1. A nurse is caring for a patient who has a chest tube

connected to a water-seal drainage system. The nurse

notices that there is continuous bubbling in the water-seal

chamber. What should the nurse do next?

a) Clamp the chest tube and notify the physician.

b) Check the system for air leaks and tape any connections

that are loose.

c) Document the finding and continue to monitor the

patient.

d) Increase the suction pressure to remove the excess air.

*Answer: b) Check the system for air leaks and tape any

connections that are loose.*

Rationale: Continuous bubbling in the water-seal chamber

indicates an air leak in the system, which can compromise

the drainage of fluid and air from the pleural space and

increase the risk of tension pneumothorax. The nurse

should check the system for air leaks and tape any

connections that are loose. Clamping the chest tube can

cause a buildup of pressure in the pleural space and worsen

the patient's condition. Documenting the finding and

continuing to monitor the patient is not enough to address

the problem. Increasing the suction pressure will not stop

the air leak and may cause damage to the lung tissue.

2. A nurse is preparing to administer an intramuscular

injection to a patient who has a history of anaphylaxis. The

nurse has drawn up 0.3 mL of epinephrine 1:1000 in a

syringe. What is the most appropriate site for the injection?

a) Deltoid muscle