Free NCLEX RN Practice Test Practice Question
The client is admitted to the ER with multiple rib fractures on the right. The nurse's assessment reveals that an area over the right clavicle is puffy and that there is a 'crackling' noise with palpation. The nurse should further assess the client for which of the following problems?
Correct Answer: B
Rationale: The presence of puffiness and a 'crackling' noise over the right clavicle suggests subcutaneous emphysema, where air escapes into the subcutaneous tissue, often due to trauma or rib fractures.
Flail chest (Option A) involves multiple rib fractures leading to paradoxical movement of the chest wall, but does not typically present with subcutaneous air.
Infiltrated subclavian IV (Option C) would not cause crackling sounds or puffiness in the tissue; it usually presents with localized swelling and pain.
Pneumothorax (Option D) involves air in the pleural space, leading to respiratory distress and decreased breath sounds, but does not produce the subcutaneous symptoms observed here.
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