Certified Post Anesthesia Nurse (CPAN) Practice Exam

What could be a concerning symptom in a post-operative patient experiencing tachypnea and chest pain?

1. Horner's syndrome

2. Cervical facet displacement

3. Tracheal deviation

4. Anxiety

The correct answer is: Tracheal deviation

In the context of a post-operative patient experiencing tachypnea and chest pain, tracheal deviation is a concerning symptom because it may indicate a serious underlying condition such as tension pneumothorax or significant respiratory distress. Tracheal deviation occurs when the trachea shifts from its normal midline position, which can be caused by either a mass effect from a large pleural effusion or the presence of air in the pleural space. The presence of tachypnea (rapid breathing) together with chest pain suggests that the patient may be experiencing a respiratory or circulatory problem that could rapidly worsen if not addressed. In contrast, while Horner's syndrome, cervical facet displacement, and anxiety can potentially occur in post-operative patients, they do not directly indicate an acute respiratory compromise or require immediate medical intervention in the same way that tracheal deviation does. Horner's syndrome relates to neurological issues in the cervical sympathetic trunk, cervical facet displacement involves spinal structures, and anxiety could certainly contribute to the patient's symptoms but does not signify a potential life-threatening situation like tracheal deviation does. Hence, tracheal deviation stands out as a sign that necessitates prompt assessment and intervention to prevent complications.