RN Comprehensive Online Practice 2019 B with NGN | Nurselytic

Correct Answer: D

Rationale: The correct answer is D: Absence of breath sounds on the affected side. This finding indicates a possible pneumothorax, a serious complication that requires immediate intervention. Absence of breath sounds suggests that the lung is not expanding properly, leading to inadequate ventilation. This can be life-threatening and requires prompt attention to prevent respiratory distress or respiratory failure. Tidaling in the water seal chamber (choice
A) is a normal fluctuation in the water level with breathing and is expected. Continuous bubbling in the suction control chamber (choice
B) indicates an air leak, which should be assessed but may not necessarily require immediate intervention. Drainage of 50 mL/hr in the collection chamber (choice
C) is within the expected range for chest tube output and does not indicate a need for immediate intervention unless it significantly increases.

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