The nurse is assessing a client with a chest tube. Which finding requires immediate action?

Correct Answer: A

Rationale: The correct answer is A because continuous bubbling in the water seal chamber indicates an air leak in the chest tube system, which can lead to pneumothorax. Immediate action is needed to prevent respiratory compromise. Choice B is incorrect because drainage of 50 mL in the past hour is within normal limits for a chest tube output. Choice C, tidaling in the water seal chamber, is a normal finding indicating proper functioning of the chest tube system. Choice D is incorrect because although the chest tube dressing intact with no drainage is a good sign, it does not require immediate action compared to an air leak.

Correct Answer: B

Rationale: The correct answer is B: High Fowler's with arms supported on a table. This position allows for easier access to the thoracic cavity, facilitating the thoracentesis procedure. High Fowler's position also helps the client breathe more comfortably and reduces the risk of complications. A: Supine with arms at the sides would not provide optimal access to the thoracic cavity. C: Prone with a pillow under the chest would hinder access to the thoracic cavity and compromise the procedure. D: Side-lying with the affected side down could also impair access to the thoracic cavity and make the procedure more challenging.

Correct Answer: B

Rationale: The primary goal of oxygen therapy for a client with chronic bronchitis is to improve oxygen delivery to tissues. In chronic bronchitis, the airways are inflamed and narrowed, leading to decreased oxygen exchange. Providing supplemental oxygen helps increase oxygen levels in the blood, improving oxygen delivery to tissues throughout the body. This can alleviate symptoms such as shortness of breath and fatigue. Choice A is incorrect because oxygen therapy primarily focuses on increasing oxygen levels, not reducing carbon dioxide levels. Choice C is incorrect as oxygen therapy does not directly address mucus production. Choice D is incorrect as the goal of oxygen therapy is not specifically to prevent pneumonia, although adequate oxygenation can support overall respiratory health and reduce the risk of complications.

Correct Answer: B

Rationale: The correct answer is B: Increased shortness of breath. After a thoracentesis, a potential complication is a pneumothorax, causing increased shortness of breath. This requires immediate medical attention to prevent respiratory compromise. Choices A, C, and D are common post-thoracentesis symptoms that may occur but do not indicate an urgent need for medical intervention.

Correct Answer: B

Rationale: Step-by-step rationale: 1. Pulse oximetry is a non-invasive method to measure oxygen saturation in the blood by using a sensor on the patient's finger. 2. It is commonly used in assessing respiratory conditions like asthma exacerbation to monitor oxygen levels. 3. Thoracentesis is a procedure to remove fluid from the pleural space, not for measuring oxygen saturation. 4. Diffusion capacity measures how well oxygen and carbon dioxide are exchanged in the lungs, not oxygen saturation. 5. Maximal respiratory pressure assesses the strength of respiratory muscles, not oxygen saturation. Summary: Pulse oximetry is the correct choice as it is a non-invasive method to measure oxygen saturation, which is crucial in assessing and managing respiratory conditions like acute asthma exacerbation. Thoracentesis, diffusion capacity, and maximal respiratory pressure are not appropriate for measuring oxygen saturation in this context.