Chapter 30 - Chest Injuries Flashcards
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.
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.
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.
D. a segment of the chest wall is detached from the thoracic cage.
Chapter 29, page 1045
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.
C. pulmonary contusion.
Chapter 29, page 1047
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.
A. is commonly caused by blunt chest trauma.
Chapter 29, page 1042
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.
D. paralysis of the intercostal muscles.
Chapter 29, page 1031
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.
A. air enters the pleural space from outside the body.
Chapter 29, page 1041
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
C. their intercostal muscles are not developed
Closed chest injuries are typically caused by _______.
Select one:
A. flying debris
B. high-velocity weapons
C. penetrating trauma
D. blunt trauma
D. blunt trauma
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
D. Engorged jugular veins
Chapter 29, page 1045
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.
D. must increase his or her respiratory rate to maintain adequate minute volume.
Chapter 29, page 1034
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
B. primary assessment
Chapter 29, page 1037
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.
D. pneumothorax.
Patients with chest injuries will often present with _______.
Select one:
A. tachypnea
B. agonal respirations
C. Cheyne-Stokes respirations
D. Kussmaul respirations
A. tachypnea
Chapter 29, page 1036
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.
A. diaphragm.
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.
D. may rise as high as the nipple line.
Chapter 29, page 1031
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
A. Aortic rupture
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:
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.
A. administer oxygen and transport to the hospital.
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. Y 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.
D. laceration of the aorta.
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:
A. partially remove the dressing.
B. begin rapid transport at once.
C. begin ventilatory assistance.
D. call for a paramedic ambulance.
A. partially remove the dressing.
