Question 1

``` H-1) An open abdominal wound with protruding organs is​ called: A. an evisceration. B. a puncture wound. C. an unstable abdomen. D. a flail abdomen. ```

Accepted Answer

A. an evisceration. An evisceration is an intestine or other internal organ protruding through a wound in the abdomen.

Question 2

``` H-2) When a patient who has a flail segment​ exhales, the segment of the ribs will push outward while the rest of the chest cavity pulls inward. This is referred to​ as: A. subcutaneous emphysema. B. paradoxical motion. C. unequal respiration. D. fractional expansion. ```

Accepted Answer

B. paradoxical motion. The movement of ribs in a flail segment that is opposite to the direction of movement of the rest of the chest cavity is called paradoxical motion.

Question 3

H-3) A pneumothorax may occur​ when: A. a fractured rib breaks through the skin of the outer chest and keeps the wound sealed with the bone end. B. a hemothorax caused by a penetrating wound to the chest is left untreated for an extended period. C. a sucking chest wound is sealed with an occlusive dressing that is taped on only three sides. D. air leaks into the chest cavity from a damaged lung with no opening through the outer chest.

Accepted Answer

D. air leaks into the chest cavity from a damaged lung with no opening through the outer chest. Pneumothorax occurs when air accumulates in the potential space in the area where the lung tissue adheres to the chest wall. When air accumulates in this​ space, it pushes lung tissue away from the chest​ wall, causing collapse of the lung. Air can enter this space through an external wound or through escape from a punctured lung. Occasionally both events may occur.

Question 4

H-4) Which of the following best describes an open chest wall​ injury? A. A patient with pericardial tamponade following a blow to the chest from a baseball bat B. Blunt trauma to the sternum during a sporting event C. A patient trapped under a car D. Knife wound to the left anterior chest

Accepted Answer

D. Knife wound to the left anterior chest A knife wound is a type of mechanism that can cause an open chest wall injury. The other options are more likely to cause a closed chest injury.

Question 5

``` H-5) A​ 34-year-old female patient received a​ small-caliber gunshot wound to the right anterior chest. She is complaining of dyspnea. Her respirations are 22 and shallow. This patient is presenting​ with: A. a cardiac tamponade. B. a flail chest. C. an open pneumothorax. D. a pulmonary embolism. ```

Accepted Answer

C. an open pneumothorax. The location and type of trauma and the reduced breath sounds indicate an open​ pneumothorax, and the lack of hyperresonance does not exclude pneumothorax.

Question 6

``` H-6) Your patient has received a blunt trauma injury to the chest from being hit with a baseball bat. You notice a flail​ segment, lung sounds are​ diminished, and the patient is having difficulty breathing. You note that the​ patient's trachea is deviating toward the uninjured side. You​ suspect: A. a pneumothorax. B. a hemothorax. C. an open wound that you cannot see. D. a tension pneumothorax. ```

Accepted Answer

D. a tension pneumothorax. A tension pneumothorax occurs when air accumulates in the pleural cavity until the lung​ collapses, and the pressure buildup will eventually start to shift the intrathoracic contents toward the contralateral side of the injury. This injury can happen with either blunt or penetrating trauma.

Question 7

H-7) Paradoxical motion is caused​ by: A. increased use of the diaphragm to breathe because of injury to the chest. B. a flail segment moving in the direction opposite to the movement of the uninjured side of the rib cage. C. a tension pneumothorax limiting the expansion of the injured side of the chest. D. a damaged​ lung's not inflating as much as the undamaged lung.

Accepted Answer

B. a flail segment moving in the direction opposite to the movement of the uninjured side of the rib cage. During inhalation and​ exhalation, the flail segment displays paradoxical​ motion; that​ is, the flail segment moves in a direction opposite to the movement of the rest of the chest wall.

