Chest X-ray interpretation: Not just black and white.

Chest X-rays (CXRs) are a fundamental diagnostic tool in acute and critical care, providing a rapid and noninvasive method for evaluating thoracic conditions. Although radiologists interpret the images, nurses are often the first to review the reports and relay findings to the clinical team. This article provides a practical guide to understanding and interpreting CXRs and outlines a systematic approach to aid in consistent evaluation. The visualization of both normal anatomy and key abnormalities are discussed, including pleural effusions, pulmonary edema, pneumonia, atelectasis, pneumothorax, acute respiratory distress syndrome, chronic obstructive pulmonary disease, and lung nodules. By developing basic competency in CXR interpretation, nurses can improve diagnostic accuracy, promote timely interventions, and enhance patient outcomes.