Advanced Patient Assessment Practice Exam

What condition is most likely to cause tracheal deviation?

1. Left upper lobe pneumothorax

2. Left lower lobe pleural effusion

3. Right lower lobe pleural effusion

4. Right upper lobe pneumothorax

The correct answer is: Right upper lobe pneumothorax

Tracheal deviation is often associated with conditions that alter pressures within the thoracic cavity. In the case of a right upper lobe pneumothorax, air accumulates in the pleural space on the affected side, leading to an increase in intrathoracic pressure. This change can result in the trachea being pushed away from the site of the pneumothorax towards the left side. The other conditions listed, such as pleural effusions or pneumothorax on the opposite side, may not create as significant a deviation in the trachea. For example, a left lower lobe pleural effusion would likely cause the trachea to deviate to the right rather than away, since the fluid accumulation on one side creates a bulging effect that typically pushes structures. Similarly, a left upper lobe pneumothorax would also deviate the trachea to the right. In contrast, a right lower lobe pleural effusion tends to not cause a clear tracheal shift and may lead to more central or minimal deviations, depending on the volume. Thus, a right upper lobe pneumothorax is the most likely condition to cause tracheal deviation, specifically moving the