NCLEX Medical-Surgical: Respiratory Conditions 3

Question 1

A nurse cares for a client with a chest tube. The water-seal chamber shows continuous bubbling. What does this indicate?

Accepted Answer

An air leak in the system

Answer

Continuous bubbling in the water-seal chamber suggests an air leak that must be located and corrected.

Question 2

If a chest tube becomes disconnected from the drainage system, what is the priority action?

Accepted Answer

Submerge the end of the tube in sterile water

Answer

Placing the tube end in sterile water re-establishes a water seal and prevents air from entering the pleural space.

Question 3

Which clinical sign suggests a tension pneumothorax?

Accepted Answer

Tracheal deviation away from the affected side

Answer

Increasing intrathoracic pressure pushes mediastinal structures, deviating the trachea toward the unaffected side.

Question 4

A client develops sudden sharp chest pain and dyspnea after a deep-vein thrombosis. What is the nurse's first suspicion?

Accepted Answer

Pulmonary embolism

Answer

A dislodged DVT clot traveling to the lung causes sudden pleuritic pain and dyspnea, classic for pulmonary embolism.

Question 5

Which position best promotes lung expansion in a client with respiratory distress?

Accepted Answer

High-Fowler's position

Answer

High-Fowler's allows maximum diaphragm descent and chest expansion, easing the work of breathing.

NCLEX Practice Test