ATI MEDICAL SURGICAL RESPIRATORY
COMPREHENSIVE SCRIPT 2026 FULL
QUESTIONS CORRECT ANSWERS
◉ Respiratory Diagnostic and Therapeutic Procedures:
Thoracentesis - Intraprocedure. Answer: o Nursing actions
• Assist the provider with the procedure (strict surgical aseptic
technique).
• Prepare clients for a feeling of pressure with needle insertion and
fluid removal.
• Monitor the client's vital signs, skin color, and oxygen saturation
throughout the procedure.
• Measure and record the amount of fluid removed from the client's
chest.
• Label specimens at the bedside and promptly send them to the
laboratory.
o Note - The amount of fluid removed is limited to 1 L at a time to
prevent cardiovascular collapse.
◉ Respiratory Diagnostic and Therapeutic Procedures:
Thoracentesis - Postprocedure. Answer: o Nursing actions
• Apply a dressing over the puncture site and position clients on the
unaffected side for 1 hr.
,• Monitor the client's vital signs and respiratory status (respiratory
rate and rhythm, breath sounds, oxygenation status) hourly for the
first several hours after the Thoracentesis.
• Encourage clients to deep breathe to assist with lung expansion.
• Allow clients to resume normal activity after 1 hour if no signs of
complications are present.
• Obtain a Postprocedure chest x-ray (check resolution of effusions,
rule out pneumothorax).
• Document the procedure to include the client's response; volume
and character of fluid removed; and vital signs.
◉ Respiratory Diagnostic and Therapeutic Procedures:
Thoracentesis - Complications - Pneumothorax. Answer: •
Pneumothorax is a collapsed lung. It can occur due to injury to the
lung during the procedure.
• Nursing Actions
o Monitor clients for signs and symptoms of pneumothorax, such as
diminished breath sounds.
o Monitor Postprocedure chest x-ray results.
◉ Respiratory Diagnostic and Therapeutic Procedures:
Thoracentesis - Complications - Bleeding. Answer: • Bleeding can
occur if clients are moved during the procedure or are at an
increased risk for bleeding.
,◉ Respiratory Diagnostic and Therapeutic Procedures:
Thoracentesis - Complications - Bleeding - Nursing Actions. Answer:
o Monitor clients for coughing and/or hemoptysis.
o Monitor the client's vital signs and laboratory results for evidence
of bleeding (hypotension, reduced Hgb level).
◉ Respiratory Diagnostic and Therapeutic Procedures:
Thoracentesis - Complications - Infection. Answer: • Infection can
occur due to the introduction of bacteria with the needle puncture.
• Nursing Actions
o Insure that sterile technique is maintained.
o Monitor the client's temperature following the procedure
◉ Respiratory Diagnostic and Therapeutic Procedures: Chest Tube
Systems - Types of chest drainage systems:. Answer: o Single-
chamber systems have a water seal and a drainage collection in the
same chamber.
o Two chamber systems have a water seal and a drainage collection
in separate chambers, which allows for the collection of larger
amounts of drainage.
o Three chamber systems have a water seal, a drainage collection,
and suction control in separate chambers.
o Disposable chest tube drainage systems are now commonly used.
, ◉ Respiratory Diagnostic and Therapeutic Procedures: Chest Tube
Systems - Water Seals. Answer: Water seals are created by adding
sterile fluid to a chamber up to the 2 cm line. The water seal allows
air to exit from the pleural space on exhalation and stops air from
entering with inhalation.
.
◉ Respiratory Diagnostic and Therapeutic Procedures: Chest Tube
Systems - Water Seals Maintenance. Answer: o To maintain the
water seal, the chamber must be kept upright and below the chest
tube insertion site at all times. The nurse should routinely monitor
the water level due to the possibility of evaporation. The nurse
should add fluid as needed to maintain the 2 cm water seal level
o The height of the water in the suction control chamber determines
the amount of suction transmitted to the pleural space. A suction
pressure of -20 cm H2O is common. The application of suction
results in continuous bubbling in the suction chamber. The nurse
should monitor the fluid level and add fluid as needed to maintain
the prescribed level of suctioning.
◉ Respiratory Diagnostic and Therapeutic Procedures: Chest Tube
Systems - Water Seals Tidaling. Answer: o Tidaling (movement of the
water level with respiration) is expected in the water seal chamber.
