Chest Tube Practice PDF

Chest Tube Practice: **1. What is the purpose of a chest tube?** - A. To deliver medication into the pleural space - B. To remove air or fluid from the pleural space and restore negative pressure - C. To prevent infection in the pleural cavity - D. To increase positive pressure in t...

Chest Tube Practice: **1. What is the purpose of a chest tube?** - A. To deliver medication into the pleural space - B. To remove air or fluid from the pleural space and restore negative pressure - C. To prevent infection in the pleural cavity - D. To increase positive pressure in the lungs **Correct Answer:** B\ **Rationale:** A chest tube is used to remove air, blood, or fluid from the pleural space to restore negative pressure and re-expand the lung​​. **2. Which condition is a common indication for chest tube placement?** - A. Asthma - B. Pneumothorax - C. COPD exacerbation - D. Pulmonary embolism **Correct Answer:** B\ **Rationale:** A pneumothorax involves air in the pleural space, requiring a chest tube to remove it and restore normal lung function​. **3. Where is the chest tube typically inserted to remove air?** - A. Mid-axillary, 7th intercostal space - B. Mid-clavicular, 2nd intercostal space - C. Sternal border, 4th intercostal space - D. Mid-clavicular, 10th intercostal space **Correct Answer:** B\ **Rationale:** For air removal, the chest tube is placed at the mid-clavicular line, 2nd intercostal space, near the lung apex​. **4. What is the expected finding in the water seal chamber of a functioning chest tube?** - A. Continuous bubbling - B. No fluid fluctuation - C. Intermittent bubbling - D. The chamber should be empty **Correct Answer:** C\ **Rationale:** Intermittent bubbling indicates the system is removing air from the pleural space. Continuous bubbling may indicate an air leak​. **5. What should the nurse do if the chest tube is accidentally dislodged?** - A. Reinsert the tube immediately - B. Apply Vaseline gauze taped on three sides - C. Clamp the tube and notify the physician - D. Place the patient in a prone position **Correct Answer:** B\ **Rationale:** Taping three sides prevents a tension pneumothorax by allowing air to escape during exhalation while preventing air entry during inhalation​​. **6. Which type of chest tube system uses water to regulate suction pressure?** - A. Dry suction system - B. Water seal system - C. Closed drainage system - D. Continuous pressure system **Correct Answer:** B\ **Rationale:** Wet suction systems regulate suction pressure using the height of the water column in the suction control chamber​. **7. When monitoring a chest tube, what observation indicates a need for intervention?** - A. Gentle tidaling in the water seal chamber - B. Sudden increase in bright red drainage - C. No bubbling in the suction control chamber - D. Decrease in drainage over time **Correct Answer:** B\ **Rationale:** A sudden increase in bright red drainage may indicate active bleeding and requires immediate intervention​. **8. What is the priority nursing action if the chest tube becomes disconnected from the drainage system?** - A. Clamp the chest tube - B. Submerge the distal end in sterile water - C. Reconnect it to the drainage system - D. Apply an occlusive dressing **Correct Answer:** B\ **Rationale:** Submerging the distal end in sterile water creates a temporary water seal, preventing air from entering the pleural space​​. **9. What is the purpose of the Vaseline gauze dressing after chest tube removal?** - A. Prevent infection at the site - B. Seal the site and prevent air entry - C. Reduce scarring at the site - D. Improve patient comfort **Correct Answer:** B\ **Rationale:** Vaseline gauze creates an airtight seal to prevent air from re-entering the pleural space​. **10. Which finding in the water seal chamber suggests an air leak?** - A. Gentle tidaling with respiration - B. Intermittent bubbling - C. Continuous bubbling - D. Absence of bubbling **Correct Answer:** C\ **Rationale:** Continuous bubbling in the water seal chamber indicates an air leak in the system​. **11. What is a priority assessment after chest tube insertion?** - A. Checking for lung sounds and respiratory effort - B. Monitoring bowel sounds - C. Checking capillary refill time - D. Assessing for pedal edema **Correct Answer:** A\ **Rationale:** Post-insertion assessments focus on lung re-expansion and respiratory status​. **12. What should the nurse teach a patient before chest tube removal?** - A. \"You may need to hold your breath during removal.\" - B. \"We will place you in the prone position.\" - C. \"No dressing is needed after removal.\" - D. \"You can resume heavy lifting immediately after removal.\" **Correct Answer:** A\ **Rationale:** During removal, the patient may be instructed to hold their breath (Valsalva maneuver) to prevent air entry into the pleural space​. **13. How should the chest tube drainage system be positioned?** - A. Above the level of the chest - B. Below the level of the chest - C. At the level of the chest - D. Lying flat on the floor **Correct Answer:** B\ **Rationale:** The system must remain below the chest to prevent backflow of drainage into the pleural cavity​. **14. Which finding indicates the chest tube is ready for removal?** - A. Continuous bubbling in the water seal chamber - B. Absence of drainage for 2 hours - C. Symmetrical chest expansion and clear lung sounds - D. Persistent respiratory distress **Correct Answer:** C\ **Rationale:** Symmetrical chest expansion and clear lung sounds suggest the lung has re-expanded​​. **15. Which is a potential complication of chest tube placement?** - A. Subcutaneous emphysema - B. Hypoglycemia - C. Dehydration - D. Pleural effusion **Correct Answer:** A\ **Rationale:** Air can leak into subcutaneous tissue, causing swelling and crepitus​. **16. What is the purpose of tidaling in the water seal chamber?** - A. Indicates an air leak - B. Reflects changes in intrapleural pressure - C. Suggests a blocked chest tube - D. Indicates lung re-expansion **Correct Answer:** B\ **Rationale:** Tidaling reflects normal intrapleural pressure changes during breathing​. **17. What is the primary nursing goal for a patient with a chest tube?