NCLEX-RN® Question of the Day: Preparing a client for a thoracentesis

Today’s NCLEX-RN® question of the day focuses on a client preparing for a thoracentesis.

When preparing a client for a thoracentesis, the nurse should assist the client into which of these positions?

A. Prone with the head turned to one side

B. High Fowler position with the arms at the side

C. Semi-Fowler with the arms crossed in front

D. Sitting while leaning forward over a pillow

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The correct answer to today’s NCLEX-RN® Question is…

D. Sitting while leaning forward over a pillow

Rationale: During a thoracentesis a needle is inserted into the intercostal space, so the nurse should assist the client to sit at the edge of the bed while leaning forward with their arms supported on a bedside table and a pillow or folded towel. This position promotes separation of the ribs to allow easy insertion of the needle into an enlarged intercostal space. Alternatively, the client can sit upright with the arm up, or if the client is unable to sit upright, the lateral recumbent position can be used.

Major Takeaway

During a thoracentesis the client should be sitting while leaning forward over a pillow so the intercostal spaces are separated.

Incorrect answer explanations

A. Prone with the head turned to one side

Rationale: During a thoracentesis a needle is inserted into the intercostal space, so a prone position would not be helpful.

B. High Fowler position with the arms at the side

Rationale: During a thoracentesis a needle is inserted into the intercostal space. A high Fowler’s position would not be helpful and the client’s arms will cover the insertion site.

C. Semi-Fowler with the arms crossed in front

Rationale: During a thoracentesis a needle is inserted into the intercostal space. A high Fowler’s position would not be helpful for this procedure.

Reference

Berman, A. & Snyder, S. (2016). Skills in clinical nursing (8th ed.). Pearson.

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