You respond to the scene of a 56-year-old obese female complaining of respiratory distress. she states that she has been feeling weak and a "little sick" for the past two days but the respiratory distress has been getting progressively worse for the past several hours. she states she has "heart problems," suffers from high blood pressure, and takes a "water pill." she is afebrile and has coarse crackles (rales) bilaterally. what is most likely the cause of her respiratory distress.

A92-year-old man with a 45-year history of chronic obstructive pulmonary disease is intubated in the icu because of a bout of viral pneumonia that fails to improve after 72 hours of antibiotics. although the inspired fraction of oxygen is 100%, the patient's po2 remains at 57 mmhg. positive-end expiratory pressure (peep) is added to allow the inspired fraction of oxygen. twelve hours after the introduction of peep the patient suddenly become hypotensive. at the same time, his oxygen saturation drops from 92% to 61%. on physical examination, his bp is 80/50 mmhg and his pulse is 124/min. he has distended neck veins and distant heart sounds. which of the following would also most likely be seen on this patient's physical examination? - absence of breath sounds in the right hemithorax- high amplitude carotid artery upstroke- a pleural friction rub- pulsus alternans- splenomegaly