A nurse in the emergency department is caring for a patient who was injured in a motor-vehicle crash. The patient reports dyspnea and severe pain.
The nurse notes that the patient’s chest moves inward during inspiration and bulges out during expiration. The nurse should identify this finding as which of the following?

Flail chest

Hemothorax

Atelectasis

Pneumothorax

Answer and Explanation

The Correct Answer is A

Choice A rationale

The symptoms described, including the paradoxical movement of the chest wall (moving inward during inspiration and outward during expiration), are indicative of a flail chest, which is a life-threatening condition that occurs when a segment of the rib cage breaks due to trauma and becomes detached from the rest of the chest wall.

Choice B rationale

Hemothorax is a collection of blood in the space between the chest wall and the lung (the pleural cavity). It’s often caused by chest trauma. It does not cause the chest to move inward during inspiration and outward during expiration.

Choice C rationale

Atelectasis is a complete or partial collapse of the entire lung or area (lobe) of the lung. It does not cause the chest to move inward during inspiration and outward during expiration.

Choice D rationale

Pneumothorax is a collapsed lung. It does not cause the chest to move inward during inspiration and outward during expiration.

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Correct Answer is D

Explanation

Choice A rationale

Lidocaine does not primarily serve to relieve pain when administered intravenously. It is primarily used as an antiarrhythmic agent.

Choice B rationale

Lidocaine does not slow intestinal motility. This is not one of its primary actions.

Choice C rationale

Lidocaine does not dissolve blood clots. It is not an anticoagulant.

Choice D rationale

Lidocaine prevents dysrhythmias. It is an antidysrhythmic medication that delays the conduction in the heart and reduces the automaticity of heart tissue.

A. Clamp the patient’s chest tube. B. Increase the patient’s wall suction. C. Strip the patient’s chest tube. D. Reposition the patient.

Correct Answer is D

Explanation

Choice A rationale

Clamping the patient’s chest tube is not the appropriate action. Clamping the tube can lead to tension pneumothorax, which is a life-threatening condition.

Choice B rationale

Increasing the patient’s wall suction is not the correct action. The sensation of chest burning is not related to the level of suction. Increasing the suction could potentially cause more harm.

Choice C rationale

Stripping the patient’s chest tube is not recommended. This action can cause negative pressure in the chest and can lead to injury of the lung tissue.

Choice D rationale

Repositioning the patient is the correct action. The sensation of chest burning could be due to the position of the chest tube. Repositioning the patient may alleviate the discomfort.

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Naxlex Comprehensive Predictor Exams

A nurse in a coronary care unit is admitting a patient who has had CPR following a cardiac arrest. The patient is receiving lidocaine IV at 2 mg/min.When the patient asks the nurse why he is receiving that medication, the nurse should explain that it has which of the following actions?

Correct Answer is D

Explanation

A nurse is caring for a patient with a chest tube connected to wall suction due to a right-sided pneumothorax. The patient reports a sensation of chest burning.What should the nurse do next?

Correct Answer is D

Explanation

A nurse is educating a parent of a 6-month-old infant about car seat safety.Which statement from the parent indicates a correct understanding of the teaching?

A nurse is performing Leopold maneuvers on a patient in labor and determines the fetus is in an RSA position. What fetal presentations should the nurse document in the patient’s medical record?

A nurse is caring for an older adult patient with left-sided heart failure. What assessment findings should the nurse expect?

A nurse is admitting an elderly patient suspected of having a cognitive disorder. What inventories should be included as part of the admission assessment?

A nurse is formulating a care plan for a patient recovering from severe burns.Which of the following strategies should the nurse incorporate to provide emotional support?

A nurse is providing care to a group of patients with chronic illnesses. Who among the following patients should the nurse identify as being at the highest risk for sepsis?

A nurse is caring for a patient and notices that the patient’s urine is dark amber, cloudy, and has an unpleasant odor. Which of the following conditions should the nurse associate these findings with?