The nurse is caring for a patient with a closed-chest drainage system with chest tubes. Which observation confirms that the system is intact and working?

Correct Answer: A

Rationale: The correct answer is A because fluctuations in the water level in the water-seal chamber indicate that the system is intact and working properly. When the water level fluctuates, it signifies that the system is maintaining the pressure gradient needed for proper drainage and lung re-expansion. Explanation of why other choices are incorrect: B: The level of fluid in the collection chamber rising does not confirm the system's integrity or functionality. C: Constant bubbles in the water-seal chamber indicate an air leak, which is not desirable in a closed-chest drainage system. D: Attaching suction is a step in setting up the system but does not confirm ongoing function or integrity.

Correct Answer: D

Rationale: The correct answer is D: "I have trouble breathing when I climb a flight of stairs." This statement indicates exertional dyspnea, a common symptom of heart failure due to impaired cardiac function leading to inadequate oxygen delivery. Shortness of breath with exertion is a hallmark sign of heart failure, as the heart's inability to pump effectively results in fluid accumulation in the lungs, causing difficulty in breathing during physical activities. Choices A, B, and C do not directly correlate with heart failure symptoms. Seeing spots before eyes (A) may suggest visual issues, tiredness at the end of the day (B) is a common complaint and can be due to various reasons, while feeling bloated after a meal (C) could be related to gastrointestinal issues.

Correct Answer: D

Rationale: The correct answer is D because in a patient with anemia and low hemoglobin concentration, their PaO2 will be decreased due to reduced oxygen-carrying capacity of blood. This is a result of decreased oxygen saturation in the blood. A: Decreased TPR is incorrect because anemia can lead to compensatory mechanisms such as increased sympathetic tone and vasoconstriction, resulting in increased total peripheral resistance. B: Increased cardiac output is incorrect as the heart may need to work harder to maintain oxygen delivery to tissues due to decreased oxygen-carrying capacity. C: Increased 2,3 DPG in RBC is incorrect because anemia can lead to decreased 2,3 DPG levels, which shift the oxygen-hemoglobin dissociation curve to the left, impairing oxygen release to tissues.

Correct Answer: D

Rationale: The correct answer is D: body tissues. The respiratory system is responsible for breathing and exchanging gases, involving organs like the nose, trachea, and lungs. Body tissues, on the other hand, are not specific organs exclusively dedicated to respiration. They may play a role in gas exchange, but they are not organs of the respiratory system. Therefore, the correct answer is D. Choices A, B, and C are incorrect because the nose, trachea, and lungs are all integral parts of the respiratory system involved in the process of breathing and gas exchange.

Correct Answer: A

Rationale: The correct answer is A: Do nothing, because this is an expected finding. When managing a client with a chest tube for a pneumothorax, gentle bubbling in the suction control chamber indicates that the system is functioning properly. This bubbling represents the movement of air and fluid out of the pleural space. It is important not to clamp the chest tube or increase suction pressure as this can lead to complications. Checking for an air leak is unnecessary in this scenario as continuous bubbling is an expected finding. Therefore, the appropriate action is to monitor the bubbling and ensure it remains gentle, as this signifies effective drainage.