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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 C

Explanation

A. Compartment syndrome is a complication of fractures, particularly when swelling within a closed muscle compartment compromises circulation. However, it typically presents with severe localized pain, paresthesia, pallor, and pulselessness, not systemic symptoms like shortness of breath and chest pain.

B. Hypovolemic shock can occur due to significant blood loss from fractures, but it is characterized by hypotension, tachycardia, and altered mental status rather than chest pain and shortness of breath.

C. Fat embolism syndrome (FES) is a serious complication of long bone fractures. Fat globules from the bone marrow can enter the bloodstream and lodge in the lungs, causing respiratory distress, chest pain, hypoxemia, and sometimes a petechial rash. The timing (24 hours post-injury) and symptoms suggest FES.

D. Venous thromboembolism (VTE) can cause similar symptoms, but it typically develops later than 24 hours post-injury and is less common immediately after fractures compared to FES.

A. Presence of tidal fluctuation in the water seal chamber B. Continuous bubbling in the suction control chamber C. Chest tube eyelets not visible D. Development of subcutaneous emphysema

Correct Answer is D

Explanation

A. Tidal fluctuation in the water seal chamber is an expected finding in a chest tube drainage system. It indicates that the pleural space is still connected to the atmosphere, and the lungs are expanding and contracting normally.

B. Continuous bubbling in the suction control chamber is normal when the chest tube is connected to suction. This shows that the suction system is functioning properly.

C. Chest tube eyelets not being visible is expected when the chest tube is properly positioned inside the pleural space. This finding does not require immediate notification.

D. Development of subcutaneous emphysema (air trapped under the skin) may indicate an air leak or improper chest tube placement. This finding requires immediate notification of the provider to address the underlying cause and prevent complications.

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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

A nurse is caring for a client who has multiple long bone fractures caused by a motor-vehicle crash that happened 24 hr ago. The client tells the nurse he is short of breath and experiencing chest pain. The nurse should assess the client further for which of the following potential complications?

Correct Answer is C

Explanation

A nurse is assessing a client who is 1 day postoperative following a lobectomy and has a chest tube drainage system in place. Which of the following findings by the nurse indicates a need for immediate notification?

Correct Answer is D

Explanation

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A nurse is caring for a client who has asthma and is taking Beclomethasone. The nurse should monitor the client for which of the following adverse effects?

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