Certified Clinical Transplant Nurse (CCTN) Practice Exam

A tension pneumothorax is a life-threatening condition characterized by the accumulation of air in the pleural space, which increases intrathoracic pressure and can compromise cardiovascular function. When Positive End-Expiratory Pressure (PEEP) is applied during mechanical ventilation, it can inadvertently lead to tension pneumothorax if air becomes trapped in the pleural space and cannot escape.

Tachycardia is a key indicator of tension pneumothorax as the body compensates for decreasing cardiac output and systemic hypoxia. When the pleural pressure rises significantly, it can impede venous return to the heart, leading to decreased stroke volume and resultant compensatory tachycardia. As the heart attempts to maintain adequate perfusion, an elevated heart rate becomes evident.

In contrast, increased breath sounds would generally not be associated with tension pneumothorax; in such cases, breath sounds may be diminished on the affected side due to trapped air preventing normal lung expansion. Elevated blood pressure could occur initially with compensatory mechanisms but may eventually drop due to decreased cardiac output. Clear lung sounds bilaterally would also not indicate tension pneumothorax, as one would expect findings of diminished or absent breath sounds on the affected side. Thus,