While percussing a patient's chest wall, you encounter an area that produces a decreased reso-nance to percussion. Which of the following are potential causes of this finding?
1. Pneumothorax
2. Pleural effusion
3. Pneumonia
4. Atelectasis
a. 2 and 3 only
b. 2 and 4 only
c. 2, 3, and 4 only
d. 1, 2, 3, and 4
ANS: C
Any abnormality that increases lung tissue density, such as pneumonia, tumor, or atelectasis, re-sults in a loss of resonance and decreased resonance to percussion over the affected area. Pleural spaces filled with fluid, such as blood or water, also produce decreased resonance to percussion.
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