A nurse is assessing a client who has a pleural effusion. Which of the following findings should the nurse expect?

Substernal retractions noted on the client's chest.

Dullness percussed over the client's lung fields.

Crepitus palpated on the client's chest.

Crackles auscultated over the client's lung fields.

Answer and Explanation

The Correct Answer is B

A. Substernal retractions noted on the client's chest: This is a sign of respiratory distress, not specific to pleural effusion.

B. Dullness percussed over the client's lung fields: Pleural effusion causes fluid accumulation in the pleural space, leading to dullness on percussion over the affected area.

C. Crepitus palpated on the client's chest: Crepitus indicates subcutaneous emphysema, not pleural effusion.

D. Crackles auscultated over the client's lung fields: Crackles suggest fluid within the alveoli (e.g., pulmonary edema), not fluid in the pleural space.

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Correct Answer is D

Explanation

A. Flail chest: Flail chest involves paradoxical chest wall movement and is not associated with tracheal deviation.

B. Pulmonary contusion: This involves lung tissue injury with potential respiratory distress but does not cause tracheal deviation.

C. Fractured rib: While it can cause pain and respiratory distress, it does not lead to tracheal deviation or absent breath sounds.

D. Tension pneumothorax: Tension pneumothorax is characterized by respiratory distress, absent breath sounds on the affected side, and tracheal deviation away from the affected side. It occurs due to the accumulation of air in the pleural space, causing increased intrathoracic pressure and shifting of mediastinal structures.

A. Muffled heart sounds. B. Flattened neck veins. C. Bradycardia. D. Sudden lethargy.

Correct Answer is A

Explanation

A. Muffled heart sounds: Muffled heart sounds are a hallmark finding in cardiac tamponade due to fluid accumulation in the pericardial sac, which dampens the sound of the heart.

B. Flattened neck veins: Flattened neck veins are inconsistent with cardiac tamponade. Instead, distended neck veins are commonly seen due to impaired venous return to the heart.

C. Bradycardia: Tachycardia, rather than bradycardia, is more likely as a compensatory response to maintain cardiac output.

D. Sudden lethargy: While lethargy may occur as a late sign of decreased cardiac output, it is not specific to cardiac tamponade.

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A nurse is assessing a client who has a pleural effusion. Which of the following findings should the nurse expect?

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