Ok bud, first of all its Pnuemo, not Phuemo. . .pnuemo as in pneumatic or relating to air and stuff ya follow??
I'm 99.999% sure that the correct answer is D. wheezes, although in theory there could be wheezes present also. . .but that is the least of your worries my friend. So, youre right, a tension pnuemothorax is air trapped in the chest as a result of a punctured lung. but think about it, there is a hole in the lung, so any air that you breathe in, is going to go down the trachea, into the lungs, and out the hole. where does it go then? it goes into the pleural cavity of the chest, or the lining between the outside of your lungs, and the inside of your ribs. ever watch the movie "3 Kings" with Ice cube, george clooney, and mark whatever his name is? very good illustration of a pneumothorax there. anyway the air in the pleural space begins to compress the lung with every breath you take, why you ask?, because everytime you breathe in, the pleural space fills with more air, and there is less room for you lung to inflate. . .thats why as an early treatment, you use an occlusive dressing. . .with a tension pnuemo, pretty much the entire side of the chest, (on the inside) has filled with air, your lung now looks like a limp condom. as a result the other lung is now the only one able to inflate, your trachea deviates to the side of the good lung, the entire mediastinum is pushed over by this pressure build up. .compressing your heart, causing JVD. The Tx for this @ the EMT level with all of those Signs/Sx? Uh i dunno. . .prayer. . .profanity. . .incontinence. . .just jokin, the patient needs a needle de-compression and ultimatley a chest tube. . .so better hope u got a Paramedic or an ER with a MD close by or the patient is toast. Tracheal deviation is a late sign. . .anyway a little long winded, but i'm bored/snowed in @ work with no calls. so let me know if ya have more questions. . .be glad to answer for the next 18 hours if I know the answer. . .Jon. emt-p