Which assessment finding indicates a tension pneumothorax, a complication of untreated pneumothorax?

Symmetrical chest expansion.

Tracheal deviation away from the affected side.

Increased breath sounds on the affected side.

Hyperresonance to percussion on the affected side.

Answer and Explanation

The Correct Answer is B

A. Symmetrical chest expansion: In a tension pneumothorax, chest expansion is usually asymmetrical because air trapped in the pleural space prevents full lung expansion on the affected side. Symmetrical movement would not be expected in this condition.

B. Tracheal deviation away from the affected side: This is a hallmark sign of tension pneumothorax. As intrapleural pressure increases, the mediastinum shifts, pushing the trachea and other structures toward the unaffected side, which is a medical emergency requiring immediate intervention.

C. Increased breath sounds on the affected side: Breath sounds are typically absent or markedly diminished over the affected lung due to lung collapse. Increased breath sounds would not occur in the presence of trapped air compressing the lung.

D. Hyperresonance to percussion on the affected side: Hyperresonance can occur with a simple pneumothorax due to excess air in the pleural cavity. However, while present, it is not as specific or critical as tracheal deviation, which directly indicates a tension pneumothorax.

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Correct Answer is A

Explanation

A. Kaposi Sarcoma: This is an AIDS-defining illness caused by human herpesvirus-8 and is characterized by painless, purplish-brown lesions on the skin and mucous membranes. It is commonly seen in clients with advanced untreated HIV infection due to severe immunosuppression.

B. Atopic Dermatitis: Atopic dermatitis presents as itchy, inflamed, and eczematous skin lesions, often with a history of allergies or asthma. It does not cause purple lesions on the skin or oral mucosa and is unrelated to untreated HIV progression.

C. Herpes simplex virus type 2: HSV-2 usually causes painful vesicular lesions in the genital or perianal region. While HIV clients are at higher risk of herpes outbreaks, the presentation is painful blisters or ulcers, not painless purplish patches.

D. Oral candidiasis: Oral candidiasis presents with white, creamy plaques on the tongue and oral mucosa that can be scraped off. It is common in HIV but looks different from purplish lesions, making it distinct from Kaposi sarcoma.

A. Non-adherence to medications B. Non-attendance of treatment programs C. Lack of social activities D. Substance use to self medicate

Correct Answer is A

Explanation

A. Non-adherence to medications: Antipsychotic medications are essential for symptom control, and missing doses or discontinuing treatment often leads to exacerbation of psychotic symptoms and the need for hospitalization.

B. Non-attendance of treatment programs: While skipping therapy or support groups can negatively affect progress, it is not the main cause of relapse. Medication adherence remains the most critical component in preventing symptom recurrence and maintaining stability.

C. Lack of social activities: Social isolation can worsen negative symptoms and impact overall quality of life, but it does not directly cause acute relapse requiring hospitalization. The client may remain stable on medications even with limited social interactions.

D. Substance use to self medicate: Substance use can complicate treatment and increase relapse risk, but it is not the primary factor. Even clients without substance use issues frequently relapse if they stop taking prescribed antipsychotics.

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Which assessment finding indicates a tension pneumothorax, a complication of untreated pneumothorax?

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