1. The nurse is assessing the respiratory status of a client who has suffered a fractured rib. Which observation if made by the nurse would not be related to the fractured rib?

1. *Slow deep respirations

2. Splinting or guarding the chest

3. Pain especially with inspiration

4. Bruising over the fractured area.

2. A patient is admitted to the respiratory unit with flail chest. The nurse should know that flail chest is?

1. Pneumothorax

2. Tension pneumothorax

3. Blood rapidly collects in pericardial sac.

4. *Fracture of two or more adjacent ribs in two or more places

3. An hour after a left thoracotomy, a patient reports incisional pain at a level 7 (based on 0 to 10 scale) and has decreased left-sided breath sounds. The pleural drainage system has 100 mL of bloody drainage and a large air leak. Which action should the nurse take?

a) Clamp the chest tube in two places. b) *Administer the prescribed morphine.

3. Milk the chest tube to remove any clots.

4. Assist the patient with incentive spirometry.

4. The nurse monitors a patient in the emergency department after chest tube placement for a hemopneumothorax. Which assessment finding is of most concern?

1. A large air leak in the water-seal chamber

2. Report of pain with each deep inspiration

3. *400 mL of blood in the collection chamber

4. Subcutaneous emphysema at the insertion site

5. A patient has a chest wall contusion as a result of being struck in the chest with a baseball bat. Which initial assessment finding is of most concern to the emergency department nurse?

1. Report of chest wall pain

2. Heart rate of 110 beats/min

3. *Paradoxical chest movement

4. Large, bruised area on the chest

6. The emergency department nurse notes tachycardia and absent breath sounds over the right thorax of a patient who has just arrived after an automobile accident. For which intervention will the nurse prepare the patient?

1. Emergency pericardiocentesis

2. Stabilization of the chest wall

3. Bronchodilator administration

4. *Chest tube insertion connected to suction.