Trauma Nurse Core Course (TNCC) Practice Exam 2025 - Free Practice Questions and Study Guide

A tension pneumothorax occurs when air becomes trapped in the pleural cavity and creates increasing pressure that collapses the lung on the affected side and pushes the mediastinum (which includes the trachea, heart, and major blood vessels) toward the opposite side.

The presence of tracheal deviation away from the affected side is a key clinical finding because the pressure from the pneumothorax causes a shift of the mediastinum. When the trachea deviates away from the pneumothorax, it indicates significant mediastinal shift due to the pressure imbalance, which is a hallmark of this condition. Recognizing this physical sign is crucial for clinicians, as it emphasizes the urgency in managing the tension pneumothorax appropriately, typically through needle decompression followed by chest tube placement.

Other findings, while relevant in assessing respiratory distress or compromised airway, do not specifically indicate a tension pneumothorax in the same definitive manner. For instance, while decreased breath sounds on the affected side and cyanosis may occur, they are not exclusive indicators of a tension pneumothorax. Chest wall expansion on the affected side would not typically be seen in this scenario, as the lung is usually collapsed due to the pressure and therefore