The nurse is caring for a postoperative client who has a chest tube connected to suction and a water seal drainage system. Which of the following indicates to the nurse that the chest tube is functioning properly?

Equal amount of ﬂuid drainage in each collection chamber

Fluctuation of the ﬂuid level within the water seal chamber

Continuous bubbling within the water seal chamber

Absence of ﬂuid in the drainage tubing

Answer and Explanation

The Correct Answer is B

Choice A Reason: Equal amount of ﬂuid drainage in each collection chamber is not a sign of proper chest tube function. The amount of ﬂuid drainage depends on the type and extent of the client's injury or surgery, and may vary from one chamber to another.

Choice B Reason: Fluctuation of the fluid level in the water seal chamber (tidaling) indicates that the chest tube is functioning properly. This fluctuation corresponds with the client's respirations and shows that air or fluid is being effectively removed from the pleural space.

Choice C Reason:Continuous bubbling within the water seal chamber: Continuous bubbling in the water seal chamber indicates an air leak, which is not normal unless the client has a pneumothorax and air is being evacuated. Otherwise, it suggests a problem with the system.

Choice D Reason: Absence of ﬂuid in the drainage tubing is not a sign of proper chest tube function. It may indicate that the chest tube is obstructed, kinked, or clamped, or that the suction is not working properly. The nurse should assess and troubleshoot the chest tube system.

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Correct Answer is D

Explanation

Choice A Reason: This is incorrect because dextrose 5% in 0.9% sodium chloride is a hypertonic solution that can cause ﬂuid overload and pulmonary edema in a client who has burns.

Choice B Reason: This is incorrect because dextrose 5% in water is a hypotonic solution that can cause ﬂuid shifts from the intravascular space to the interstitial space, resulting in hypovolemia and hypotension in a client who has burns.

Choice C Reason: This is incorrect because 0.9% sodium chloride is an isotonic solution that can cause hypernatremia and hyperchloremia in a client who has burns, as the ﬂuid loss from burns is greater than the sodium loss.

Choice D Reason: This is correct because lactated Ringer's is an isotonic solution that contains electrolytes similar to plasma, such as sodium, potassium, calcium, and chloride. It also contains lactate, which is converted to bicarbonate in the liver and helps correct the metabolic acidosis that occurs in a client who has burns.

Correct Answer is ["125"]

Explanation

Step 1: Determine the total time required to infuse 40 mEq at a rate of 10 mEq/hr.

40 mEq ÷ 10 mEq/hr = 4 hours

Result: 4 hours

Step 2: Determine the infusion rate in mL/hr.

500 mL ÷ 4 hours = 125 mL/hr

Result: 125 mL/hr

The nurse should set the IV pump to deliver 125 mL/hr.

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The nurse is caring for a postoperative client who has a chest tube connected to suction and a water seal drainage system. Which of the following indicates to the nurse that the chest tube is functioning properly?

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Naxlex Comprehensive Predictor Exams

A nurse is monitoring the ﬂuid replacement of a client who has sustained burns. The nurse should administer which of the following ﬂuids in the first 24 hr following a burn injury?

Correct Answer is D

Explanation

A nurse is preparing to administer 40 mEq of potassium chloride in 45% sodium chloride (NaCl) 500 mL IV to infuse 10 mEq/hr. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["125"]

Explanation

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