Wk. 5 - Closed Chest Drainage Practice Questions Foreign Language

The primary goal of closed-chest drainage is to: a. Increase intrapleural pressure b. Remove air, blood, or fluid from pleural/mediastinal space c. Prevent lung re-expansion d. Allow medications to be instilled into pleural space

B

Which condition is a common indication for a mediastinal chest tube? a. Pneumothorax b. Hemothorax c. Post-cardiac surgery drainage d. Pleural effusion

C

A pleural chest tube is placed basilar/laterally. This position is chosen to: a. Drain air b. Drain fluid or blood c. Prevent cardiac tamponade d. Reduce pain

B

Which assessment finding in the water-seal chamber is expected in a patient with a pneumothorax? a. Continuous bubbling b. No bubbling or tidaling c. Intermittent bubbling with cough/exhalation d. Constant tidaling without bubbling

C

A nurse observes continuous bubbling in the water-seal chamber. The most appropriate initial action is: a. Clamp the chest tube for 1 hour b. Notify the provider immediately without further assessment c. Assess the patient and check system connections for leaks d. Increase the wall suction

C

In a wet-suction system, suction level is determined by: a. Provider’s suction order b. Height of water in suction chamber c. Speed of bubbling d. Wall suction regulator

B

Which finding would require immediate provider notification? a. Drainage of 50 mL serosanguinous fluid in 1 hour b. Intermittent bubbling in the water-seal chamber with coughing c. Sudden increase in drainage from 50 mL/hr to 250 mL/hr d. Tidaling in the water-seal chamber

C

The nurse should position the drainage system: a. At the level of the chest b. Above the patient’s chest c. Below the patient’s chest d. At the level of the heart

C

A patient with a chest tube becomes acutely short of breath. Trachea is deviated, neck veins distended, and breath sounds absent on one side. The nurse suspects: a. Pleural effusion b. Tension pneumothorax c. Hemothorax d. Cardiac tamponade

B

During transport without suction, the nurse should: a. Clamp the chest tube b. Place drainage unit below chest level, maintain water-seal c. Remove the drainage system temporarily d. Leave system on bed

B

Indications for closed-chest drainage include (Select All That Apply): a. Pneumothorax b. Pleural effusion c. Pulmonary embolism d. Hemothorax e. Post-cardiac surgery drainage

A,B,D,E

Nursing responsibilities during chest tube insertion include (Select All That Apply): a. Obtain baseline vital signs and oxygen saturation b. Prepare equipment and maintain sterile field c. Encourage patient to cough forcefully during insertion d. Monitor patient’s vital signs and comfort e. Document procedure details after insertion

A,B

Which findings are consistent with hypotension from cardiac tamponade in a patient with a mediastinal tube? (Select All That Apply) a. Narrow pulse pressure b. Pulsus paradoxus c. Clear lung sounds d. Jugular venous distension e. Hyperresonance on percussion

A,B,D

The nurse must intervene if which of the following are observed? (Select All That Apply) a. Dependent loops in the tubing b. Drainage unit at waist level c. Chest tube connections taped securely d. Patient splints chest during coughing e. Drainage unit below chest level

A,B

Evidence-based emergency interventions for chest tube dislodgement include: (Select All That Apply) a. Apply occlusive dressing taped on 3 sides b. Clamp tube permanently c. Call provider immediately after securing site d. Reinsert tube without provider present e. Monitor patient’s oxygenation and VS closely

A,C,E

True or False: Tidaling in the water-seal chamber indicates the system is patent.

True

True or False: Continuous bubbling in the water-seal chamber is a normal finding.

False

True or False: Never strip or milk a chest tube unless ordered and policy allows.

True

True or False: A sudden absence of tidaling may indicate lung re-expansion or obstruction.

True

True or False: It is safe to administer IV medications directly into the chest tube.

False

A patient’s chest tube disconnects from the drainage system. The priority action is: a. Clamp tube for 24 hours b. Instruct patient to exhale and cough, place tube end in sterile water c. Call provider before taking action d. Connect tube back to suction immediately without cleaning

B

Which type of chest tube is most likely to be used after a sternotomy? a. Pleural tube at apical space b. Pleural tube at basilar space c. Mediastinal tube below sternum d. Small-bore pleural pigtail catheter

C

The nurse should prepare which equipment for a sterile chest tube dressing change? a. Clean gloves, adhesive bandage b. Sterile gloves, chlorhexidine, occlusive dressing c. Non-sterile gauze, tape, iodine swab d. Sterile gloves, povidone-iodine, transparent dressing only

B

Which finding is most concerning during chest tube assessment? a. 70 mL serosanguinous drainage in past hour b. Slight redness at insertion site c. Subcutaneous emphysema near site d. Intermittent bubbling with cough

C

Which nursing intervention reduces risk of CLABSI with a chest tube? a. Strict sterile technique during dressing changes b. Keep drainage unit at bed level c. Disconnect tubing daily to flush clots d. Tape all connections and change dressing weekly

A

Which is the correct patient instruction during chest tube removal? a. “Take a deep breath and hold it.” b. “Exhale and bear down (Valsalva).” c. “Inhale quickly and cough.” d. “Remain silent during removal.”

B

Which safety equipment must always be kept at the bedside of a patient with a chest tube? a. Ambu bag and suction only b. Sterile water, two clamps, occlusive dressing c. Defibrillator pads d. Intubation tray

B

The nurse finds the dressing around the chest tube insertion site saturated with blood. Best action is: a. Reinforce with sterile dressing and notify provider b. Remove dressing and leave site open to air c. Clamp tube immediately d. Disconnect from drainage system

A

A patient’s chest tube is accidentally removed. The nurse should: a. Leave site open to air b. Cover with sterile occlusive dressing taped on three sides c. Clamp site with hemostat d. Reinsert tube independently

B

The nurse suspects re-expansion pulmonary edema after rapid pleural drainage. Which finding supports this? a. Improved breath sounds b. Sudden dyspnea, hypoxia, tachypnea c. Decreased O₂ requirement d. Clear chest x-ray

B