# A client with blunt chest trauma has severe dyspnea, absent breath sounds on the left, hypotension, and tracheal deviation to the right. Which condition should the nurse suspect?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=397168&lang=en  
> language: en  
> subject: Complications of Procedures  
> category: ROR

## Question

A client with blunt chest trauma has severe dyspnea, absent breath sounds on the left, hypotension, and tracheal deviation to the right. Which condition should the nurse suspect?

## Option

1. Tension pneumothorax. **✔ Correct answer**
2. Pleural effusion.
3. Atelectasis.
4. Pulmonary embolism.

**Correct answer: 1**

## Explanation

Unilateral absent breath sounds, hypotension, severe respiratory distress, and tracheal deviation away from the affected side are classic cues of tension pneumothorax. This is an emergency. Pleural effusion, atelectasis, and pulmonary embolism do not match the full trauma and mediastinal shift pattern.

## In-depth explanation

Clinical Judgment
Use the client cues, timing, labs, and safety risks to select the response that best fits Chest trauma tension pneumothorax.

Memory Tip
Match the strongest cue cluster to the safest nursing judgment.

KR vs US
NCLEX items reward cue-based priority thinking rather than isolated recall.

## Clinical scenario

Clinical Practice Guide
For Chest trauma tension pneumothorax, compare the complete cue pattern with the client's current stability, ordered data, and expected nursing scope.

Caution
Do not choose an action from one isolated cue when the full scenario changes priority or safety.

## Key concepts

- **Tension Pneumothorax** — Air trapped under pressure in the pleural space that compromises ventilation and circulation.
- **Tracheal Deviation** — Displacement of the trachea that may occur with pressure changes in the thorax.
- **Blunt Chest Trauma** — Nonpenetrating injury to the chest that can damage lungs or vessels.

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