For a patient with a pneumothorax, where does the nurse anticipate that the chest tube will be located?

Mediastinal area

Fifth to sixth intercostal space, lateral

Second to third intercostal space, anterior

Fifth to sixth intercostal space, posterior

Answer and Explanation

The Correct Answer is C

Rationale:

A. The mediastinum contains critical structures such as the heart, great vessels, esophagus, and trachea. Placing a chest tube here is unsafe and not standard practice for a pneumothorax.

B. The lateral lower chest is typically used for draining pleural effusions or hemothorax, because fluid collects in the dependent (gravity-dependent) part of the pleural cavity, not air.

C. Air rises in the pleural cavity due to gravity. For a pneumothorax, the chest tube is placed high in the anterior chest, usually at the 2nd or 3rd intercostal space along the midclavicular line, allowing effective evacuation of air and re-expansion of the lung. This placement is critical for preventing tension pneumothorax and improving oxygenation.

D. This location is ideal for draining fluid rather than air. Blood or pleural effusion collects posteriorly and inferiorly when the patient is upright, so chest tubes in this location are used for fluid removal, not air evacuation.

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Correct Answer is D

Explanation

Rationale:
A. Chronic stable angina is incorrect because PCI may be considered for symptom relief in stable angina, but it is not the primary or emergent indication. Stable angina is usually managed first with lifestyle changes, medications (such as nitrates, beta-blockers, and calcium channel blockers), and risk factor modification.

B. Left main coronary artery disease is incorrect as a primary indication because significant left main disease often requires coronary artery bypass grafting (CABG) rather than PCI due to high risk of major adverse cardiac events. PCI may be used in select cases, but it is not the standard primary indication.

C. Unstable angina is partially correct because PCI can be performed in patients with unstable angina who have high-risk features; however, it is still not the primary emergent indication. Management may involve medications and risk stratification before intervention.

D. Acute myocardial infarction (MI) is correct because PCI is the first-line, time-sensitive intervention for patients experiencing an acute MI, especially STEMI (ST-elevation myocardial infarction). PCI restores blood flow to the occluded coronary artery, limits myocardial damage, reduces complications, and improves survival. Timely PCI is often referred to as “door-to-balloon” treatment and is the standard of care in acute coronary syndromes.

A. Intermittent mandatory ventilation B. Controlled ventilation C. Positive end-expiratory pressure D. Assist/control ventilation

Correct Answer is A

Explanation

Rationale:
A. Intermittent mandatory ventilation (IMV) is correct because IMV delivers a preset number of mandatory breaths per minute while allowing the patient to breathe spontaneously in between these breaths. The patient controls the rate and tidal volume of the spontaneous breaths, which helps maintain respiratory muscle function and promotes weaning from mechanical ventilation.

B. Controlled ventilation is incorrect because in this mode, the ventilator delivers all breaths at a preset rate and tidal volume, regardless of the patient’s own respiratory efforts. The patient cannot trigger spontaneous breaths, making it less suitable for patients who can breathe partially on their own.

C. Positive end-expiratory pressure (PEEP) is incorrect because PEEP is not a mode of ventilation; it is a ventilator setting that maintains positive pressure in the lungs at the end of exhalation. PEEP helps improve oxygenation but does not determine the mode or rate of breaths.

D. Assist/control ventilation (A/C) is incorrect because in A/C mode, the ventilator delivers a preset tidal volume with every patient-initiated breath, and also provides mandatory breaths at a set rate if the patient does not initiate them. While it allows some patient-initiated breaths, the tidal volume is controlled by the ventilator, not the patient’s spontaneous effort as in IMV.

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For a patient with a pneumothorax, where does the nurse anticipate that the chest tube will be located?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

What is the primary indication for Percutaneous Coronary Intervention (PCI)?

Correct Answer is D

Explanation

The nurse has a patient on mechanical ventilation and the pulmonologist wants the patient to receive 10 breaths/min from the ventilator but wants to encourage the patient to breathe spontaneously in between the mechanical breaths at his own tidal volume. What is this mode of ventilation called?

Correct Answer is A

Explanation

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