Question 8

``` H-8) You are treating a patient who was diagnosed with multiple rib fractures following a motor vehicle collision. You note equal chest rise and fall. He appears short of breath as well as​ pale, cool, and diaphoretic. Given the​ patient's presentation as well as his acute medical​ history, what condition is he most likely to​ suffer? A. Flail chest B. Hemothorax C. Tension pneumothorax D. Pneumothorax ```

Accepted Answer

B. Hemothorax Hemothorax can be caused when lacerations within the chest cavity are produced by penetrating objects or fractured ribs. Blood will flow into the space around the​ lung, the lung may​ collapse, and the patient will experience a loss of​ blood, leading to shock.

Question 9

H-9) Emergency care of a patient with an open chest wound should​ include: A. applying an occlusive dressing taped on three sides to any open chest wound. B. removing the occlusive dressing if the​ patient's breathing status deteriorates. C. immediate removal of any impaled object from the chest wound. D. positioning the patient on the uninjured​ side, so that the lung can inflate more fully.

Accepted Answer

A. applying an occlusive dressing taped on three sides to any open chest wound. Apply an occlusive dressing to seal the wound​ (not a regular porous​ dressing, which would allow air to enter​ easily). The occlusive dressing should be a few inches wider than the wound. Place it over the entire​ wound, and tape it on three sides.

Question 10

H-10) Which of the following signs and symptoms would lead you to believe that your patient had a tension​ pneumothorax? A. Decreased blood pressure B. Severely decreased or absent breath sounds on the injured side C. Paradoxical motion D. Tachycardia

Accepted Answer

B. Severely decreased or absent breath sounds on the injured side Severely decreased or absent breath sounds on the injured side are the most serious of the signs and symptoms listed that would indicate development of a tension pneumothorax

Question 11

H-11) A tension pneumothorax differs from a simple pneumothorax in​ that: A. a tension pneumothorax seals off any wounds as a result of the increased pressure. B. a tension pneumothorax puts pressure on the​ heart, the great​ vessels, and the unaffected lung. C. a simple pneumothorax is not a serious emergency. D. a simple pneumothorax is not caused by an external open wound.

Accepted Answer

B. a tension pneumothorax puts pressure on the​ heart, the great​ vessels, and the unaffected lung. If there is no opening to the outside​ chest, air that leaks from the lung has no avenue of escape. Pressure builds up in the chest​ cavity, compressing the​ heart, the great​ vessels, and the unaffected lung.

Question 12

H-12) Blunt abdominal trauma that causes the perforation of a vascular structure in the abdomen may​ cause: A. spinal cord damage to motor nerve roots. B. loss of function to the lower extremities. C. significant blood loss. D. rupture of the urinary​ bladder, with resultant chemical inflammation

Accepted Answer

C. significant blood loss. An injury to a vascular structure such as the liver or spleen typically involves a serious and often​ life-threatening hemorrhage. There is often heavy blood loss into the abdominal compartment that may go unrecognized for a period of time.

Question 13

H-13) Why should the EMT complete a full assessment on a patient with a bullet wound to the​ abdomen? A. To determine whether transport is necessary B. To determine how straight the​ bullet's trajectory was C. To definitively identify all injured organs D. To determine the probable extent of injuries

Accepted Answer

D. To determine the probable extent of injuries Penetrating abdominal wounds can be associated with wounds in adjacent areas of the body. For​ example, a bullet can enter the chest​ cavity, pierce the​ diaphragm, and cause widespread damage in the abdomen. A complete patient assessment is essential in determining the probable extent of injuries. Always assess for an exit wound. Bullet trajectories are rarely​ straight, and internal damage cannot be easily​ assessed, so determining the straightness of the​ bullet's trajectory and definitively identifying all injured organs is likely impossible in a prehospital setting. Transport is mandatory.

Question 14

``` H-14) An object that is impaled in the abdomen should​ be: A. stabilized in place. B. twisted while being pulled out. C. immediately removed. D. slowly removed. ```

Accepted Answer

A. stabilized in place. Like any impaled object in the trunk of the​ body, the item should be stabilized in place and not removed by the EMT. The amount of damage that could be caused by pulling it out is​ unknown, and may be fatal.

Question 15

H-15) You arrive on scene to an alert​ 27-year-old male patient with an obvious abdominal evisceration. He is​ restless, pale,​ cool, and diaphoretic. After administering​ high-concentration oxygen, you should​ immediately: A. cover the wound with a dressing moistened with saline. B. use a dry dressing on the​ wound, covered by aluminum foil. C. have the patient lie flat. D. transport.

