Editing Medical-Surgical Nursing – RN Practice Questions (section)

==Question 7==
A nurse observes continuous vigorous bubbling in the water seal chamber of a patient's closed chest drainage system. The patient is dyspneic with decreased breath sounds on the affected side. What should the nurse do first?
# Clamp the chest tube near the insertion site and observe for improvement.
# Increase the wall suction to improve lung reexpansion.
# Assess the tubing and all connections for a leak, beginning at the chest.
# Strip the chest tube to clear any obstructing clot.

'''Answer:''' Option 3, assess the tubing and all connections for a leak, beginning at the chest.

''Rationale:'' Continuous bubbling in the water seal chamber indicates air entering the system, which is an air leak. The nurse systematically assesses the dressing, insertion site, connections, and tubing to locate it. Option 1 is dangerous, because prolonged clamping traps air and can produce a tension pneumothorax. Option 2 does not correct a leak and may worsen air entrainment. Option 4 is contraindicated, because stripping generates high negative pressure and can damage lung tissue.