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NRSG 3323 ADVANCED ASSESSMENT
MODULES 5-9 LATEST 2025 ACTUAL EXAM|
COMPLETE ACCURATE QUESTIONS AND
CORRECT DETAILED ANSWERS ( VERIFIED
ANSWERS) ALREADY GRADED A+
How do you stabilize an endotracheal tube (ETT)? - ANSWER - - use two pieces of tape to tape the ETT onto the face
- maximum 20-25 mmHg cuff pressure
What are nursing interventions you can implement after placing and stabilizing the ETT? - ANSWER - - assess respiratory system every 2 hours
- check oral/nasal status
- place in semi-fowler's position
- reposition every 2 hours
- move tube to opposite side of mouth every 8 hours
- mouth care every 4 hours
- give white board to patient to help them communicate
When is the laryngeal mask airway used and why? What does it have in common with the ETT and what part of it is slightly different? - ANSWER - - it is used in emergency because it is easier to insert and does not require advanced skills- nurses can insert these due to emergency 1 / 4
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- it is an alternative to ET tube
- less risk of injury compared to ETT
- also has inflated cuff like ETT; but it is inflated over the larynx rather
than trachea
What is tracheostomy and when/why is it used? How is it slightly different from ETT and laryngeal mask airway? - ANSWER - - it is a surgical hole in cervical tracheal airway
- placed under larynx and is used to establish an airway
- used for long term airway support
- different in that it allows for people to speak easier than with a ETT or
LMA (possible but still difficult since air is not reaching larynx where vocal cords are)
What are four purposes/indications of tracheostomy? - ANSWER - - replace an ET tube (since ET tubes are short term)
- mechanical ventilation
- acute or chronic airway obstruction
- copious secretions
What are the four types of tracheostomy tubes? - ANSWER - - single outer cannula- 1 lumen; not take out for cleaning
- double cannula- 2 lumens; one outer and one inner; better for people
- cuffed/uncuffed 2 / 4
with copious secretions; inner lumen taken out for cleaning
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- fenestrated/non-fenestrated
Permanent inner cannula vs disposable inner cannula? - ANSWER - - permanent inner cannula- cleaned and put back in
- disposable inner cannula- throw out after use
What is the purpose of chest tube thoracostomy? - ANSWER - - Used to re-establish intrapleural pressure
- drains the pleural space
define hemothorax, pneumothorax, and pleural effusion. what are they usually caused by? - ANSWER - - hemothorax- blood in pleural space
- pneumothorax- air in pleural space
- pleural effusion- fluid (transudate/exudate) in pleural space
- usually caused by trauma
Do you need negative or positive pressure in the pleural space? - ANSWER - negative space- in order to allow for air exchange
How do you confirm placement of chest tube thoracostomy? - ANSWER
- confirm with chest X-ray
What are the differences in function for large chest tubes vs small chest tubes? - ANSWER - large- for blood and exudate/fluids small- for air 3 / 4
pg. 4 What is the chest drainage unit and what are the 3 parts/chambers?Where should it be placed? - ANSWER - - it is disposable and helps drain out hemothorax, pneumothorax, and pleural effusion; prevents it from returning to the pleural space 1) drainage collection 2) water seal chamber (indicates any air leak) 3) suction chamber/control (controls pressure)
- should be placed upright below level of tube insertion
How much do you fill the water seal chamber? What are normal findings in the water seal chamber? What are abnormal findings in the water seal chamber? What do you do if it is an abnormal finding? - ANSWER - - fill to 2cm of water
- tidal with respirations (breathes taken by patient)
- bubbling indicates the degree of the air leak; clamp tubing to see
where/when bubbling stops and assess system
What do you do with the collection chamber once the system is attached and put together? - ANSWER - - keep upright
- mark level every hour for 24 hours and then every 8 hours afterwards
- do not empty
- report excessive drainage
(- encourage deep breathing)
What is the difference between the wet- suction control chamber vs the dry-suction control chamber? - ANSWER - wet- this is different from
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