Difficulty: Medium
Average Score: 88%
Simulated
An adult has a chest drainage system. The client's wife reports to the nurse that her husband is restless. The nurse enters the room just in time to see him pull out his chest tube. The most appropriate initial action for the nurse to take is to:
Correct answer
B
Rationale
Placing a hand firmly over the wound prevents air from entering the pleural space, which could cause a pneumothorax.