NURS 480: PROFESSIONAL NURSING LEADERSHIP EXАМ 1 2026/2027
100% VERIFIED QUESTIONS & ANSWERS | LATEST NURSING CORE
CURRICULUM
Which action should the nurse take first when a patient complains of acute chest
pain and dyspnea soon after insertion of a centrally inserted IV catheter?
a. Notify the health care provider.
b. Offer reassurance to the patient.
c. Auscultate the patients breath sounds.
d. Give the prescribed PRN morphine sulfate IV.
ANSWER: C
The initial action should be to assess the patient further because the history and
symptoms are consistent with several possible complications of central line
insertion, including embolism and pneumothorax. The other actions may be
appropriate, but further assessment of the patient is needed before notifying the
health care provider, offering reassurance, or administration of morphine
The nurse palpates the posterior chest while the patient says 99 and notes absent
fremitus. Which action should the nurse take next?
a. Palpate the anterior chest and observe for barrel chest.
b. Encourage the patient to turn, cough, and deep breathe.
c. Review the chest x-ray report for evidence of pneumonia.
d. Auscultate anterior and posterior breath sounds bilaterally.
,ANSWER: D
To assess for tactile fremitus, the nurse should use the palms of the hands to
assess for vibration when the patient repeatsaword or phrase such as 99. After
noting absent fremitus, the nurse should then auscultate the lungs to assess for
the presence or absence of breath sounds. Absent fremitus may be noted with
pneumothorax or atelectasis. The vibration is increased in conditions such as
pneumonia, lung tumors, thick bronchial secretions, and pleural effusion.
Turning, coughing, and deep breathing is an appropriate intervention for
atelectasis, but the nurse needs to first assess breath sounds. Fremitus is
decreased if the hand is farther from the lung or the lung is hyperinflated (barrel
chest).The anterior of the chest is more difficult to palpate for fremitus because
of the presence of large muscles and breast tissue.
The nurse monitors a patient after chest tube placement for a
hemopneumothorax. The nurse is most concerned if which assessment finding
is observed?
a. A large air leak in the water-seal chamber
b. 400 mL of blood in the collection chamber
c. Complaint of pain with each deep inspiration
d. Subcutaneous emphysema at the insertion site
ANSWER: B
The large amount of blood may indicate that the patient is in danger of
developing hypovolemic shock. An air leak would be expected immediately
after chest tube placement for a pneumothorax. Initially, brisk bubbling of air
occurs in this chamber when a pneumothorax is evacuated. The pain should be
treated but is not as urgent a concern as the possibility of continued hemorrhage.
Subcutaneous emphysema should be monitored but is not unusual in a patient
with pneumothorax. A small amount of subcutaneous air is harmless and will be
reabsorbed.
, A patient who has a right-sided chest tube following a thoracotomy has
continuous bubbling in the suction-control chamber of the collection device.
Which action by the nurse is most appropriate?
a. Document the presence of a large air leak.
b. Notify the surgeon of a possible pneumothorax.
c. Take no further action with the collection device.
d. Adjust the dial on the wall regulator to decrease suction.
ANSWER: C
Continuous bubbling is expected in the suction-control chamber and indicates
that the suction-control chamber is connected to suction. An air leak would be
detected in the water-seal chamber. There is no evidence of pneumothorax.
Increasing or decreasing the vacuum source will not adjust the suction pressure.
The amount of suction applied is regulated by the amount of water in this
chamber and not by the amount of suction applied to the system.
The nurse cares for a patient who has just had a thoracentesis. Which
assessment information obtained by the nurse is a priority to communicate to
the health care provider?
a. Oxygen saturation is 88%.
b. Blood pressure is 145/90 mm Hg.
c. Respiratory rate is 22 breaths/minute when lying flat.
d. Pain level is 5 (on 0 to 10 scale) with a deep breath.
