RCP 160 MIDTERM EXAM QUESTIONS AND COMPLETE SOLUTIONS (VERIFIED)

Identify the indications for chest tube insertion from the list below: I. Pleural effusion II. Acute shortness of breath III. Pneumothorax IV. Empyema - Correct Answer I, III, IV Identify the proper placement of a chest tube for a pneumothorax. - Correct Answer Mid-axillary, over the edge of the 4th to 6th intercostal space toward the apex of the lung. Identify the proper placement of a chest tube for fluid removal. - Correct Answer Mid-axillary over the edge of the 6th to 8th intercostal space toward the posterior base of the lung. Identify two reasons for no bubbling in the Suction Control Chamber: - Correct Answer Leak in the system between the regulator and the drainage system and The vacuum pressure is turned off. Which of the following troubleshooting interventions is appropriate when no drainage is coming out, when there was drainage before? I. Try to drain loop and prevent tube from looping. II. Try to milk the clot out of the tubing carefully. III. Pull the Chest tube out and replace it. IV. Check CXR for pleural fluid having been cleared. - Correct Answer I, II, IV Which of the following statements about pleural fluid is false? - Correct Answer Fluid can move easily between each hemithorax. Pleural fluid with a total protein concentration of less than ____________ of the serum total protein level is one of the indications of transudative pleural effusion. - Correct Answer 50% What is the most common cause of pleural effusion in the clinical setting? - Correct Answer Congestive heart failure The chest radiograph showed the presence of a meniscus in the right chest together with a blunted right costophrenic angle. Which of the following procedures would you recommend at this point to treat Ms. Paul? - Correct Answer Posterior chest tube thoracostomy Forty-eight hours after the chest tube insertion Ms. Paul remains on mechanical ventilation. While assessing the chest tube system, you note small bubbles in the water seal chamber generated during peak inspiration. This is an indication of which of the following: - Correct Answer bronchopleural fistula.