,NSG4100/NSG 4100 Exam 3 | Nursing Practice – Adult
Health III | Galen College | Q & A | 2026/2027 Edition
(PDF)
1. A nurse is caring for a client with an endotracheal tube. Which disadvantage of an endotracheal tube
should the nurse recognize?
A) Cognition is decreased
B) Daily ABGs are necessary
C) Slight tracheal bleeding is anticipated
D) The cough reflex is depressed
Correct Answer: The cough reflex is depressed
Rationale: Endotracheal tubes bypass the upper airway and glottis, which significantly depresses the
cough reflex. This impairs the client's ability to clear secretions, increasing the risk of pneumonia and
atelectasis.
2. A critical care nurse is assessing a client who may require a tracheotomy. Which condition would
indicate a client's need for a tracheotomy?
A) A respiratory rate of 10 breaths/min
B) A requirement for permanent ventilation
C) Exhibiting symptoms of dyspnea
D) Respiratory acidosis
Correct Answer: A requirement for permanent ventilation
Rationale: A tracheotomy is indicated when a client requires long-term or permanent mechanical
ventilation, or when an endotracheal tube cannot be used. It provides a more stable and comfortable
airway for prolonged ventilatory support.
,3. A nurse is preparing a client for a thoracotomy. What information should the nurse include in the
preoperative teaching?
A) How to milk the chest tubing
B) How to splint the incision when coughing
C) How to take prophylactic antibiotics correctly
D) How to manage the need for fluid restriction
Correct Answer: How to splint the incision when coughing
Rationale: Preoperative teaching for a thoracotomy should include how to splint the incision with a
pillow or hands during coughing. This reduces pain and tension on the suture line, making coughing
more effective for clearing secretions.
4. A client is scheduled for a procedure requiring a water-sealed chest drainage system. What is the
primary purpose of this system?
A) Maintaining a positive chest-wall pressure
B) Monitoring pleural fluid osmolarity
C) Providing passive intrathoracic pressure
D) Removing excess air and fluid
Correct Answer: Removing excess air and fluid
Rationale: A water-sealed chest drainage system is used to remove excess air (pneumothorax) and fluid
(hemothorax, pleural effusion) from the pleural space. This allows the lungs to re-expand and restores
negative intrapleural pressure.
5. A client exhibits signs of a pneumothorax following a tracheostomy. The surgeon inserts a chest tube
into the anterior chest wall. What is the primary purpose of this chest tube?
A) To remove air from the pleural space
B) To drain copious sputum secretions
C) To monitor bleeding around the lungs
, D) To assist with mechanical ventilation
Correct Answer: To remove air from the pleural space
Rationale: A chest tube inserted into the anterior chest wall is typically placed to evacuate air from the
pleural space in a client with a pneumothorax. This allows the lung to re-expand.
6. A client's plan of care includes postural drainage. What action should the nurse perform when
providing this therapy?
A) Administer the treatment with the client in a high-Fowler's or semi-Fowler's position
B) Perform the procedure immediately following the client's meals
C) Apply percussion firmly to bare skin to facilitate drainage
D) Assist the client into a position that allows gravity to move secretions
Correct Answer: Assist the client into a position that allows gravity to move secretions
Rationale: Postural drainage uses gravity to facilitate the drainage of secretions from different lung
segments. The client is positioned so that the affected lung segments are superior to the trachea,
allowing secretions to drain.
7. While assessing a client, the nurse observes constant bubbling in the water-seal chamber of the
closed chest-drainage system. What should the nurse conclude?
A) The system is functioning normally
B) The client has a pneumothorax
C) The system has a leak
D) The chest tube is obstructed
Correct Answer: The system has a leak
Health III | Galen College | Q & A | 2026/2027 Edition
(PDF)
1. A nurse is caring for a client with an endotracheal tube. Which disadvantage of an endotracheal tube
should the nurse recognize?
A) Cognition is decreased
B) Daily ABGs are necessary
C) Slight tracheal bleeding is anticipated
D) The cough reflex is depressed
Correct Answer: The cough reflex is depressed
Rationale: Endotracheal tubes bypass the upper airway and glottis, which significantly depresses the
cough reflex. This impairs the client's ability to clear secretions, increasing the risk of pneumonia and
atelectasis.
2. A critical care nurse is assessing a client who may require a tracheotomy. Which condition would
indicate a client's need for a tracheotomy?
A) A respiratory rate of 10 breaths/min
B) A requirement for permanent ventilation
C) Exhibiting symptoms of dyspnea
D) Respiratory acidosis
Correct Answer: A requirement for permanent ventilation
Rationale: A tracheotomy is indicated when a client requires long-term or permanent mechanical
ventilation, or when an endotracheal tube cannot be used. It provides a more stable and comfortable
airway for prolonged ventilatory support.
,3. A nurse is preparing a client for a thoracotomy. What information should the nurse include in the
preoperative teaching?
A) How to milk the chest tubing
B) How to splint the incision when coughing
C) How to take prophylactic antibiotics correctly
D) How to manage the need for fluid restriction
Correct Answer: How to splint the incision when coughing
Rationale: Preoperative teaching for a thoracotomy should include how to splint the incision with a
pillow or hands during coughing. This reduces pain and tension on the suture line, making coughing
more effective for clearing secretions.
4. A client is scheduled for a procedure requiring a water-sealed chest drainage system. What is the
primary purpose of this system?
A) Maintaining a positive chest-wall pressure
B) Monitoring pleural fluid osmolarity
C) Providing passive intrathoracic pressure
D) Removing excess air and fluid
Correct Answer: Removing excess air and fluid
Rationale: A water-sealed chest drainage system is used to remove excess air (pneumothorax) and fluid
(hemothorax, pleural effusion) from the pleural space. This allows the lungs to re-expand and restores
negative intrapleural pressure.
5. A client exhibits signs of a pneumothorax following a tracheostomy. The surgeon inserts a chest tube
into the anterior chest wall. What is the primary purpose of this chest tube?
A) To remove air from the pleural space
B) To drain copious sputum secretions
C) To monitor bleeding around the lungs
, D) To assist with mechanical ventilation
Correct Answer: To remove air from the pleural space
Rationale: A chest tube inserted into the anterior chest wall is typically placed to evacuate air from the
pleural space in a client with a pneumothorax. This allows the lung to re-expand.
6. A client's plan of care includes postural drainage. What action should the nurse perform when
providing this therapy?
A) Administer the treatment with the client in a high-Fowler's or semi-Fowler's position
B) Perform the procedure immediately following the client's meals
C) Apply percussion firmly to bare skin to facilitate drainage
D) Assist the client into a position that allows gravity to move secretions
Correct Answer: Assist the client into a position that allows gravity to move secretions
Rationale: Postural drainage uses gravity to facilitate the drainage of secretions from different lung
segments. The client is positioned so that the affected lung segments are superior to the trachea,
allowing secretions to drain.
7. While assessing a client, the nurse observes constant bubbling in the water-seal chamber of the
closed chest-drainage system. What should the nurse conclude?
A) The system is functioning normally
B) The client has a pneumothorax
C) The system has a leak
D) The chest tube is obstructed
Correct Answer: The system has a leak
