The nurse is assessing a client with rib fractures. Which of the following findings would indicate that the client is developing a tension pneumothorax?

A. Retractions or depressions between ribs usually indicate increased work of breathing, but they are not specific for tension pneumothorax and do not involve tracheal deviation or mediastinal shift. B. Hyperresonance is typically percussed on the side with trapped air (the affected side), not the unaffected side. Hyperresonance alone does not confirm a tension pneumothorax. C. Rales (crackles) are associated with fluid in the alveoli, such as in pneumonia or pulmonary edema. Tension pneumothorax involves air in the pleural space, not fluid, so rales are not expected. D. In tension pneumothorax, air accumulates under pressure in the pleural space, compressing the lung and pushing the mediastinum, including the trachea, toward the unaffected side. This is a classic and life-threatening sign that requires immediate decompression.