A nurse is caring for a client who has a chest tube in place to a closed chest drainage system. Which of the following findings should indicate to the nurse that the client’s lung has expanded?

The correct answer is A. Moderate.

Choice A: Moderate

A moderate traumatic brain injury (TBI) is characterized by a loss of consciousness (LOC) lasting between 30 minutes and 6 hours. In this scenario, the client lost consciousness for 45 minutes, which falls within this range. Moderate TBIs often result in more significant symptoms and may require more intensive medical intervention compared to mild TBIs.

Choice B: Severe

Severe TBIs are typically defined by a loss of consciousness lasting more than 6 hours. Since the client in this case was unconscious for only 45 minutes, this classification does not apply. Severe TBIs often involve extensive brain damage and can lead to long-term complications or disabilities.

Choice C: Mild

Mild TBIs, also known as concussions, are characterized by a loss of consciousness lasting less than 30 minutes. Given that the client was unconscious for 45 minutes, this classification is not appropriate. Mild TBIs usually result in temporary symptoms that resolve with minimal medical intervention.

Choice D: No traumatic brain injury

This option is incorrect because the client experienced a significant head injury with a loss of consciousness for 45 minutes. Such an event clearly indicates a traumatic brain injury, and it is essential to classify it correctly to ensure appropriate medical care.

Choice A reason: Justice. This answer is incorrect because justice is the ethical principle that ensures fair and equal treatment for all clients, regardless of their personal or social characteristics. Justice does not apply to this situation, as the client is not being discriminated against or denied any resources.

Choice B reason: Veracity. This answer is incorrect because veracity is the ethical principle that requires honesty and truthfulness from the provider and the nurse in providing information and education to the client. Veracity does not apply to this situation, as the client is not being deceived or misled about their condition or treatment options.

Choice C reason: Fidelity. This answer is incorrect because fidelity is the ethical principle that obligates the provider and the nurse to be faithful and loyal to the client and to honor their commitments and promises. Fidelity does not apply to this situation, as the client is not being abandoned or betrayed by the provider or the nurse.

Choice D reason: Autonomy. This answer is correct because autonomy is the ethical principle that respects the client's right to make their own decisions about their health care, even if they are different from the provider's or the nurse's recommendations. Autonomy applies to this situation, as the client is expressing their preference to discontinue the ventilator, which is a life sustaining treatment.