ACCS Practice Exam 2025 – Complete Test Preparation Guide

In a situation where there is no fluctuation in the underwater seal of a chest tube, the first action that should be taken is to request a chest radiograph. This step is crucial because the absence of fluctuation can indicate several potential issues, such as a possible clot or kink in the tubing, or the presence of a pleural effusion or pneumothorax that may not be effectively draining.

By obtaining a chest radiograph, the clinician can visually assess the position of the chest tube as well as the status of the pleural space. It helps to determine if there are any anatomical changes or complications that need to be addressed. This imaging is essential for guiding subsequent interventions and ensuring that the initial placement and ongoing functionality of the chest tube are appropriately managed.

Other interventions, like adjusting suction or manipulating the tube, might be appropriate based on the findings from the radiograph, but determining the underlying cause through imaging is the most critical initial step.