Question

the nurse is assessing a client diagnosed with community - acquired pneumonia who reports shortness of breath and new - onset sharp chest pain that worsens with deep breathing. upon auscultation, the nurse auscultates a grating sound over the lower lung fields. which condition should the nurse suspect as a complication of pneumonia?
atelectasis
pleurisy
pulmonary embolism
pneumothorax

Explanation:

1. Analyze each option:

• Atelectasis: Usually involves collapsed alveoli, and the auscultation findings here (grating sound) don't match typical atelectasis signs.
• Pleurisy: Inflammation of the pleura. Symptoms include sharp chest pain worsened by deep breathing, and a grating sound (pleural friction rub) on auscultation, which matches the client's presentation as a complication of pneumonia.
• Pulmonary embolism: Typically presents with sudden dyspnea, chest pain (often pleuritic but also with other signs like hemoptysis, tachycardia, and is more related to blood clots, not the grating sound here).
• Pneumothorax: Involves air in the pleural space, with findings like absent breath sounds on the affected side, not a grating sound.

1. Based on the symptoms (sharp chest pain with deep breathing, grating sound) and the context of pneumonia complication, pleurisy is the best match.

Answer:

B. pleurisy