Progressive Care Nursing Certification (PCCN) Practice Exam

What procedure should a nurse anticipate for a patient diagnosed with a right hemothorax following multiple rib fractures?

1. Needle decompression, 2nd ICS at midclavicular line

2. Bronchoscopy with bronchial lavage

3. Placement of a right-side chest tube in the 6th ICS at the posterior axillary line

4. CT scan for further evaluation and diagnosis

The correct answer is: Placement of a right-side chest tube in the 6th ICS at the posterior axillary line

The placement of a right-side chest tube in the 6th intercostal space (ICS) at the posterior axillary line is the most appropriate procedure for a patient diagnosed with a right hemothorax following multiple rib fractures. When a hemothorax occurs, blood accumulates in the pleural space, which can lead to respiratory distress, decreased lung capacity, and other complications. In cases of significant hemothorax, the primary goal is to drain the blood from the pleural space to allow the lung to re-expand and to prevent further complications such as infection or continued respiratory distress. The 6th ICS at the posterior axillary line is the standard site for chest tube insertion for optimal drainage. Other options may not be suitable for immediate management in the context of a hemothorax. For example, needle decompression is typically reserved for tension pneumothorax rather than a hemothorax, and bronchoscopy is not indicated for addressing blood accumulation in the pleural space. While a CT scan might provide further evaluation of the extent of the injury or associated complications, it is not a therapeutic procedure and would delay necessary intervention to manage the hemothorax. Therefore, the immediate and appropriate course of action