Question 1

The nurse is caring for a client who had a chest tube inserted 48 hours ago.During the first AM assessment,the nurse noted there was intermittent bubbling of the water in the water-seal chamber.When assessing the client 2 hours later,the nurse notes that the water is now continuously bubbling.Which is the nurse's priority action at this time?

Accepted Answer

A) Document the presence of the bubbling. 
B) Immediately contact the healthcare provider. 
C) Instruct the client to perform deep-breathing exercises. 
D) Disconnect the chest tube from the drainage system and place the chest tube in a new chest tube drainage system.

Question 2

The nurse is assisting a client in obtaining a sputum specimen.After a deep cough,the client produces approximately 1/2 tsp of sputum.Which is the nurse's next action?

Accepted Answer

A) Assist the client to cough again and produce more sputum. 
B) Send the specimen to the lab. 
C) Allow the client to rest for one hour and then ask the client to cough again. 
D) Ask the client to walk around for 30 minutes and try again to produce sputum.

Question 3

The nurse observes a client using the incentive spirometer and s that further instruction is required when the client performs which action?

Accepted Answer

A) Exhales before placing the incentive spirometer to the lips 
B) Seals the lips tightly around the mouthpiece of the incentive spirometer 
C) Inhales quickly,causing the spirometer balls to snap to the top of the incentive spirometer 
D) Attempts to cough productively after using the incentive spirometer

Exam 11: Oxygenation

The nurse is assisting a client in obtaining a sputum specimen.After a deep cough,the client produces approximately 1/2 tsp of sputum.Which is the nurse's next action?

The nurse observes a client using the incentive spirometer and s that further instruction is required when the client performs which action?