A client sustained a chest injury and is experiencing a pleural effusion. What would the nurse expect as assessment findings? Select all that apply.

A. Fever: Pleural effusion may be secondary to infection (parapneumonic effusion or empyema) or inflammatory processes after trauma. Fever indicates a systemic inflammatory response and often accompanies infectious or inflammatory pleural fluid accumulation. B. Dyspnea on exertion: Fluid accumulation in the pleural space compresses lung tissue, reducing lung expansion and functional residual capacity. This leads to impaired gas exchange and shortness of breath, especially during activity when oxygen demand increases. C. Chest pain with inhalation: Pleuritic pain occurs when the inflamed pleural surfaces rub against each other during inspiration. This sharp, localized pain is a hallmark symptom of pleural effusion and differentiates it from other causes of chest discomfort. D. Tachypnea: The decreased lung compliance and reduced alveolar ventilation from fluid accumulation stimulate compensatory rapid breathing to maintain adequate oxygenation, resulting in an increased respiratory rate. E. Coarse crackles: Crackles are usually associated with fluid within the alveoli (e.g., pulmonary edema), not the pleural space. In pleural effusion, breath sounds are typically diminished or absent over the effusion site rather than producing coarse crackles. F. Productive cough: Pleural effusion itself does not cause productive cough because fluid is outside the airways. Cough may occur if there is an underlying pneumonia, but it is not a direct finding of pleural effusion.