Registered Nurse (RN) Respiratory Practice Exam

For a patient with an open pneumothorax, placing a sterile occlusive dressing over the chest wound and taping it on three sides is the most appropriate nursing intervention. This method creates a one-way valve, allowing air to escape from the pleural cavity during expiration while preventing additional air from entering the pleural space during inspiration. This is crucial as the primary goal in managing an open pneumothorax is to restore normal intrathoracic pressure and protect the lungs.

Using a sterile occlusive dressing helps prevent contamination and reduces the risk of developing a tension pneumothorax, which can occur if the dressing is not adequately applied or is loose. Taping the dressing on three sides ensures that it can function effectively as a valve, permitting exhaled air to escape, yet still protecting the wound.

In contrast, other interventions such as positioning the patient supine may not provide adequate respiratory function or facilitate airflow and could increase the risk of complications. Similarly, a non-occlusive dressing would not address the problem of air entering the pleural space, while preparing for a thoracentesis is not immediately necessary for treating an open pneumothorax; the priority is to stabilize the wound first.