K. is a 39-year-old female who was admitted for evaluation of progressive

activity intolerance, and chest radiography revealed a large right lower lobe pleural effusion. A pleural fluid tap was performed, but fluid analysis results were inconclusive and the cause of the effusion could not be identified. The AGACNP knows that which diagnostic study is most appropriate to identify the cause of pleural effusion when fluid analysis is inadequate?

A. Scalene biopsy       B. Video-assisted thoracoscopic surgery (VATS)      C. Pleural needle biopsy D.Open surgical biopsy