Progressive Care Nursing Certification (PCCN) Practice Exam

When preparing a patient for a thoracentesis, which position is most appropriate?

1. Lying on the affected side with head of the bed flat

2. Lying on the affected side with head of the bed elevated 15 degrees

3. Lying on the opposite side with head of the bed flat

4. Patient upright and slightly bent forward

The correct answer is: Patient upright and slightly bent forward

The most appropriate position for a patient preparing for a thoracentesis is upright and slightly bent forward. This positioning is beneficial because it allows for optimal access to the pleural space while minimizing the risk of complications. When the patient is upright, gravity helps to pull the fluid in the pleural cavity downward, making it easier for the clinician to aspirate the fluid accurately. The forward bending posture also expands the intercostal spaces, which facilitates better access between the ribs where the needle is inserted. This position can help reduce the likelihood of injury to the lungs and other surrounding structures during the procedure. Additionally, being upright can help the patient feel more comfortable and less anxious, promoting relaxation during the procedure. Other positions, such as lying on the affected side or the opposite side, may not provide the same level of accessibility to the pleural space and could complicate the procedure, as the clinician may find it more challenging to target the correct area for fluid aspiration. Therefore, the upright, slightly bent forward position is the best choice for thoracentesis preparation.