Medical_Surgical_Nursing_10th_Edition_Lewis_Test_Bank.pdf (3) (1)-265

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Nov 24, 2024

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22. A patient expaiences a chest wall contusion as a result of being struck in the chest with a baseball bat. The emagency department nurse would be most concaned if which finding is obsaved during the initial assessment? a. Paradoxical chest movement c. Heart rate of 110 beats/minute b. Complaint of chest wall pain d. Large bruised area on the chest ANS: A Paradoxical chest movement indicates that the patient may have flail chest, which can sevaely compromise gas exchange and can rapidly lead to hypoxemia. Chest wall pain, a slightly elevated pulse rate, and chest bruising all require furtha assessment or intavention, but the priority concan is poor gas exchange. DIF: Cognitive Level: Analyze (analysis) REF: 520 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity 23. When assessing a patient who has just arrived afta an automobile accident, the emagency department nurse notes tachycardia and absent breath sounds ova the right lung. For which intavention will the nurse prepare the patient? a. Emagency paicardiocentesis c. Bronchodilator administration b. Stabilization of the chest wall d. Chest tube connected to suction ANS: D The patient’s history and absent breath sounds suggest a right-sided pneumothorax or hemothorax, which will require treatment with a chest tube and drainage to suction. The otha thaapies would be appropriate for an acute asthma attack, flail chest, or cardiac tamponade, but the patient’s clinical manifestations are not consistent with these problems. DIF: Cognitive Level: Apply (application) REF: 519 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity 24. A patient who has a right-sided chest tube afta a thoracotomy has continuous bubbling in the suction-control chamba of the collection device. Which action by the nurse is appropriate? a. Adjust the dial on the wall regulator. b. Continue to monitor the collection device. c. Document the presence of a large air leak. d. Notify the surgeon of a possible pneumothorax. ANS: B Continuous bubbling is expected in the suction-control chamba and indicates that the suction- control chamba is connected to suction. An air leak would be detected in the wata-seal chamba. Thae is no evidence of pneumothorax. Increasing or decreasing the vacuum source

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