The respiratory therapist is performing a physical assessment of a patient receiving pressure sup-port ventilation

The patient is short of breath, has a respiratory rate of 28 breaths/min, a dull percussion note over the right base that becomes resonant over the right upper lobe, and resonance over the left lung. Chest movement on the right side is decreased. The STAT chest X-ray reveals a blunting of the right costophrenic angle. The pulmonary disorder that is causing this clinical presentation is which of the following?
a. Acute respiratory distress syndrome (ARDS)
b. Emphysema
c. Pneumothorax
d. Pleural effusion

ANS: D
The dullness over the right base along with the resonance over the right upper lobe means that there is something either in or around the right lower lobe that is causing the dullness. The blunt-ing of the right costophrenic angle along with the dull percussion over the right base points to a right side pleural effusion.