** - A. Prevent infection and promote lung re-expansion - B. Increase fluid intake - C. Prevent ambulation - D. Monitor only oxygen saturation **Correct Answer:** A\ **Rationale:** The goal is to prevent infection and ensure the lung re-expands​. **18. What should the nurse do if continuous bubbling is observed in the water seal chamber of a chest drainage system?** - A. Increase the suction pressure - B. Notify the healthcare provider immediately - C. Check for air leaks in the system - D. Clamp the chest tube near the insertion site **Correct Answer:** C\ **Rationale:** Continuous bubbling indicates an air leak in the system, requiring the nurse to identify and address the source of the leak​​. **19. Which statement indicates that a patient understands the discharge instructions after chest tube removal?** - A. \"I can shower immediately without covering the site.\" - B. \"I should call my doctor if I experience shortness of breath.\" - C. \"I can resume vigorous exercise the next day.\" - D. \"The dressing should only be changed weekly.\" **Correct Answer:** B\ **Rationale:** Shortness of breath may indicate a complication, such as re-accumulation of air or fluid in the pleural space​. **20. When should a nurse suspect subcutaneous emphysema in a patient with a chest tube?** - A. When crepitus is felt under the skin around the tube insertion site - B. When there is sudden cessation of drainage - C. When the patient reports sharp chest pain - D. When the water seal chamber shows tidaling **Correct Answer:** A\ **Rationale:** Subcutaneous emphysema occurs when air leaks into the tissue, presenting as swelling and a crackling sensation (crepitus) on palpation​. **21. What is the correct method for clamping a chest tube?** - A. Clamp the chest tube continuously to prevent drainage - B. Clamp the chest tube momentarily when changing the drainage system - C. Clamp the chest tube for at least 30 minutes before removal - D. Never clamp the chest tube under any circumstance **Correct Answer:** B\ **Rationale:** Clamping is only done momentarily, such as when changing the collection system, to prevent complications like tension pneumothorax​. **22. What is the priority nursing intervention if the chest tube drainage system tips over?** - A. Replace the drainage system immediately - B. Call the healthcare provider - C. Check for proper function and water seal integrity - D. Secure the chest tube with an occlusive dressing **Correct Answer:** C\ **Rationale:** Ensuring that the water seal chamber is intact and properly functioning is critical to maintaining the chest tube system\'s effectiveness​. **23. What is the expected outcome of chest tube therapy for a hemothorax?** - A. The tube remains in place indefinitely - B. All drainage stops within the first hour - C. Decrease in respiratory distress and absence of fluid on imaging - D. Continuous bubbling in the water seal chamber **Correct Answer:** C\ **Rationale:** The goal of chest tube therapy is to alleviate symptoms, re-expand the lung, and remove blood or fluid​. **24. Which of the following requires immediate intervention for a patient with a chest tube?** - A. Gentle tidaling in the water seal chamber - B. Sudden cessation of drainage - C. Decreased respiratory rate - D. Patient requesting pain medication **Correct Answer:** B\ **Rationale:** Sudden cessation of drainage may indicate a blockage or other complication requiring immediate attention​. **25. What equipment should always be available at the bedside for a patient with a chest tube?** - A. Ventilator and suction catheter - B. Vaseline gauze, sterile water, padded hemostats - C. Intravenous fluids and arterial blood gas kit - D. Endotracheal tube and laryngoscope **Correct Answer:** B\ **Rationale:** Emergency equipment like Vaseline gauze, sterile water, and hemostats are essential for managing dislodgement or disconnection of the chest tube​. **26. A patient with a chest tube reports increased pain during deep breathing. What is the nurse's best response?** - A. \"This is normal and does not require any intervention.\" - B. \"Let me assess the tube placement and your pain level.\" - C. \"Avoid deep breathing until the pain subsides.\" - D. \"I will reduce the suction pressure.\" **Correct Answer:** B\ **Rationale:** Increased pain could indicate complications like subcutaneous emphysema or tube misplacement, requiring further assessment​​. **27. What should the nurse do if tidaling is absent in the water seal chamber?** - A. Document this as a normal finding - B. Assess for lung re-expansion or a blocked tube - C. Increase the suction pressure - D. Clamp the tube to restore tidaling **Correct Answer:** B\ **Rationale:** Absence of tidaling may indicate lung re-expansion or an obstruction in the tubing, which requires investigation​. **28. A nurse is assisting with chest tube placement. What position is most appropriate for the patient?** - A. Supine with the head of the bed elevated - B. Sitting upright or lying on the unaffected side - C. Prone with the head turned to one side - D. Flat on the back with arms at the sides **Correct Answer:** B\ **Rationale:** Sitting upright or lying on the unaffected side provides optimal access for chest tube placement​​. **29. When is it appropriate to transition a patient from suction to a water seal?** - A. When the patient is hemodynamically unstable - B. When drainage is continuous and heavy - C. When lung re-expansion is nearly complete - D. When bubbling in the water seal chamber stops **Correct Answer:** C\ **Rationale:** Transitioning to a water seal is typically done when the lung is almost fully re-expanded and fluid drainage has slowed​​. **30. What action should a nurse take before assisting in chest tube removal?** - A. Position the patient in high Fowler\'s position - B. Pre-medicate the patient for pain - C. Clamp the chest tube for 24 hours before removal - D. Ensure the patient fasts for 8 hours **Correct Answer:** B\ **Rationale:** Pre-medicating the patient reduces pain and anxiety during chest tube removal​.