CH 36

Question 1

Isolated rib fractures may result in inadequate ventilation because:
the patient often purposely limits chest wall movement.
the pain associated with the fracture causes hyperventilation.
preferential use of the intercostal muscles reduces tidal volume.
most rib fractures cause paradoxical chest wall movement.

Answer 1

the patient often purposely limits chest wall movement.

Question 2

As air accumulates in the pleural space, the first thing to occur is:
compression of the great vessels.
marked decrease in venous return.
decreased pulmonary function.
jugular venous distension.

Answer 2

decreased pulmonary function.

Question 3

Dysrhythmias following a myocardial contusion are usually secondary to:
damage to myocardial tissue at the cellular level.
excess tachycardia that accompanies the injury.
aneurysm formation caused by vascular damage.
direct damage to the vasculature of the epicardium.

Answer 3

damage to myocardial tissue at the cellular level.

Question 4

With the exception of the aorta, great vessel injury is most likely to occur following:
rotational injury.
penetrating trauma.
shearing forces.
blunt trauma.

Answer 4

penetrating trauma.

Question 5

An open pneumothorax causes ventilatory inadequacy when:
the glottic opening is much larger than the open wound on the chest wall.
positive pressure created by expiration forces air into the pleural space.
the heart stops perfusing the lung on the side of the open chest injury.
negative pressure created by inspiration draws air into the pleural space.

Answer 5

negative pressure created by inspiration draws air into the pleural space.

Question 6

A blood pressure of 110/68 mm Hg in the presence of clinical signs of a tension pneumothorax:
suggests adequate cardiac compensation for the diminished venous return.
is likely the result of systemic vasodilation in an attempt to reduce preload.
should be treated with crystalloid fluid boluses to prevent hypotension.
indicates that prehospital needle decompression likely will not be required.

Answer 6

suggests adequate cardiac compensation for the diminished venous return.

Question 7

A pulmonary contusion following blunt chest trauma results in:
pulmonary vasodilation as the body attempts to shunt blood to the injury.
alveolar and capillary damage with intraparenchymal lung hemorrhage.
blood leakage from injured lung tissue into the pleural space.
decreased pulmonary shunting with rupture of the alveolar sacs.

Answer 7

alveolar and capillary damage with intraparenchymal lung hemorrhage.

Question 8

Increased central venous pressure commonly manifests as:
jugular venous distention.
a pulsating abdominal mass.
a widened pulse pressure.
bounding peripheral pulses.

Answer 8

jugular venous distention.

Question 9

Which of the following interventions would most likely convert a simple pneumothorax to a tension pneumothorax?
Needle thoracentesis
A semi-sitting position
Positive-pressure ventilation
A 500-mL fluid bolus

Answer 9

Positive-pressure ventilation

Question 10

Tracheobronchial injuries have a high mortality rate due to:
massive internal hemorrhage.
concomitant spinal cord injury.
associated airway obstruction.
perforation of the esophagus.

Answer 10

associated airway obstruction.