a patient is experiencing continuous bubbling in the water seal chamber of a chest tube what does this indicate

ATI RN

ATI Capstone Adult Medical Surgical Assessment 2

1. What does continuous bubbling in the water seal chamber of a chest tube indicate?

A. An air leak
B. A blocked chest tube
C. Normal chest tube function
D. Continuous drainage from the chest tube

Correct answer: A

Rationale: Continuous bubbling in the water seal chamber of a chest tube indicates an air leak in the system. This occurs when air is entering the system through a leak, preventing the lung from fully re-expanding. Choice B, a blocked chest tube, is incorrect as a blocked tube would result in a lack of drainage rather than continuous bubbling. Choice C, normal chest tube function, is incorrect as continuous bubbling signifies an issue. Choice D, continuous drainage from the chest tube, is incorrect as bubbling in the water seal chamber specifically indicates an air leak, not just the presence of drainage.

2. What medication should be given first to a patient experiencing wheezing and coughing due to an allergic reaction?

A. Albuterol 3 ml via nebulizer
B. Cromolyn via nebulizer
C. Aminophylline IV
D. Methylprednisolone 100 mg IV

Correct answer: A

Rationale: The correct answer is Albuterol 3 ml via nebulizer. Albuterol is a bronchodilator that helps relieve wheezing and coughing by opening up the airways, making it the first-line treatment for allergic reactions presenting with these symptoms. Cromolyn and aminophylline are not typically used as first-line treatments for acute allergic reactions with wheezing and coughing. Methylprednisolone, a corticosteroid, may be beneficial for inflammation in the setting of an allergic reaction but is not the initial medication of choice to address wheezing and coughing.

3. A client has a Transient Ischemic Attack (TIA). What should the nurse teach?

A. Avoid eating within 3 hours of bedtime
B. Consume liquids between meals
C. Eat large meals to increase caloric intake
D. Avoid liquids to prevent aspiration

Correct answer: A

Rationale: The correct answer is A: Avoid eating within 3 hours of bedtime. For a client with a Transient Ischemic Attack (TIA), it is crucial to avoid eating within 3 hours of bedtime to reduce reflux that can worsen symptoms. Choice B is incorrect because consuming liquids between meals is not specifically related to managing TIA. Choice C is incorrect as eating large meals may not be recommended, especially if the client needs to watch their caloric intake. Choice D is incorrect because avoiding liquids entirely can lead to dehydration and is not a standard recommendation for TIA management.

4. What teaching should be provided to a patient following cataract surgery?

A. Avoid NSAIDs
B. Wear dark glasses outdoors
C. Creamy white drainage is normal
D. Avoid alcohol

Correct answer: A

Rationale: The correct teaching to provide to a patient following cataract surgery is to avoid NSAIDs. NSAIDs should be avoided post-cataract surgery to reduce the risk of bleeding. Choice B, wearing dark glasses outdoors, is important to protect the eyes from bright light but is not directly related to medication use. Choice C, stating that creamy white drainage is normal, is incorrect as drainage should be monitored for excessive redness, swelling, or pain. Choice D, avoiding alcohol, is not a direct post-cataract surgery teaching point related to medication use.

5. What should a healthcare provider monitor for in a patient with HIV and a CD4 T-cell count below 180 cells/mm3?

A. Monitor for signs of infection
B. Monitor for anemia
C. Monitor for dehydration
D. Monitor for bleeding

Correct answer: A

Rationale: A CD4 T-cell count below 180 cells/mm3 indicates severe immunocompromise in a patient with HIV. Monitoring for signs of infection is crucial because the patient is at high risk of developing opportunistic infections. Anemia (choice B), dehydration (choice C), and bleeding (choice D) are not directly associated with a low CD4 T-cell count in patients with HIV.