A physical examination of the chest is performed on a patient who is being mechanically venti-lated. Breath sounds and percussion are normal except over the right middle lobe, where late in-spiratory crackles are heard
This area is dull to percussion. An evaluative chest radiograph image reveals infiltrates in the right middle lobe. Based on these findings alone, which of the following is the most likely problem?
a. Pneumothorax in the right hemithorax
b. Congestive heart failure
c. Right middle lobe pneumonia
d. Asthma affecting the right side only
ANS: C
For patients with pneumonia, the chest is dull to percussion, breath sounds are decreased, and crackles (rales) occur late in inspiration over the affected area.
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