After a motor vehicle accident, Armand an 22-year-old client is admitted with a pneumothorax. The surgeon inserts a chest tube and attaches it to a chest drainage system. Bubbling soon appears in the water seal chamber. Which of the following is the most likely cause of the bubbling?

Correct Answer: A

Rationale: The correct answer is A: Air leak. Bubbling in the water seal chamber indicates air is escaping from the pleural space through the chest tube, confirming the presence of an air leak. This is a common complication after chest tube insertion for pneumothorax. Adequate suction (choice B) would not cause bubbling in the water seal chamber. Inadequate suction (choice C) would result in no bubbling or fluctuation of the water in the water seal chamber. A kinked chest tube (choice D) would obstruct the drainage but not cause bubbling in the water seal chamber.

Correct Answer: D

Rationale: The correct answer is D (80 mm Hg). Respiratory arrest leads to inadequate ventilation, causing carbon dioxide (CO2) retention. A high PaCO2 level indicates respiratory acidosis, which is a common consequence of respiratory arrest. In this scenario, the administration of a narcotic analgesic can depress the respiratory drive, leading to hypoventilation and subsequent respiratory acidosis. Choices A, B, and C are incorrect because they represent lower PaCO2 levels, which would not be expected in a patient at risk of respiratory arrest.

Correct Answer: D

Rationale: Step 1: Unstable angina indicates a serious condition requiring immediate intervention. Step 2: Percutaneous transluminal coronary angioplasty (PTCA) is a surgical procedure used to open blocked coronary arteries. Step 3: PTCA helps improve blood flow to the heart, reducing the risk of a heart attack. Step 4: Cardiac catheterization (choice A) is a diagnostic procedure, not a direct treatment. Step 5: Echocardiogram (choice B) is an imaging test, not a surgical intervention. Step 6: Nitroglycerin (choice C) is a medication used for symptom relief, not a surgical solution.

Correct Answer: A

Rationale: The correct answer is A because it directly addresses the issue of abuse by asking if the wife and child are being threatened or hurt by the partner. This question is clear, specific, and focuses on the potential abuse situation. It allows the nurse to gather crucial information to assess the safety of the family. Choice B is not as effective because it only asks if the wife is frightened, which may not necessarily reveal if abuse is present. Choice C is too vague and open-ended, not directly addressing the suspected abuse. Choice D focuses on arguments, which may not uncover the extent of abuse occurring in the household. Therefore, A is the most appropriate question in this situation.

Correct Answer: A

Rationale: The correct answer is A because it acknowledges the client's pain while also addressing the fact that test results are negative, validating their experience. This response shows empathy and understanding. B is incorrect as it dismisses the client's pain, potentially causing them to feel unheard. C is incorrect as it suggests avoiding the issue rather than addressing it. D is not the best response as it does not acknowledge the negative test results, which may confuse the client.