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 1. The purpose of a chest drainage unit is:

      a. Evacuation of air from the chest cavity

      b. Evacuation of fluid from the chest cavity

      c. Assist in reestablishment of normal intra-thoracic pressure

      d. All of the above

 2. Under normal conditions, pleural pressure is:

      a. Positive

      b. Negative

      c. Zero

      d. The same as atmospheric pressure

 3. Inhalation occurs when:

      a. The diaphragm contracts and moves downward

      b. The external intercostal muscles move the rib cage up and out

      c. The pressure inside the lungs is lower than atmospheric pressure and air flows in

      d. All of the above

 4. A tension pneumothorax occurs when:

      a. Air accumulates in the pleural space faster than it is dispersed

      b. High pressures collapse lung function

      c. Fluid occupies normal lung space

      d. Both A & B

 5. Bubbling in the water seal chamber of a chest drain indicates:

      a. Normal functioning

      b. An air leak

      c. The chest tube is ready to be removed

      d. Suction is too high

 6. The fluctuation of the water level in the small arm of the water seal with respirations is called:

      a. Air leak

      b. Tidaling

      c. Cycling

      d. Suction

 7. A commonly recommended suction pressure is:

      a. -10 cm H2O

      b. -20 cm H2O

      c. -50 cm H2O

      d. -450 cm H2O

 8. High negative pressure generated by a patient in respiratory distress causes:

      a. The water to rise in the small air (manometer) of the water seal chamber

      b. Chest drainage to cease

      c. The suction chamber to bubble vigorously

      d. None of the above

 9. The primary advantages a dry suction control chamber has over wet suction control are:

      a. Higher suction pressure levels, easy set-up, quiet operation

      b. Positive pressure relief valves, uncapped tubing

      c. Continuous bubbles, highlighted float pressure indicator

      d. Slower water evaporation, fewer dressing changes

 10. In addition to a respiratory assessment, nursing assessment of a patient with a chest tube should

    include:

      a. Looking at the insertion site for drainage on the dressing

      b. Checking for an air leak

      c. Noting the color, consistency, and amount of drainage

      d. All of the above

 11. Nursing actions for a patient with a chest tube include:

      a. Adjusting the water level in the suction control and water seal chambers if evaporation has occurred

      b. Preventing dependent loops from forming in the patient drainage tube

      c. Notifying the physician of a new or increase air leak

      d. All of the above

 12. When converting a chest drainage system from suction to gravity drainage:

      a. turn source suction off and leave tubing connected

      b. clamp patient drainage tube

      c. raise chest drainage unit above the chest

      d. disconnect suction tubing and leave port uncapped

 13. If drainage from a mediastinal chest tube suddenly decreases, the patient may rapidly develop:

      a. Spontaneous pneumothorax

      b. Tension pneumothorax

      c. Chylothorax

      d. Cardiac tamponade

 14. Milking or stripping tubes:

      a. Can create dangerously high negative pressures

      b. Can put a patient at risk for mediastinal and/or graft trauma

      c. Should be done with extreme caution and by hospital policy

      d. All of the above

 15. If the patient pulls out a chest tube and there was bubbling in the air leak meter, what action is

      not appropriate?

      a. Notify the doctor

      b. Prepare for reinsertion of chest tube

      c. Apply occlusive dressing to chest tube insertion site

      d. Periodically release dressing over chest tube insertion site

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