During spontaneous inspiration, intrathoracic pressures become more positive causing more blood to flow into major thoracic vessels, thereby increasing venous return.

Correct Answer: B

Rationale: The correct answer is B) FALSE. During spontaneous inspiration, intrathoracic pressures actually become more negative, not positive. This negative pressure change expands the thoracic cavity, leading to an increase in venous return to the heart. When the diaphragm contracts and moves downward, and the external intercostal muscles contract, the thoracic volume increases, causing a decrease in intrathoracic pressure. This negative pressure gradient causes blood to flow from the major thoracic vessels into the right atrium, increasing venous return. Option A) TRUE is incorrect because, as explained, intrathoracic pressures do not become more positive during spontaneous inspiration. This option is a common misconception that can be clarified through understanding the mechanics of breathing and circulation. Educationally, understanding the relationship between intrathoracic pressure changes during inspiration and venous return is crucial for healthcare professionals, especially when managing patients receiving oxygen therapy. By comprehending these physiological processes, nurses and other healthcare providers can optimize patient care and ensure proper oxygenation and circulation. Remembering the correct response to this NCLEX question will help reinforce this essential knowledge for nursing practice.

Correct Answer: B

Rationale: In the context of assessing a patient with a pneumothorax, the correct answer is B) Hyper-resonant percussion sound. Hyper-resonance is indicative of excess air in the chest cavity, which is characteristic of a pneumothorax where air has accumulated in the pleural space. Option A) Resonant percussion sound is typically heard over normal lung tissue. It is the expected sound when percussing a healthy lung. Option C) Tympany is a sound that is more commonly associated with percussing over a hollow organ filled with air, such as the stomach or intestines. It is not a typical finding over a pneumothorax. Option D) Dullness is heard over areas of increased density like fluid-filled or solid organs. It is not the expected percussion sound over a pneumothorax, which is characterized by the presence of air. Educationally, understanding the nuances of percussion sounds is crucial for nursing practice, especially in the context of respiratory assessments. Recognizing the specific percussion sounds associated with different conditions can aid in accurate diagnosis and appropriate intervention. This knowledge is particularly important for nurses preparing for the NCLEX exam, as it assesses their ability to apply theoretical knowledge in clinical scenarios.

Correct Answer: B

Rationale: In the context of an infant born with Congenital Diaphragmatic Hernia (CDH), the correct action to be performed after birth is option B: Intubation and positive pressure ventilation (PPV). This intervention is crucial as it helps in stabilizing the infant's breathing by providing adequate oxygenation and ventilation support. Intubation is necessary to secure the airway and deliver PPV, which helps to prevent lung collapse and improve oxygenation. Infants with CDH often have compromised lung function due to the herniation of abdominal organs into the chest cavity, leading to lung hypoplasia and pulmonary hypertension. PPV aids in opening up the alveoli, improving lung compliance, and facilitating gas exchange, which are essential in managing respiratory distress in these infants. The other options are incorrect in this scenario: - Option A: Bag-Valve-Mask ventilation may not provide adequate support and may not be sufficient to stabilize the infant's breathing in CDH. - Option C: Administering fluids and inotropic agents may be necessary for hemodynamic support in some cases, but it is not the primary intervention needed immediately after birth in a CDH infant. - Option D: Intermittent suction of the stomach is not a priority in the management of CDH; respiratory support and stabilization take precedence in this critical situation. Educationally, understanding the rationale behind the correct intervention in CDH infants is vital for nurses and healthcare providers working in neonatal care settings. It highlights the importance of prompt and appropriate respiratory support to optimize outcomes for these fragile patients. This knowledge can guide clinical decision-making and improve patient care in emergency situations involving respiratory distress in neonates with CDH.

Correct Answer: D

Rationale: The correct answer is 'Monitoring the patency and integrity of the drainage system.' This is the right nursing responsibility for the client's chest drainage systems because it involves ensuring that the system is functioning properly and that there are no obstructions or leaks. This is important for the patient's respiratory status and overall well-being.

Correct Answer: C

Rationale: The correct answer is C) a closed water-seal drainage system. This system prevents air from re-entering the pleural space by creating a one-way flow mechanism that allows air and fluid to exit the pleural space but prevents them from returning. The water seal acts as a barrier that only allows air to move in one direction, out of the pleural space. It is crucial in maintaining the negative pressure needed for proper lung expansion and function. Option A is incorrect because the location of the tube insertion alone does not prevent air from re-entering the pleural space. It is the mechanism of the closed water-seal system that ensures proper drainage and prevents complications. Option B is incorrect as well because the sutures holding the tube in place do not prevent air from re-entering the pleural space. While secure placement is essential to prevent dislodgement, it does not control the flow of air within the drainage system. Option D is incorrect because respiratory inspiration and expiration are part of the natural breathing process and do not directly impact the prevention of air re-entering the pleural space through a chest tube. Understanding the function of a closed water-seal drainage system is crucial for nurses and healthcare providers caring for patients with chest tubes. It is essential to ensure the system is set up correctly to prevent complications such as pneumothorax or hemothorax. Proper education and training on chest tube management are vital to provide safe and effective patient care.