1. Normal breathing mechanisms operate on the Negative pressure (when the lung
principle of . is punctured this ettects the neg-
ative pressure thus why a chest
tube may be placed)
2. A procedure where a plastic tube (chest tube) is A
inserted into the pleural space.
A. Thoracostomy
B. Thoracentesis
C. Thoracotomy
3. How should a patient be positioned for thoracen- feet on the floor, sitting upright
tesis? with elbows rested on pillows,
leaning slightly forward.
4. Surgical procedure in which part a cut is made C
between the ribs to see and reach the lungs or
other organs in the chest or thorax.
A. Thoracostomy
B. Thoracentesis
C. Thoracotomy
5. What is the reason for insertion of chest tube into Restores negative pressure and
the pleural space after surgery? allows for lung re-expansion
6. What is the reason for insertion of a chest tube Drain blood
into the mediatinal space after surgery?
7. A small bore chest tube is typically used to drain? A
A. Air
B. Blood
C. Fluid
,8. A medium bore chest tube is typically used to C
drain?
A. Air
B. Blood
C. Fluid
9. A large bore chest tube is typically used to drain? B
A. Air
B. Blood
C. Fluid
10. To remove air a chest tube is typically placed in second
the intercostal space.
11. To remove blood and fluid a chest tube is typically fifth - seventh
placed in the intercostal spaces.
12. How much water should be added to the wa- 2cm
ter-seal chamber?
13. Fow which may you see tidaling upon inhalation A
and exhalation?
A. Water-seal chamber
B. Suction control chamber
14. For which might you see bubbling? B
A. Water-seal chamber
B. Suction control chamber
15. Bubbling may be present in the water-seal cham- F (if bubbling is present here
ber. T or F? there is a leak somewhere)
16. How much water should be added to the suction 20cm
control chamber (water suction chanber)?
,17. How should the drainage system be positioned Below the patients chest
for a chest tube patient?
18. Why might humidified air be needed for a trach Thins secretions, reduces mucus
patient? plugs
19. What is the normal cuff inflation pressure on a 20-25 cm H2O
trach?
20. When should trach ties be changed after place- Not for at least 24 hours after
ment of a new tracheostomy? placement
21. When should the trach tube be changed after Not for at least 7 days after place-
placement? ment (this will be done by HCP)
22. If accidental dislodgement happens and you are Cover stoma with sterile gauze
not able to insert a new trach tube what must you and BVM (bag valve mask) patient
do?
23. The cuff on a tracheostomy tube is inflated when- Patient is high risk for aspiration
ever?
24. If the trach cuff is inflated due to the patient Thickened liquids or soft foods
being as risk for aspiration, what kind of diet
might they be on?
25. The nurse is caring for a patient with a chest tube A,C,D
hooked to water suction. The nurse notices that
tidaling has stopped in the water seal chamber.
Which of the following could explain the reason
for this finding? SATA
A. The patients lungs have fully expanded
B. There is an air leak in the tubing
, C. There may be an obstruction
D. The tubing could be kinked
26. A patient has just had a chest tube inserted for a A
pleural effusion. The initial drainage is 1.2L in 1
hour. Which finding would the nurse expect?
A. BP 98/54
B. P 50
C. O2 sat 90%
D. R 30
27. The nurse is assessing a patient who has a long C
term tracheostomy. Which finding is the most
concerning?
A. Soiled trach ties
B. Cuff is deflated
C. Obturator is inserted
D. Replacement trach is not at bedside
28. How often should a non-disposable inner tra- B
cheostomy cannula be cleaned?
A. Every 24 hours
B. Every shift
C. As needed
D. Every month
29. Which of the following symptoms are considered B,D,E
early symptoms of head and neck cancer?
A. Unintentional weight loss
B. Leukoplakia
C. Dysphagia
D. Hoarsness that lasts > 2 weeks