Deck 11: Thoracic Injuries

Question 1

Which of the following are indicative signs and symptoms of someone experiencing traumatic asphyxia?

A) Paleness of the skin
B) Ashen complexion
C) Cyanosis
D) Dark red or blue coloring head and neck

Answer 1

D

Question 2

Following the history portion of an assessment, you will be making a series of observations. Which of the following might you be observing in your patient?

A) Level of anxiety
B) Ability to speak in full sentences
C) Demeanor
D) Mental status
E) All of the above

Answer 2

E

Question 3

When performing an assessment of an athlete with a suspected thoracic injury, what is the first step?

A) Observe the athlete's general appearance; level of consciousness; and airway, breathing, and circulation (ABCs).
B) Activate the emergency action plan.
C) Correct any life-threatening condition.
D) Take a thorough history.

Answer 3

A

Question 4

A patient with a tension pneumothorax will present with _________.

A) jugular artery distention
B) increased cardiac output
C) lateral displacement of the trachea
D) increased blood pressure

Question 5

Which of the following can result in or contribute to a simple pneumothorax?

A) Internal injury causing a laceration or rupture of a lung
B) External injury causing an open wound in the chest wall
C) Can occur spontaneously in tall, thin, and young males
D) Significant blunt trauma
E) All of the above

Question 6

_________ are caused by fluid in the smaller airways, in many cases because of pulmonary edema.

A) Stridors
B) Rhonchi
C) Crackles
D) Diminished lung sounds

Question 7

A patient presents to you appearing pale, ashen, and cyanotic. Which of the following conditions do you suspect?

A) Respiratory collapse
B) Traumatic asphyxia
C) Hypovolemic shock
D) Open chest wound

Question 8

Each of the following is a sound that may occur as the result of an airway obstruction. Which of the following represents what a clinician might hear as a result of constriction caused by bronchospasm?

A) Wheezing
B) Rhonchi
C) Snoring
D) Stridor

Question 9

Subcutaneous emphysema _________.

A) is air trapped under the skin
B) results from air escaping the lungs
C) presents as crackling and crepitus during palpation
D) All of the above

Question 10

_________ involves air being trapped between the parietal and visceral pleurae, causing the lung to collapse.

A) Simple pneumothorax
B) Tension pneumothorax
C) Open pneumothorax
D) None of the above

Question 11

When assessing whether someone has a punctured lung, which of the following statements is not true?

A) If you note a hyperresonant sound in the thorax, you might suspect a pneumothorax.
B) If you note a hyporesonant sound in the thorax, you might suspect a pneumothorax.
C) A pneumothorax involves air that is trapped between the parietal and visceral pleurae.
D) A dull sound during percussion testing is indicative of a hemothorax.

Question 12

Which of the following would be an indication of an upper airway obstruction?

A) Snoring sound
B) Rhonchi
C) Crackles
D) Diminished lung sounds

Question 13

_________ are most commonly heard in patients with congestive heart failure or pneumonia.

A) Rhonchi and wheezing
B) Rhonchi and crackles
C) Wheezing and stridor
D) Stridor and wheezing

Question 14

________ is a condition involving fractures of two or more adjacent ribs, resulting in paradoxical respiration.

A) A flail chest
B) Pneumothorax
C) Hemothorax
D) Costochondral separation

Question 15

Of the following conditions, which presents as a medical emergency?

A) A single-rib fracture
B) Fractures of the sternum
C) Posterior dislocation of the sternoclavicular joint with concomitant respiratory distress
D) A & B
E) B & C

Question 16

Which of the following is not true regarding paradoxical motion of the rib cage during breathing?

A) Paradoxical movement of the rib cage is the result of an unstable segment.
B) Acute muscle spasm will exacerbate paradoxical rib motion.
C) Fatigue of the intercostal muscles will cause paradoxical rib motion to become exaggerated.
D) All of the above

Question 17

When managing an athlete with a flail chest, _____________.

