NUR 198 EXAM PRACTICE QUESTIONS WITH
VERIFIED SOLUTIONS | 2026 UPDATE
What is a normal amount of suction for a chest tube? What type of liquid should you use?
-20 sonimeters
-Sterile Water (NEVER NS)
Where should the collection system be placed?
Below the pt. or else the drainage could go back into the chest
Is air normal in a water seal chamber for a pneumothorax?
Yes, it will lessen as the pneumothorax is resolved
What could happen if there is an air leak? What will the patient exhibit?
Pt will not be able to take a deep breath
HR will increase
- due to air/fluid build-up
What should you do if there is an air leak and you can't find the the air leak in the system?
Take the dressing off, and make sure the tube is still in the chest, and get a chest x-ray. If you
take the dressing off and it is not in the right place you will feel subq emphysema.
What is tidaling for a pt with a chest tube? Why does it occur?
As pt takes a deep breath, the water in the seal chamber will rise, after they breathe out, it will go
down. It is a reflection of the pressure in the pleural space.
What should you do if a chest tube falls out?
,Cover with sterile dressing and tape 3 sides
Chest tube interventions
-drainage system upright and below chest level.
-incentive spirometry and deep breathing
-Never clamp the chest tube unless ordered (can cause tension pneumothorax).
-Monitor for subcutaneous emphysema (air under the skin – feels like “Rice Krispies”).
-Document drainage color, amount, and any changes.
-avoid lying on the affected side
What should you know about DNRs?
You cannot assume someone is DNR because they want to be. You have to have the legal,
signed document in place.
-If there is a disagreement between family members, reach out to charge nurse, nurse supervisor,
healthcare providers to figure it out
What is a thoracentesis?
surgical puncture to remove fluid from the pleural space
Fluid causes you to not breathe well.
Why would you do a thoracentesis over a chest tube?
,Ex1: If a pt has cancer in the chest cavity, fluid builds up for weeks/months in the pleural space,
it makes more sense just to drain it now and then, and prevents infection, and they don't have to
have a chest tube around all the time.
Ex2: If a pt has a bad case of pneumonia, and they have a lot of serous fluid from inflammation
so we just want to drain it.
How do you position a pt for a thoracentesis? Why?
Pt will be leaning forward over a table, with their hands on the table. It makes the space between
the ribs larger. We insert the needle as far down as we can cause fluid sits in the bottom.
-Use lidocaine to deaden the area, so it doesn't hurt. But the pressure is still uncomfortable, so
make sure to comfort them
What is the risk of a thoracentesis?
Puncturing the lung, causing an air leak, air will travel to the highest point. After the procedure
get an x-ray to see if this occurred.
-If so, keep them overnight and the small pneumothorax should've resolved by morning.
thoracentesis nursing considerations
- informed consent needed
- local anesthetic (pt. is awake during procedure)
- inform patient they will feel pressure when large-bore needle is inserted
- Will remove 1000-1200 mL of fluid at one time
- Monitor vitals, pulse ox, and observe for respiratory distress.
- post-procedure Chest xray
, - put pressure on insertion site post-procedure
- send fluid to lab
What is the number one sign of pulmonary edema?
Coughing up pink-tinged frothy sputum
What are expected orders for pulmonary edema?
-diuretics (Furosemide/Lasix)
-morphine (decreases air hunger, anxiety, pre-load, and after-load of the heart)
-vasodilators (nitro, minoxidil)
What position should you put a pt in that has pulmonary edema
HOB up
Pulmonary Edema manifestations/nursing care
Dyspnea
Tachypnea
Cough
Pink frothy sputum
Cyanosis
Crackles
Tachycardia
Hypoxemia
VERIFIED SOLUTIONS | 2026 UPDATE
What is a normal amount of suction for a chest tube? What type of liquid should you use?
-20 sonimeters
-Sterile Water (NEVER NS)
Where should the collection system be placed?
Below the pt. or else the drainage could go back into the chest
Is air normal in a water seal chamber for a pneumothorax?
Yes, it will lessen as the pneumothorax is resolved
What could happen if there is an air leak? What will the patient exhibit?
Pt will not be able to take a deep breath
HR will increase
- due to air/fluid build-up
What should you do if there is an air leak and you can't find the the air leak in the system?
Take the dressing off, and make sure the tube is still in the chest, and get a chest x-ray. If you
take the dressing off and it is not in the right place you will feel subq emphysema.
What is tidaling for a pt with a chest tube? Why does it occur?
As pt takes a deep breath, the water in the seal chamber will rise, after they breathe out, it will go
down. It is a reflection of the pressure in the pleural space.
What should you do if a chest tube falls out?
,Cover with sterile dressing and tape 3 sides
Chest tube interventions
-drainage system upright and below chest level.
-incentive spirometry and deep breathing
-Never clamp the chest tube unless ordered (can cause tension pneumothorax).
-Monitor for subcutaneous emphysema (air under the skin – feels like “Rice Krispies”).
-Document drainage color, amount, and any changes.
-avoid lying on the affected side
What should you know about DNRs?
You cannot assume someone is DNR because they want to be. You have to have the legal,
signed document in place.
-If there is a disagreement between family members, reach out to charge nurse, nurse supervisor,
healthcare providers to figure it out
What is a thoracentesis?
surgical puncture to remove fluid from the pleural space
Fluid causes you to not breathe well.
Why would you do a thoracentesis over a chest tube?
,Ex1: If a pt has cancer in the chest cavity, fluid builds up for weeks/months in the pleural space,
it makes more sense just to drain it now and then, and prevents infection, and they don't have to
have a chest tube around all the time.
Ex2: If a pt has a bad case of pneumonia, and they have a lot of serous fluid from inflammation
so we just want to drain it.
How do you position a pt for a thoracentesis? Why?
Pt will be leaning forward over a table, with their hands on the table. It makes the space between
the ribs larger. We insert the needle as far down as we can cause fluid sits in the bottom.
-Use lidocaine to deaden the area, so it doesn't hurt. But the pressure is still uncomfortable, so
make sure to comfort them
What is the risk of a thoracentesis?
Puncturing the lung, causing an air leak, air will travel to the highest point. After the procedure
get an x-ray to see if this occurred.
-If so, keep them overnight and the small pneumothorax should've resolved by morning.
thoracentesis nursing considerations
- informed consent needed
- local anesthetic (pt. is awake during procedure)
- inform patient they will feel pressure when large-bore needle is inserted
- Will remove 1000-1200 mL of fluid at one time
- Monitor vitals, pulse ox, and observe for respiratory distress.
- post-procedure Chest xray
, - put pressure on insertion site post-procedure
- send fluid to lab
What is the number one sign of pulmonary edema?
Coughing up pink-tinged frothy sputum
What are expected orders for pulmonary edema?
-diuretics (Furosemide/Lasix)
-morphine (decreases air hunger, anxiety, pre-load, and after-load of the heart)
-vasodilators (nitro, minoxidil)
What position should you put a pt in that has pulmonary edema
HOB up
Pulmonary Edema manifestations/nursing care
Dyspnea
Tachypnea
Cough
Pink frothy sputum
Cyanosis
Crackles
Tachycardia
Hypoxemia
