patient. 
D) Removes the chest tube firmly and quickly.

Question 10

What is the expected amount of drainage for an adult patient with a posterior chest tube?

Accepted Answer

A) 100 to 300 mL during the first 3 hours 
B) 10 to 50 mL during the first 2 hours 
C) 200 mL during the first 24 hours 
D) 400 to 500 mL during the first 24 hours 
A) 100 to 300 mL during the first 3 hours 
B) 10 to 50 mL during the first 2 hours 
C) 200 mL during the first 24 hours 
D) 400 to 500 mL during the first 24 hours

Question 11

The nurse is caring for a patient with a chest tube that was inserted 4 days earlier.She notices that the drainage contains a large amount of pus.What does the presence of the pus indicate?

Accepted Answer

A) Malignancy 
B) Pulmonary infarction 
C) Empyema 
D) Hemothorax 
A) Malignancy 
B) Pulmonary infarction 
C) Empyema 
D) Hemothorax

Question 12

What is the expected amount of drainage for an adult patient with a mediastinal chest tube?

Accepted Answer

A) Less than 100 mL/hr during the immediate postoperative period 
B) Less than 10 mL/hr during the immediate postoperative period 
C) 1000 mL/hr during the first 24-hour period 
D) 200 mL/hr during the first 24-hour period 
A) Less than 100 mL/hr during the immediate postoperative period 
B) Less than 10 mL/hr during the immediate postoperative period 
C) 1000 mL/hr during the first 24-hour period 
D) 200 mL/hr during the first 24-hour period

Question 13

The nurse is caring for a patient with a chest tube connected to water-seal drainage.The nurse may delegate which of the following tasks to nursing assistive personnel (NAP)?

Accepted Answer

A) Changing the chest tube drainage system 
B) Milking the chest tube 
C) Measuring chest tube output 
D) Turning and positioning the patient 
A) Changing the chest tube drainage system 
B) Milking the chest tube 
C) Measuring chest tube output 
D) Turning and positioning the patient

Question 14

The nurse is preparing to assist the physician in removal of a chest tube.What should the nurse do to prepare the patient? (Select all that apply. )

Accepted Answer

A) Assess the patient's need for pain medication. 
B) Instruct the patient about the process. 
C) Teach the patient to take a deep breath and hold it. 
D) Clamp the chest tubes. 
A) Assess the patient's need for pain medication. 
B) Instruct the patient about the process. 
C) Teach the patient to take a deep breath and hold it. 
D) Clamp the chest tubes.

Question 15

A nurse determines that there may be a leak in the chest tube system.Clamps are applied near the patient's chest,and the nurse finds that the bubbling stops.What should the nurse do next?

Accepted Answer

A) Change the tubing. 
B) Change the drainage container. 
C) Move the clamps farther down the chest tube. 
D) Reinforce the dressing and notify the physician. 
A) Change the tubing. 
B) Change the drainage container. 
C) Move the clamps farther down the chest tube. 
D) Reinforce the dressing and notify the physician.

Question 16

The nurse is caring for a patient who is comatose and on a ventilator.When she enters the room,she notices that the patient's trachea has shifted toward the left side of the patient's neck,and he has become tachycardic.She assesses the patient's blood pressure and notes that it is 84/38.The nurse calls for help,having recognized that the patient has developed which of the following conditions?

Accepted Answer

A) Hemothorax 
B) Pneumothorax on the left side 
C) Pneumothorax on the right side 
D) Myocardial infarction 
A) Hemothorax 
B) Pneumothorax on the left side 
C) Pneumothorax on the right side 
D) Myocardial infarction

Question 17

The nurse is caring for a patient who has a chest tube.Attached to the top of the patient's bed are two shodded hemostats.In which situations would these be used? (Select all that apply. )

Accepted Answer

A) To assess an air leak 
B) To quickly empty or change disposable systems 
C) To quickly seal off the lungs if the system becomes disconnected 
D) To assess whether the patient is ready to have the chest tube removed 
A) To assess an air leak 
B) To quickly empty or change disposable systems 
C) To quickly seal off the lungs if the system becomes disconnected 
D) To assess whether the patient is ready to have the chest tube removed

Question 18

The nurse knows that _______________ is the proper term to describe that the patient's water seal is fluctuating up and down with each breath.

