Chapter 29 Quiz

Question 1

A 28-year-old male was struck in the chest with a baseball bat during an altercation. He is conscious and alert and complains of severe chest pain. Your assessment reveals a large area of ecchymosis over the sternum and a rapid, irregular pulse. In addition to providing supplemental oxygen, you should:
Select one:
A. prepare for immediate transport.
B. apply bulky dressings to the sternum.
C. determine if he has cardiac problems.
D. apply an AED and assess his BP.

Answer 1

A. prepare for immediate transport.

Question 2

A flail chest occurs when:
Select one:
A. more than three ribs are fractured on the same side of the chest.
B. a segment of fractured ribs bulges during the inhalation phase.
C. multiple ribs are fractured on both sides of the thoracic cage.
D. a segment of the chest wall is detached from the thoracic cage.

Answer 2

D. a segment of the chest wall is detached from the thoracic cage.

Question 3

A man called EMS 12 hours after injuring his chest. Your assessment reveals a flail segment to the right side of the chest. The patient is experiencing respiratory distress and his oxygen saturation is 78%. His breath sounds are equal bilaterally and his jugular veins are normal. You should suspect:
Select one:
A. massive hemothorax.
B. traumatic asphyxia.
C. pulmonary contusion.
D. tension pneumothorax.

Answer 3

C. pulmonary contusion.

Question 4

A simple pneumothorax:
Select one:
A. is commonly caused by blunt chest trauma.
B. heals on its own without any treatment.
C. often has a nontraumatic cause.
D. is caused by penetrating chest trauma.

Answer 4

A. is commonly caused by blunt chest trauma.

Question 5

A spinal cord injury at the level of C7 would MOST likely result in:
Select one:
A. paralysis of all the respiratory muscles.
B. paralysis of the diaphragm.
C. immediate cardiac arrest.
D. paralysis of the intercostal muscles.

Answer 5

D. paralysis of the intercostal muscles.

Question 6

An open pneumothorax occurs when:
Select one:
A. air enters the pleural space from outside the body.
B. a fractured rib perforates the tissue of the lung.
C. extreme pleural pressure causes the lung to rupture.
D. air enters the pleural space from a perforated lung.

Answer 6

A. air enters the pleural space from outside the body.

Question 7

Children are often “belly breathers” because _______.
Select one:
A. they are consciously controlling ventilations
B. their diaphragm is not functional
C. their intercostal muscles are not developed
D. they are routinely hypoxic

Answer 7

C. their intercostal muscles are not developed

Question 8

Closed chest injuries are typically caused by \_\_\_\_\_\_\_.
Select one:
A. flying debris
B. high-velocity weapons
C. penetrating trauma
D. blunt trauma

Answer 8

D. blunt trauma

Question 9

Following a stab wound to the left anterior chest, a 25-year-old male presents with a decreased level of consciousness and signs of shock. Which of the following additional assessment findings should increase your index of suspicion for a cardiac tamponade?
Select one:
A. Diminished breath sounds
B. Widening pulse pressure
C. A rapid, irregular pulse
D. Engorged jugular veins

Answer 9

D. Engorged jugular veins

Question 10

If a patient with a chest injury is only able to inhale small amounts of air per breath, he or she:
Select one:
A. often breathes at a slower rate because of lung damage caused by the injury.
B. will eliminate more carbon dioxide than if he or she were breathing deeply.
C. will maintain adequate minute volume if his or her respiratory rate stays the same.
D. must increase his or her respiratory rate to maintain adequate minute volume.

Answer 10

D. must increase his or her respiratory rate to maintain adequate minute volume.

Question 11

Immediately life-threatening chest injuries must be found and managed during the \_\_\_\_\_\_\_.
Select one:
A. scene size-up
B. primary assessment
C. secondary assessment
D. patient history

Answer 11

B. primary assessment

Question 12

In order to avoid exacerbating a patient's injury, it is especially important to use extreme caution when providing positive-pressure ventilation to patients with a:
Select one:
A. cardiac tamponade.
B. myocardial contusion.
C. flail chest.
D. pneumothorax.

Answer 12

D. pneumothorax.

Question 13

Patients with chest injuries will often present with \_\_\_\_\_\_\_.
Select one:
A. tachypnea
B. agonal respirations
C. Cheyne-Stokes respirations
D. Kussmaul respirations

Answer 13

A. tachypnea

Question 14

The thoracic cavity is separated from the abdominal cavity by the:
Select one:
A. diaphragm.
B. costovertebral angle.
C. anterior rib cage.
D. intercostal margin.

Answer 14

A. diaphragm.

Question 15

When a person is lying supine at the end of exhalation, the diaphragm:
Select one:
A. is less prone to penetrating trauma.
B. descends below the level of the navel.
C. contracts and flattens inferiorly.
D. may rise as high as the nipple line.

Answer 15

D. may rise as high as the nipple line.

Question 16

Which of the following is most likely to cause immediate death?
Select one:
A. Aortic rupture
B. Aortic dissection
C. Myocardial contusion
D. Pulmonary contusion

Answer 16

A. Aortic rupture

Question 17

While jogging, a 19-year-old male experienced an acute onset of shortness of breath and pleuritic chest pain. He is conscious and alert with stable vital signs. Your assessment reveals that he has diminished breath sounds over the left side of the chest. You should:
Select one:
A. administer oxygen and transport to the hospital.
B. circumferentially tape a dressing around his chest.
C. immediately perform a rapid head-to-toe exam.
D. recognize that he needs a needle decompression.

Answer 17

A. administer oxygen and transport to the hospital.

Question 18

You arrive at the scene of a major motor vehicle crash. The patient, a 50-year-old female, was removed from her vehicle prior to your arrival. Bystanders who removed her state that she was not wearing a seatbelt. The patient is unresponsive, tachycardic, and diaphoretic. Your assessment reveals bilaterally clear and equal breath sounds, a midline trachea, and collapsed jugular veins. You should be MOST suspicious that this patient has experienced a:
Select one:
A. massive hemothorax.
B. tension pneumothorax.
C. pericardial tamponade.
D. laceration of the aorta.

Answer 18

D. laceration of the aorta.

Question 19

You have sealed the open chest wound of a 40-year-old male who was stabbed in the anterior chest. Your reassessment reveals that he is experiencing increasing respiratory distress and tachycardia, and is developing cyanosis. You should:
Select one:
A. partially remove the dressing.
B. begin rapid transport at once.
C. begin ventilatory assistance.
D. call for a paramedic ambulance.

Answer 19

A. partially remove the dressing.

Question 20

You respond to a residence for a 40-year-old female who was assaulted by her husband; the scene has been secured by law enforcement. Upon your arrival, you find the patient lying supine on the floor in the kitchen. She is semiconscious with severely labored breathing. Further assessment reveals a large bruise to the left anterior chest, jugular venous distention, and unilaterally absent breath sounds. As your partner is supporting her ventilations, you should:
Select one:
A. insert an oropharyngeal airway.
B. obtain a set of baseline vital signs.
C. immediately request ALS support.
D. perform a focused secondary exam.

Answer 20

C. immediately request ALS support.