Pneumothorax — NCLEX Cheat Sheet
Air in pleural spaceAlso known as: collapsed lung · air in chest · tension pneumothorax · punctured lung
Use this quick-reference guide to spot, treat, and prevent Pneumothorax on the NCLEX. Keep it handy during review and on exam day!
🩺📒 The 1-minute cheat sheet
🩺 Signs
- Sudden sharp pain, dyspnea
- ↓/absent breath sounds 1 side
- ↓ chest movement, hyperresonance
🚩 Report
- Tension: tracheal deviation
- ↓ BP, JVD → emergency
✅ Do
- Chest tube to re-expand lung
- Tension: needle decompression
- O₂, high Fowler's, monitor
⚠️ Causes
- Trauma, central line, COPD
📚 Pneumothorax — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
Key points
Understand these first- Sudden sharp pleuritic chest pain, dyspnea, and decreased or absent breath sounds on the affected side are classic.
- The affected side shows reduced chest movement and hyperresonance to percussion.
- Tachycardia, tachypnea, and hypoxemia accompany significant collapse.
- Tension pneumothorax produces tracheal deviation away from the affected side, jugular vein distention, and severe hypotension.
- A chest x-ray confirms the diagnosis by showing the collapsed lung and pleural air.
- Subcutaneous emphysema (crepitus under the skin) may be palpable around the chest and neck.
Nursing priorities
What to do, in order- Administer high-flow oxygen and position the patient in high Fowler's.
- Prepare for emergency needle decompression for tension pneumothorax, followed by chest tube insertion.
- Assist with chest tube placement to re-expand the lung and restore negative pressure.
- Monitor respiratory status, breath sounds, oxygen saturation, and the chest drainage system.
- Notify the provider immediately of any tracheal deviation or rapid deterioration.
Red flags — report now
Escalate immediately- Tracheal deviation, severe hypotension, and distended neck veins indicate a tension pneumothorax requiring immediate needle decompression.
- Rapidly worsening dyspnea, absent breath sounds, and falling oxygen saturation are emergencies.
- Sudden onset after a procedure such as central line placement or thoracentesis must be reported at once.
Labs & values
Numbers to know- ABG may show hypoxemia (PaO2 <80) and respiratory acidosis if ventilation is impaired
- Chest x-ray confirms diagnosis (no specific lab value)
Patient teaching
What patients must know- Avoid air travel, scuba diving, and high altitudes until cleared by the provider after a spontaneous pneumothorax.
- Stop smoking, which increases the risk of recurrence.
- Report sudden chest pain or shortness of breath immediately as it may signal recurrence.
❓ Pneumothorax: NCLEX FAQs
What are the priority nursing interventions for Pneumothorax?
Administer high-flow oxygen and position the patient in high Fowler's. Prepare for emergency needle decompression for tension pneumothorax, followed by chest tube insertion. Assist with chest tube placement to re-expand the lung and restore negative pressure. Monitor respiratory status, breath sounds, oxygen saturation, and the chest drainage system.
What are the warning signs of Pneumothorax a nurse must report?
Tracheal deviation, severe hypotension, and distended neck veins indicate a tension pneumothorax requiring immediate needle decompression. Rapidly worsening dyspnea, absent breath sounds, and falling oxygen saturation are emergencies. Sudden onset after a procedure such as central line placement or thoracentesis must be reported at once.
What do I need to know about Pneumothorax for the NCLEX?
Sudden sharp pleuritic chest pain, dyspnea, and decreased or absent breath sounds on the affected side are classic. The affected side shows reduced chest movement and hyperresonance to percussion. Tachycardia, tachypnea, and hypoxemia accompany significant collapse. Tension pneumothorax produces tracheal deviation away from the affected side, jugular vein distention, and severe hypotension.
What patient teaching is important for Pneumothorax?
Avoid air travel, scuba diving, and high altitudes until cleared by the provider after a spontaneous pneumothorax. Stop smoking, which increases the risk of recurrence. Report sudden chest pain or shortness of breath immediately as it may signal recurrence.
Quick Tip
Sudden sharp pleuritic chest pain, dyspnea, and decreased or absent breath sounds on the affected side are classic.
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