Accepted Answer

A) bubbling 
B) tidaling 
C) fluttering 
D) alternating 
A) bubbling 
B) tidaling 
C) fluttering 
D) alternating

Question 19

What condition is indicated when a patient with a chest tube experiences sharp,stabbing chest pain without a change in pulse or blood pressure?

Accepted Answer

A) Pneumonitis 
B) Tube displacement 
C) A myocardial infarction 
D) A tension pneumothorax 
A) Pneumonitis 
B) Tube displacement 
C) A myocardial infarction 
D) A tension pneumothorax

Question 20

The nurse is caring for a patient with blood collecting in the pleural space.The nurse documents this as:

Accepted Answer

A) pleural effusion. 
B) hemothorax. 
C) pulmonary hemorrhage. 
D) pneumothorax. 
A) pleural effusion. 
B) hemothorax. 
C) pulmonary hemorrhage. 
D) pneumothorax.

Exam 27: Closed Chest Drainage Systems

Which of the following is the correct positioning for a patient after a chest tube has been inserted for a pneumothorax?

For a patient with a pneumothorax,where does the nurse anticipate that the chest tube will be located?

The nurse is caring for a patient who has had a chest tube in place for 2 days.As the nurse begins her shift assessment,she should ensure that what equipment is at the bedside? (Select all that apply. )

Which of the following is an expected outcome of chest tube insertion?

The patient has a chest tube for a pneumothorax.Assessment revealed continuous bubbling in the water-seal chamber.The nurse finds no loose connections.After the chest tube near the patient is clamped,the bubbling stops.The nurse's first action should be to:

During assessment of a patient,the chest tube becomes dislodged.What should the nurse do first?

The nurse is caring for a patient who has a chest tube connected to a water seal.The patient is not on a ventilator.Which of the following would the nurse consider normal?

Which of the following represents appropriate technique when providing care for a patient with chest tubes?

What does the expected role of the nurse include during chest tube removal?

What is the expected amount of drainage for an adult patient with a posterior chest tube?

The nurse is caring for a patient with a chest tube that was inserted 4 days earlier.She notices that the drainage contains a large amount of pus.What does the presence of the pus indicate?

What is the expected amount of drainage for an adult patient with a mediastinal chest tube?

The nurse is caring for a patient with a chest tube connected to water-seal drainage.The nurse may delegate which of the following tasks to nursing assistive personnel (NAP)?

The nurse is preparing to assist the physician in removal of a chest tube.What should the nurse do to prepare the patient? (Select all that apply. )

A nurse determines that there may be a leak in the chest tube system.Clamps are applied near the patient's chest,and the nurse finds that the bubbling stops.What should the nurse do next?

The nurse is caring for a patient who has a chest tube.Attached to the top of the patient's bed are two shodded hemostats.In which situations would these be used? (Select all that apply. )

The nurse knows that _______________ is the proper term to describe that the patient's water seal is fluctuating up and down with each breath.

What condition is indicated when a patient with a chest tube experiences sharp,stabbing chest pain without a change in pulse or blood pressure?

The nurse is caring for a patient with blood collecting in the pleural space.The nurse documents this as:

Using Evidence in Practice

Admitting, Transfer, and Discharge

Communication and Collaboration

Documentation and Informatics

Vital Signs

Health Assessment

Specimen Collection

Diagnostic Procedures

Medical Asepsis

Sterile Technique

Safe Patient Handling, Transfer, and Positioning

Exercise Mobility

Support Surfaces and Special Beds

Patient Safety

Disaster Preparedness

Pain Management

Palliative Care

Personal Hygiene and Bed Making

Care of the Eye and Ear

Safe Medication Preparation

Administration of Nonparenteral Medications

Administration of Parenteral Medications

Oxygen Therapy

Performing Chest Physiotherapy

Airway Management

Cardiac Care

Emergency Measure for Life Support

Intravenous and Vascular Access Therapy

Blood Therapy

Oral Nutrition

Enteral Nutrition

Parenteral Nutrition

Urinary Elimination

Bowel Elimination and Gastric Intubation

Ostomy Care

Preoperative and Postoperative Care

Intraoperative Care

Pressure Injury Prevention and Care

Wound Care and Irrigations

Dressings, Bandages, and Binders

Therapeutic Use of Heat and Cold

Home Care Safety

Home Care Teaching

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