A) the athlete should be placed on her side to splint the area
B) manual pressure is not an adequate means of stabilizing the area in someone with a suspected C-spine injury
C) high-flow oxygen therapy is contraindicated
D) intubation should be avoided

Question 18

During the observation portion of your examination, you note tracheal deviation in an athlete. The athlete also appears anxious and restless and is exhibiting a rapid, thready pulse. You note that the athlete is becoming hypotensive and may be on the verge of circulatory collapse. You also note a hyperresonant sound during your percussion. What condition is your athlete experiencing?

A) Simple pneumothorax
B) Tension pneumothorax
C) Open pneumothorax
D) None of the above

Question 19

Which of the following might you be concerned with if an athlete is diagnosed with a fracture of rib 11?

A) Further injury to the lungs
B) Further injury to the cardiovascular system
C) Further injury to the liver and spleen
D) Further injury to the colon

Question 20

Which of the following should you do if an athlete is having difficulty breathing and is unable to speak in full sentences?

A) Continue your evaluation.
B) Ask the athlete to recite the alphabet in reverse order.
C) Arrange for transferring the athlete to the hospital for emergency care.
D) Assess the mental status of the athlete.

Question 21

Lungs in a patient with a pulmonary embolism will ________.

A) sound normal
B) emit wheezing noises
C) exhibit rhonchi
D) A & B
E) B & C

Question 22

_________ involves blood entering the pleural cavity and is the result of the same mechanism of injury as a pneumothorax.

A) Pulmonary embolism
B) Tension pneumothorax
C) Open pneumothorax
D) Hemothorax

Question 23

Which of the following have been linked to the development of pulmonary embolisms?

A) A clot that has broken loose from another location in the body
B) Fat cells from long bones
C) Females taking birth control pills
D) All of the above

Question 24

During your evaluation you suspect the patient may have a hemothorax. You decide to perform percussion testing on the chest wall of the patient. If the person does have a hemothorax, what sounds would confirm your diagnosis?

A) Dull hyperresonant sound
B) Dull hyporesonant sound
C) Heavy hyporesonant sound
D) None of the above

Question 25

Symptoms of a pulmonary embolism include all of the following except ________.

A) gradual onset of chest pain
B) tachycardia
C) bloody sputum
D) dyspnea

Question 26

Management of an open pneumothorax involves ______________.

A) administering low-flow oxygen
B) creating a two-way valve with a dressing
C) endotracheal intubuation
D) All of the above

Question 27

_________ is a life-threatening condition in which air is able to enter and exit the pleural space.

A) Simple pneumothorax
B) Tension pneumothorax
C) Open pneumothorax
D) None of the above

Question 28

Why is great care required with intravenous fluid resuscitation?

A) An overload of fluid may cause additional pulmonary edema.
B) An overload of fluid may result in difficultly with ventilation.
C) An overload of fluid may result in hypovolemic shock.
D) A & B
E) A & C

Question 29

The pleural cavity can hold ________liters of blood, with blood loss into this cavity resulting in shock developing quickly.

A) 1 to 2
B) 2 to 3
C) 3 to 5
D) more than 5

Question 30

Management of someone with a hemothorax should involve the following except___________.

A) intravenous fluid
B) supplemental oxygen
C) endotracheal intubation
D) transport to a hospital
E) administering Coumadin

Question 31

_________ involves a blood clot entering the venous system and becoming lodged in the lungs.

A) Pulmonary embolism
B) Tension pneumothorax
C) Open pneumothorax
D) Hemothorax

Question 32

During your assessment of an athlete who appears to be anxious, you note tracheal deviation. The athlete becomes hypotensive, loses consciousness, and is not breathing adequately. Which of the following steps should be taken to assist this athlete?

A) Emergency medical services (EMS) should be activated immediately.
B) Assist with respirations using a bag valve mask (BVM).
C) Needle decompression should be performed.
D) All of the above

Question 33

If a pulmonary embolism develops, it can be devastating because________.

A) it can block pulmonary circulation
B) it can increase dead space in the lungs
C) it can result in lung tissue death
D) A & C
E) A, B, & C