With spontaneous respirations, the water level will rise with
inspiration
COMPREHENSIVE SCRIPT 2026 FULL
QUESTIONS CORRECT ANSWERS
◉ Respiratory Diagnostic and Therapeutic Procedures:
Thoracentesis - Intraprocedure. Answer: o Nursing actions
• Assist the provider with the procedure (strict surgical aseptic
technique).
• Prepare clients for a feeling of pressure with needle insertion and
fluid removal.
• Monitor the client's vital signs, skin color, and oxygen saturation
throughout the procedure.
• Measure and record the amount of fluid removed from the client's
chest.
• Label specimens at the bedside and promptly send them to the
laboratory.
o Note - The amount of fluid removed is limited to 1 L at a time to
prevent cardiovascular collapse.
◉ Respiratory Diagnostic and Therapeutic Procedures:
Thoracentesis - Postprocedure. Answer: o Nursing actions
• Apply a dressing over the puncture site and position clients on the
unaffected side for 1 hr.
,• Monitor the client's vital signs and respiratory status (respiratory
rate and rhythm, breath sounds, oxygenation status) hourly for the
first several hours after the Thoracentesis.
• Encourage clients to deep breathe to assist with lung expansion.
• Allow clients to resume normal activity after 1 hour if no signs of
complications are present.
• Obtain a Postprocedure chest x-ray (check resolution of effusions,
rule out pneumothorax).
• Document the procedure to include the client's response; volume
and character of fluid removed; and vital signs.
◉ Respiratory Diagnostic and Therapeutic Procedures:
Thoracentesis - Complications - Pneumothorax. Answer: •
Pneumothorax is a collapsed lung. It can occur due to injury to the
lung during the procedure.
• Nursing Actions
o Monitor clients for signs and symptoms of pneumothorax, such as
diminished breath sounds.
o Monitor Postprocedure chest x-ray results.
◉ Respiratory Diagnostic and Therapeutic Procedures:
Thoracentesis - Complications - Bleeding. Answer: • Bleeding can
occur if clients are moved during the procedure or are at an
increased risk for bleeding.
,◉ Respiratory Diagnostic and Therapeutic Procedures:
Thoracentesis - Complications - Bleeding - Nursing Actions. Answer:
o Monitor clients for coughing and/or hemoptysis.
o Monitor the client's vital signs and laboratory results for evidence
of bleeding (hypotension, reduced Hgb level).
◉ Respiratory Diagnostic and Therapeutic Procedures:
Thoracentesis - Complications - Infection. Answer: • Infection can
occur due to the introduction of bacteria with the needle puncture.
• Nursing Actions
o Insure that sterile technique is maintained.
o Monitor the client's temperature following the procedure
◉ Respiratory Diagnostic and Therapeutic Procedures: Chest Tube
Systems - Types of chest drainage systems:. Answer: o Single-
chamber systems have a water seal and a drainage collection in the
same chamber.
o Two chamber systems have a water seal and a drainage collection
in separate chambers, which allows for the collection of larger
amounts of drainage.
o Three chamber systems have a water seal, a drainage collection,
and suction control in separate chambers.
o Disposable chest tube drainage systems are now commonly used.
, ◉ Respiratory Diagnostic and Therapeutic Procedures: Chest Tube
Systems - Water Seals. Answer: Water seals are created by adding
sterile fluid to a chamber up to the 2 cm line. The water seal allows
air to exit from the pleural space on exhalation and stops air from
entering with inhalation.
.
◉ Respiratory Diagnostic and Therapeutic Procedures: Chest Tube
Systems - Water Seals Maintenance. Answer: o To maintain the
water seal, the chamber must be kept upright and below the chest
tube insertion site at all times. The nurse should routinely monitor
the water level due to the possibility of evaporation. The nurse
should add fluid as needed to maintain the 2 cm water seal level
o The height of the water in the suction control chamber determines
the amount of suction transmitted to the pleural space. A suction
pressure of -20 cm H2O is common. The application of suction
results in continuous bubbling in the suction chamber. The nurse
should monitor the fluid level and add fluid as needed to maintain
the prescribed level of suctioning.
◉ Respiratory Diagnostic and Therapeutic Procedures: Chest Tube
Systems - Water Seals Tidaling. Answer: o Tidaling (movement of the
water level with respiration) is expected in the water seal chamber.
With spontaneous respirations, the water level will rise with
inspiration
