skip to main content

Tension pneumothorax — MCCQE Part 1 MCQ

Instant feedback + full explanation. One question, done properly.

HardTraumaTension pneumothoraxMCCQE Part 1

A 30-year-old man after a motor vehicle collision is hypotensive and hypoxic with distended neck veins, tracheal deviation and absent right breath sounds. Which of the following is the most appropriate next step?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Perform immediate needle decompression followed by chest tube placement

Perform immediate needle decompression followed by chest tube placement is the single best answer because the age, timing, examination findings and investigations in the vignette fit Tension pneumothorax better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to ATLS Canada guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: ATLS Canada guidance