Deck 23: Pneumothorax

Question 1

Which of the following chest assessment findings would be expected in a patient with a tension pneumothorax?

A) Decreased thoracic volume on the affected side
B) Dull percussion note
C) Tracheal shift away from the affected side
D) Wheezes

Answer 1

Tracheal shift away from the affected side

Question 2

A 40-year-old patient requires placement of a thoracostomy chest tube. Which of the following are recommended for the procedure?
1) Application of -5 cm H₂O pressure to the chest tube
2) Use of a No. 28 to 36 French gauge tube
3) Placement of the tube at the apex of the lung
4) Clamping and removing the tube within 24 hours of insertion

A)1, 3
B)1, 2, 4
C)2, 3, 4
D)1, 2, 3

Answer 2

1, 2, 3

Question 3

What is the primary cause of hypotension in a patient with a large pneumothorax?

A) Pain
B) Decreased venous return to the heart
C) Tracheal compression
D) Atelectasis

Answer 3

Decreased venous return to the heart

Question 4

Which of the following are anatomic alterations that occur when a person has a pneumothorax?
1) The lung on the affected side collapses.
2) The visceral and parietal pleura separate.
3) The visceral pleura adheres to the parietal pleura.
4) The chest wall moves outward.

A)1, 3
B)3, 4
C)2, 4
D)1, 2, 4

Question 5

If the patient has a tension pneumothorax, which of the following chest radiograph findings would be expected?
1) Elevated diaphragm
2) Mediastinal shift to the unaffected side
3) Increased translucency on the side of the pneumothorax
4) Atelectasis

A)1, 3
B)1, 2, 4
C)2, 3, 4
D)1, 2, 3

Question 6

A 17-year-old male has been brought to the hospital because he felt short of breath after being tackled in a football game. A chest radiograph shows a broken rib and a pneumothorax in the right lung with pleural space not in direct contact with the atmosphere. Which of the following conditions would be present?

A) Closed pneumothorax
B) Pleural effusion
C) Iatrogenic pneumothorax
D) Sucking chest wound

Question 7

According to the way gas enters the pleural space, a pneumothorax will be classified as:
1) intrinsic.
2) extrinsic.
3) open.
4) closed.

A)2, 3
B)1, 4
C)3, 4
D)1, 2

Question 8

Which of the following hemodynamic indices will be found in a patient with a large hemothorax?

A) Decreased Q_S/Q_T
B) Decreased CO
C) Increased CI
D) Increased SV

Question 9

A pneumothorax manifests itself clinically as a primary _____ disorder.

A) restrictive
B) obstructive
C) restrictive disorder with a secondary obstructive
D) obstructive disorder with secondary restrictive

Question 10

A sucking chest wound would be classified as a(n) _____ pneumothorax.

A) open
B) closed
C) iatrogenic
D) valvular

Question 11

An iatrogenic pneumothorax may be caused by:
1) positive-pressure mechanical ventilation.
2) pleural biopsy
3) subclavian vein cannulation.
4) endotracheal intubation.

A)1, 3
B)1, 2, 4
C)2, 3, 4
D)1, 2, 3

Question 12

Which type of untreated pneumothorax is considered to be the most serious?

A) Spontaneous
B) Tension
C) Malignant
D) Iatrogenic

Question 13

After a patient experienced four pneumothoraces of her right lung over a 24-month period, the physician recommended a procedure to reduce the occurrence of future pneumothoraces. Which procedure would the physician have recommended?

A) Pleurodesis
B) Right pneumonectomy
C) Permanent right-sided thoracostomy tube
D) Right upper lobectomy

Question 14

A 6-foot-tall, 140-pound, 28-year-old female patient has come to the emergency department with a complaint of a sudden sharp pain in the right upper chest followed by shortness of breath. The pain originated while she participated in deep breathing exercises in a yoga class. The physician has determined that she has a 15% pneumothorax. How should the pneumothorax be classified?

A) Open
B) Exercise related
C) Spontaneous
D) Traumatic

Question 15

Which type of pneumothorax would result from the rupture of bulla on the surface of a lung?

A) Spontaneous pneumothorax
B) Iatrogenic pneumothorax
C) Open pneumothorax
D) Visceral pneumothorax

Question 16

A patient has a pneumothorax with a sucking chest wound resulting in the movement of gas from one lung to another. This is called:

A) panting.
B) paradoxical movement.
C) bidirectional flow.
D) pendelluft.

Question 17

A patient had a penetrating knife wound to her chest wall that resulted in a valvular pneumothorax. What is another term for this condition?

A) Spontaneous pneumothorax
B) Tension pneumothorax
C) Iatrogenic pneumothorax
D) Benign pneumothorax