ANSWER: A
Oxygen saturation would be expected to improve after a thoracentesis. A
saturation of 88% indicates that a complication such as pneumothorax may be
100% VERIFIED QUESTIONS & ANSWERS | LATEST NURSING CORE
CURRICULUM
Which action should the nurse take first when a patient complains of acute chest
pain and dyspnea soon after insertion of a centrally inserted IV catheter?
a. Notify the health care provider.
b. Offer reassurance to the patient.
c. Auscultate the patients breath sounds.
d. Give the prescribed PRN morphine sulfate IV.
ANSWER: C
The initial action should be to assess the patient further because the history and
symptoms are consistent with several possible complications of central line
insertion, including embolism and pneumothorax. The other actions may be
appropriate, but further assessment of the patient is needed before notifying the
health care provider, offering reassurance, or administration of morphine
The nurse palpates the posterior chest while the patient says 99 and notes absent
fremitus. Which action should the nurse take next?
a. Palpate the anterior chest and observe for barrel chest.
b. Encourage the patient to turn, cough, and deep breathe.
c. Review the chest x-ray report for evidence of pneumonia.
d. Auscultate anterior and posterior breath sounds bilaterally.
,ANSWER: D
To assess for tactile fremitus, the nurse should use the palms of the hands to
assess for vibration when the patient repeatsaword or phrase such as 99. After
noting absent fremitus, the nurse should then auscultate the lungs to assess for
the presence or absence of breath sounds. Absent fremitus may be noted with
pneumothorax or atelectasis. The vibration is increased in conditions such as
pneumonia, lung tumors, thick bronchial secretions, and pleural effusion.
Turning, coughing, and deep breathing is an appropriate intervention for
atelectasis, but the nurse needs to first assess breath sounds. Fremitus is
decreased if the hand is farther from the lung or the lung is hyperinflated (barrel
chest).The anterior of the chest is more difficult to palpate for fremitus because
of the presence of large muscles and breast tissue.
The nurse monitors a patient after chest tube placement for a
hemopneumothorax. The nurse is most concerned if which assessment finding
is observed?
a. A large air leak in the water-seal chamber
b. 400 mL of blood in the collection chamber
c. Complaint of pain with each deep inspiration
d. Subcutaneous emphysema at the insertion site
ANSWER: B
The large amount of blood may indicate that the patient is in danger of
developing hypovolemic shock. An air leak would be expected immediately
after chest tube placement for a pneumothorax. Initially, brisk bubbling of air
occurs in this chamber when a pneumothorax is evacuated. The pain should be
treated but is not as urgent a concern as the possibility of continued hemorrhage.
Subcutaneous emphysema should be monitored but is not unusual in a patient
with pneumothorax. A small amount of subcutaneous air is harmless and will be
reabsorbed.
, A patient who has a right-sided chest tube following a thoracotomy has
continuous bubbling in the suction-control chamber of the collection device.
Which action by the nurse is most appropriate?
a. Document the presence of a large air leak.
b. Notify the surgeon of a possible pneumothorax.
c. Take no further action with the collection device.
d. Adjust the dial on the wall regulator to decrease suction.
ANSWER: C
Continuous bubbling is expected in the suction-control chamber and indicates
that the suction-control chamber is connected to suction. An air leak would be
detected in the water-seal chamber. There is no evidence of pneumothorax.
Increasing or decreasing the vacuum source will not adjust the suction pressure.
The amount of suction applied is regulated by the amount of water in this
chamber and not by the amount of suction applied to the system.
The nurse cares for a patient who has just had a thoracentesis. Which
assessment information obtained by the nurse is a priority to communicate to
the health care provider?
a. Oxygen saturation is 88%.
b. Blood pressure is 145/90 mm Hg.
c. Respiratory rate is 22 breaths/minute when lying flat.
d. Pain level is 5 (on 0 to 10 scale) with a deep breath.
ANSWER: A
Oxygen saturation would be expected to improve after a thoracentesis. A
saturation of 88% indicates that a complication such as pneumothorax may be
