Identify three clinical signs of tension pneumothorax.

• A. Hyperresonant chest on percussion, hypotension, fever.
• B. Tracheal deviation, nasal congestion, bradycardia.
• C. Tracheal deviation, diminished or absent breath sounds on the affected side, hyperresonant chest.
• D. Clear chest sounds, normal vitals.

Answer: (C)

In tension pneumothorax, air builds up under pressure in the pleural space, pushing the mediastinum toward the opposite side and compressing the affected lung as well as major vessels. This creates a characteristic trio of findings. The trachea often shifts away from the side with the pneumothorax because the mediastinal structures are being pushed by the accumulating air. On the side of the affected lung, breath sounds become diminished or absent due to lung collapse and limited ventilation. The chest on that side also tends to be hyperresonant to percussion, reflecting the air-filled space.

These signs together capture the mechanical impact of the condition: mediastinal shift, reduced ventilation on the affected side, and increased air in the pleural space. The other options include findings that don’t align with tension pneumothorax, such as fever, nasal congestion, or normal chest sounds with stable vitals, which don’t describe the emergency physiology at play.