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A patient is admitted to the respiratory unit with flail chest. The nurse understands that a flail chest is:

A condition in which the ribs are fractured in multiple places, resulting in a segment of the chest wall that moves independently during respiration

A condition in which the chest wall is paralyzed, resulting in difficulty breathing

A condition in which the lungs are unable to fully expand, resulting in decreased oxygenation

A condition in which the diaphragm becomes weak, resulting in decreased lung expansion

Answer and Explanation

The Correct Answer is A

A. Flail chest occurs when multiple ribs are fractured in more than one location, creating a free-floating segment of the chest wall. This segment moves paradoxically during respiration, meaning it moves inward during inspiration and outward during expiration, which impairs effective breathing and oxygenation.

B. Paralysis of the chest wall may occur in conditions like spinal cord injuries but is not the defining characteristic of flail chest.

C. While decreased oxygenation can occur with flail chest due to impaired ventilation, the defining feature is the paradoxical movement of the fractured rib segment.

D. Weakness of the diaphragm can impair lung expansion, but this is characteristic of conditions like diaphragmatic paralysis, not flail chest.

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Correct Answer is ["31"]

Explanation

Convert liters to milliliters: 1 liter = 1000 mL
Calculate total infusion time in minutes: 8 hours 60 minutes/hour = 480 minutes
Apply the formula:
- (Total volume in mL Drop factor) / Total infusion time in minutes = Drops/minute
- (1000 mL 15 gtts/mL) / 480 minutes = 31.25 gtts/minute
Round to the nearest whole number: 31 gtts/minute

A. Crepitus in the area above and surrounding the insertion site. B. Eyelets are not visible. C. Bubbling of the water in the water seal chamber with exhalation. D. Movement of the trachea toward the unaffected side.

Correct Answer is D

Explanation

A. Crepitus, or subcutaneous emphysema, near the insertion site can occur due to air leaking into the subcutaneous tissue. While it should be monitored, it does not always require immediate provider notification unless it is extensive or worsening.

B. The absence of visible eyelets indicates the chest tube is properly positioned within the pleural space. This is an expected finding and does not require provider notification.

C. Bubbling of the water in the water seal chamber with exhalation is normal in a client with a pneumothorax. It indicates air is being evacuated from the pleural space.

D. Movement of the trachea toward the unaffected side is a sign of tension pneumothorax, a life-threatening complication. This finding requires immediate notification of the provider and emergency intervention to relieve the pressure in the pleural space.

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A patient is admitted to the respiratory unit with flail chest. The nurse understands that a flail chest is:

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Naxlex Comprehensive Predictor Exams

Correct Answer is ["31"]

Explanation

A nurse is assessing a client who has a pneumothorax with a chest tube in place. For which of the following findings should the nurse notify the provider?

Correct Answer is D

Explanation

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A patient is admitted to the respiratory unit with flail chest. The nurse understands that a flail chest is: