-2027 Actual Complete Real Exam Questions
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A patient with a dry suction chest tube reports pain and
tightness in the chest.
What should the nurse
do first?
A. Administer prescribed pain medication
B. Change the suction settings
C. Assess the chest tube for proper placement
D. Notify the healthcare provider immediately - ANSWER -
Correct Answer: C
Rationale: Assessing the chest tube placement is essential to
rule out potential complications before administering
medication.
When caring for a patient with a water seal chest tube, the nurse
observes that
the fluid level in the water seal chamber is fluctuating with
respiration. What
does this finding
indicate?
,A. The chest tube is obstructed
B. The drainage system needs to be changed
C. The chest tube is functioning properly
D. The patient has developed an infection - ANSWER -Correct
Answer: C
Rationale: Fluctuation in the water seal chamber is a normal
finding and indicates that the chest tube is functioning properly
and draining air or fluid.
A patient with a chest tube has a sudden increase in
drainage output. What
should the nurse assess
for first?
A. Patient comfort level
B. Signs of a potential hemorrhage
C. The patency of the chest tube
D. The type of chest tube system in use - ANSWER -Correct
Answer: B Rationale: A sudden increase in drainage may
indicate a hemorrhage, so assessing for signs of bleeding is
a priority.
After a chest tube insertion, which of the following is a priority
nursing action?
A. Teach the patient deep breathing exercises
B. Document the procedure and patient's response
C. Assess vital signs every 2 hours
,D. Monitor for signs of respiratory distress - ANSWER -Correct
Answer: D
Rationale: Monitoring for respiratory distress is crucial after
chest tube insertion to ensure the patient's airway and
breathing are stable.
What is the primary nursing responsibility when caring for a
patient with a chest
tube?
A. Monitor respiratory status and chest tube function
B. Ensure the patient is sitting upright at all times
C. Change the chest tube dressing every 24 hours
D. Administer prescribed medications on schedule - ANSWER -
Correct Answer:
A
Rationale: Monitoring respiratory status and chest tube
function is essential to detect any complications early.
When assessing a chest tube, the nurse notes that the
drainage is cloudy and
has a foul odor. What action should the nurse
take first?
A. Document the findings
B. Notify the healthcare provider
C. Change the drainage system
D. Encourage the patient to cough and deep breathe - ANSWER
-Correct Answer: B
, Rationale: Cloudy drainage with a foul odor may indicate an
infection, requiring immediate communication with the
healthcare provider.
Which position is best for a patient with a chest tube to
promote optimal
drainage?
A. Supine
B. Prone
C. Semi-Fowler's or Fowler's position
D. Lateral position with the affected side down - ANSWER -
Correct Answer: C Rationale: Semi-Fowler's or Fowler's
position promotes optimal lung expansion and facilitates
drainage from the chest tube.
What is the nurse's priority action if the chest tube becomes
disconnected from
the drainage
system?
A. Place the end of the chest tube in a container of
sterile water
B. Clamp the chest tube
immediately
C. Notify the healthcare
provider
D. Clean the end of the chest tube with antiseptic - ANSWER -
Correct Answer: