A nurse in the recovery room is assessing a client who has a new chest tube. The nurse finds that the water seal is no longer tidaling. The nurse should identify the finding as resulting from which of the following?
An air leak noted at the insertion site.
The tubing may be kinked.
Water needs to be added to the suction-control chamber.
The suction is set too low.
The Correct Answer is B
A. An air leak noted at the insertion site would result in continuous bubbling in the water seal chamber, not the absence of tidaling.
B. If the tubing is kinked or obstructed, it can prevent the movement of air in and out of the water seal chamber, leading to the absence of tidaling.
C. If water needs to be added to the suction-control chamber, this would affect the level of suction, not the tidaling in the water seal chamber.
D. If the suction is set too low, it would not necessarily affect the tidaling in the water seal chamber; instead, it would result in inadequate drainage or lack of suction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A.
A. A BMI of 20 falls within the healthy weight range for adults.
B. Malnutrition is characterized by a BMI below the healthy weight range and is typically associated with BMI values less than 18.5.
C. Overweight is characterized by a BMI between 25 and 29.9.
D. Obesity is characterized by a BMI of 30 or higher.
Correct Answer is D
Explanation
A. Routine activities such as daily baths are not typically pertinent information to include in a change-of-shift report unless they have a significant impact on the client's condition or care.
B. While vomiting after surgery may be noteworthy, the timing and amount of emesis
immediately after surgery may not be relevant to the client's current condition, especially if it was an isolated incident.
C. Flushing the IV with normal saline is a routine nursing intervention and may not be necessary to report unless there were specific concerns or complications related to the IV.
D. Pain relief is an important aspect of postoperative care and should be included in the report to ensure continuity of care and appropriate pain management for the client.
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