Complications: tension pneumothorax under positive pressure ventilation: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Complications: tension pneumothorax under positive pressure ventilation

Sample item

A ventilated patient suddenly has rising airway pressure, falling saturation, hypotension and absent breath sounds on one side. What is the immediate treatment?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Immediate needle or finger decompression of the chest, then a chest drain

Positive pressure ventilation converts a pneumothorax into a tension pneumothorax, with mediastinal shift and obstructive shock. Immediate decompression with a needle or finger thoracostomy is followed by a chest drain. Nitrous oxide is stopped.

Option by option

  • A. Increase tidal volume

    More volume increases pressure.

  • B. Give a diuretic

    Diuretics do not help.

  • C. Chest physiotherapy

    Physiotherapy has no role.

  • D. Immediate needle or finger decompression of the chest, then a chest drain (correct)

    Correct. Decompression relieves the tension and restores venous return.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is D, Immediate needle or finger decompression of the chest, then a chest drain. Positive pressure ventilation converts a pneumothorax into a tension pneumothorax, with mediastinal shift and obstructive shock.

Why is "Increase tidal volume" not the answer?

More volume increases pressure.

Why is "Give a diuretic" not the answer?

Diuretics do not help.

Why is "Chest physiotherapy" not the answer?

Physiotherapy has no role.

What concept does this question test?

It tests Complications: tension pneumothorax under positive pressure ventilation in Anaesthesia. Immediate decompression with a needle or finger thoracostomy is followed by a chest drain. Nitrous oxide is stopped.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Complications: tension pneumothorax under positive pressure ventilation?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.