Question 1

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 20% pneumothorax in the right lung. Which of the following conditions would be present?

Accepted Answer

If the pneumothorax is the result of an internal lung injury (in this case probably from the sharp edge of the broken rib), it is called a closed pneumothorax.

Question 2

A pneumothorax manifests itself clinically as a primary _____ disorder.

Accepted Answer

A pneumothorax manifests itself clinically as a restrictive pulmonary disorder because air in the pleural space limits inspiration. In a tension pneumothorax, the heart may be pushed away from the affected lung. Although this can decrease cardiac output, a pneumothorax directly affects lung function.

Question 3

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

Accepted Answer

When blebs or bulla on the surface of the lung suddenly rupture, the pneumothorax that results is termed a spontaneous pneumothorax.

Question 4

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

Accepted Answer

Pendelluft is the movement of gas from one lung to another.

Question 5

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

Accepted Answer

An untreated tension pneumothorax is considered the most serious type of pneumothorax due to the compression of the affected lung and mediastinum.

Question 6

An iatrogenic pneumothorax may be caused by all of the following EXCEPT:

Accepted Answer

Endotracheal intubation does not pose a risk of pneumothorax. All of the other listed options can lead to medical procedure-related pneumothorax.

Question 7

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?

Accepted Answer

A pleurodesis involves placement of chemical or pharmacologic agents into the chest cavity to cause an inflammatory reaction to increase the adherence of the pleural surface to the inside of the chest wall. The procedure reduces the occurrence of future pneumothoraces.

Question 8

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

Accepted Answer

Because a large pneumothorax can impede venous blood return to the heart, the cardiac output (CO) will be decreased.

Question 9

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

Accepted Answer

A sucking chest wound is an example of an open pneumothorax.

Question 10

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.

Accepted Answer

When air is introduced between the visceral and parietal pleura, the pleura will separate, leading to lung collapse and the outward movement of the chest wall.

Question 11

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?

Accepted Answer

A spontaneous pneumothorax is one that occurs suddenly and without any obvious underlying cause. Frequently, it happens in tall, thin young adults when a high lung pressure causes a surface bleb or bulla to rupture.

Question 12

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

Accepted Answer

With a tension pneumothorax, the buildup of air pressure on the affected side of the chest pushes the trachea, lung, and heart to the opposite (unaffected) side.

Question 13

A 40-year-old patient requires placement of a thoracostomy chest tube. All of the following are recommended for the procedure EXCEPT:

Accepted Answer

Thoracostomy tubes are clamped only after bubbling from the tube has ceased and then are left in place without suction for another 24 to 48 hours.

Question 14

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

Accepted Answer

No matter how air enters the pleural space, a pneumothorax will be classified as open or closed.

Question 15

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

Accepted Answer

A valvular pneumothorax is also called a tension pneumothorax. Gas enters the pleural space on inspiration but cannot exit due to the valvelike action of the pleura or chest wall itself.

Question 16

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

Accepted Answer

A pneumothorax can cause compression of the great vessels and decrease venous return to the heart.

Question 17

If the patient has a tension pneumothorax, all of the following chest radiograph findings would be expected EXCEPT:

Accepted Answer

The buildup of air in the pleural space will depress rather than elevate the diaphragm.

Quiz 23: Pneumothorax