Accepted Answer

A. cover the wound with a dressing moistened with saline. Do not touch or try to replace any​ eviscerated, or​ exposed, organs. Apply a sterile dressing moistened with sterile saline over the wound site. Some EMS systems may recommend that you apply an occlusive dressing as well. It may be necessary to remoisten the dressings with additional saline to ensure that the eviscerated organ or organs do not dry out. In cases of large​ eviscerations, maintain warmth by placing layers of bulky dressing over the moistened dressing.

Question 16

``` PT-1) You are treating a​ 42-year-old male assault victim who presents with​ nausea, vomiting, and sharp abdominal pain. While inspecting his​ abdomen, you note redness to his right upper quadrant. Based on your assessment​ findings, the patient is most likely suffering from which of the​ following? A. Traumatic hemorrhage of the liver B. Acute appendicitis C. Trauma to the abdominal aorta D. Traumatic hemorrhage of the spleen ```

Accepted Answer

A. Traumatic hemorrhage of the liver

Question 17

PT-2) What is the purpose of a​ flutter-valve occlusive​ dressing? A. To allow air to escape but not enter B. To allow air to enter but not escape C. To allow free movement of air without risk of infection D. To prevent all movement of air

Accepted Answer

A. To allow air to escape but not enter

Question 18

``` PT-3) Which of the following is most clearly an example of an open chest​ injury? A. Commotio cordis B. Sucking chest wound C. Hemothorax D. Pneumothorax ```

Accepted Answer

B. Sucking chest wound

Question 19

PT-4) Which patient most likely has an abdominal​ injury? A. Patient complains of hypoglycemia. B. Patient complains of hunger. C. Patient tries to lie still with legs drawn up. D. Patient speaks loudly and rapidly.

Accepted Answer

C. Patient tries to lie still with legs drawn up.

Question 20

PT-5) An open wound to the​ chest, if an occlusive dressing is not​ available, should be​ sealed: A. immediately with a gloved hand. B. upon completion of the history and physical examination. C. only if bubbles are seen in the blood coming from the wound. D. immediately with a bulky trauma dressing.

Accepted Answer

A. immediately with a gloved hand.

Question 21

``` PT-6) Injury to which of the following organs would be most likely to cause​ peritonitis? A. Ovary B. Lung C. Small intestine D. Spleen ```

Accepted Answer

C. Small intestine

Question 22

``` PT-7) What type of injury is likely to produce a flail​ segment? A. Blunt trauma B. Pneumothorax C. Penetrating trauma D. Open chest wound ```

Accepted Answer

A. Blunt trauma

Question 23

``` PT-9) You respond to the scene of a​ 24-year-old gunshot victim and find your patient to have a decreased mental status as well as hypotension. You note absent breath sounds on the left side of his​ chest, where you notice a puncture wound. From what is this patient most likely​ suffering? A. Pericardial tamponade B. Commotio cordis C. Flail chest D. Tension pneumothorax ```

Accepted Answer

D. Tension pneumothorax

Question 24

``` PT-9) You respond to the scene of a​ 24-year-old gunshot victim and find your patient to have a decreased mental status as well as hypotension. You note absent breath sounds on the left side of his​ chest, where you notice a puncture wound. From what is this patient most likely​ suffering? A. Pericardial tamponade B. Commotio cordis C. Flail chest D. Tension pneumothorax ```

Accepted Answer

D. Tension pneumothorax

Question 25

``` PT-10) When air is present in the chest​ cavity, the injury is called​ a: A. tension pneumothorax. B. pneumothorax. C. sucking chest wound. D. hemothorax. ```

Accepted Answer

B. pneumothorax.

Question 26

PT-11) In the case of a large​ evisceration, you should place layers​ of: A. bulky dressings over a dressing moistened with saline. B. bulky dressings moistened with saline. C. bulky dressings moistened with saline and sealed with a large occlusive dressing. D. occlusive dressings moistened with saline.

Accepted Answer

A. bulky dressings over a dressing moistened with saline.

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CH 31 Chest and Abdominal Trauma Flashcards

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