A client with pleural effusion has just undergone a thoracentesis. Which finding suggests that the client has developed subcutaneous emphysema? A. A crackling sensation is felt when the skin near the puncture site is palpated. B. Reduced breath sounds are auscultated on the affected side. C. Paradoxical movement is noted when the client inhales and exhales. D. Chest asymmetry and distended neck veins are noted.

Subcutaneous emphysema is a condition where air gets trapped under the skin, causing a crackling sensation when the area is touched or palpated. It can occur as a complication after procedures like thoracentesis, where air escapes from the lungs and accumulates in the subcutaneous tissue.

Thoracentesis is a procedure where a needle is inserted into the pleural space (the thin space between the lung and chest wall) to remove excess fluid or air. It is usually done to relieve symptoms, such as difficulty breathing, associated with pleural effusion (buildup of fluid in the pleural space). However, it can sometimes lead to complications, including subcutaneous emphysema.

A. A crackling sensation is felt when the skin near the puncture site is palpated: This option describes the classic symptom of subcutaneous emphysema. The crackling sensation occurs because of the presence of air trapped under the skin. B. Reduced breath sounds are auscultated on the affected side: This option might indicate the presence of pleural effusion or a collapsed lung, but it does not indicate subcutaneous emphysema. C. Paradoxical movement is noted when the client inhales and exhales: This option suggests a condition called paradoxical breathing, which is caused by chest wall injury or an impaired diaphragm, but not subcutaneous emphysema. D. Chest asymmetry and distended neck veins are noted: This option might indicate a condition called tension pneumothorax, which is an emergency situation caused by air trapped in the pleural space, putting pressure on the lung and causing it to collapse. However, it does not indicate subcutaneous emphysema.

Based on our analysis, the correct answer is A. A crackling sensation is felt when the skin near the puncture site is palpated, as it indicates the presence of subcutaneous emphysema.