EMT CH. 27

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

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

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. immediately perform a rapid head-to-toe exam. C. recognize that he needs a needle decompression. D. circumferentially tape a dressing around his chest.

A. administer oxygen and transport to the hospital.

A 37-year-old male was pinned between a flatbed truck and a loading dock. On exam, you find bruising to the chest, distended neck veins, bilaterally diminished breath sounds, and bilateral scleral hemorrhaging. You should: A. aggressively manage his airway. B. request a paramedic ambulance. C. perform a secondary assessment. D. suspect a severe hemopneumothorax.

A. aggressively manage his airway.

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? A. engorged jugular veins B. widening pulse pressure C. diminished breath sounds D. a rapid, irregular pulse

A. engorged jugular veins

A spontaneous pneumothorax would MOST likely occur as the result of: A. exertion of a person with a congenital lung defect. B. excessive coughing in a patient with pneumonitis. C. abnormally slow breathing in a patient with pleurisy. D. blunt or penetrating trauma to the anterior chest wall.

A. exertion of a person with a congenital lung defect.

A 19-year-old male is unresponsive, apneic, and pulseless after being struck in the center of the chest with a softball. Based on the mechanism of injury, what MOST likely occurred? A. ventricular fibrillation when the impact occurred during a critical portion of the cardiac cycle B. asystole secondary to massive intrathoracic hemorrhage due to traumatic rupture of the aorta C. fracture of the sternum that caused a rupture of the myocardium and led to a cardiac dysrhythmia D. collapse of both lungs due to fractured ribs that perforated the lung tissue and caused cardiac arrest

A. ventricular fibrillation when the impact occurred during a critical portion of the cardiac cycle

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

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

Common signs and symptoms of a chest injury include all of the following, EXCEPT: A. tachypnea. B. hematemesis. C. localized pain. D. chest wall ecchymosis.

B. hematemesis.

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. begin ventilatory assistance. B. partially remove the dressing. C. begin rapid transport at once. D. call for a paramedic ambulance.

B. partially remove the dressing.

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 applying 100% oxygen, you should: A. apply an automated external defibrillator (AED) and take his blood pressure. B. prepare for immediate transport. C. determine if he has cardiac problems. D. apply bulky dressings to the sternum.

B. prepare for immediate transport.

Subcutaneous emphysema is an indication that: A. at least half of one lung has completely collapsed. B. your patient is experiencing a pericardial tamponade. C. air is escaping into the chest wall from a damaged lung. D. blood is slowly accumulating within the tissue of the lung.

C. air is escaping into the chest wall from a damaged lung.

You are transporting a stable patient with a possible pneumothorax. The patient is receiving 100% oxygen and has an oxygen saturation of 95%. During your reassessment, you find that the patient is now confused, hypotensive, and profusely diaphoretic. What is MOST likely causing this patient's deterioration? A. a total collapse of the affected lung B. hidden bleeding in the thoracic cavity C. compression of the aorta and vena cava D. blood accumulation in the pleural space

C. compression of the aorta and vena cava

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: A. insert an oropharyngeal airway. B. obtain a set of baseline vital signs. C. perform a focused secondary exam. D. immediately request ALS support.

D. immediately request ALS support.

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 unconscious, 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: A. massive hemothorax. B. tension pneumothorax. C. pericardial tamponade. D. laceration of the aorta.

D. laceration of the aorta.

Following blunt trauma to the chest, an 18-year-old female presents with respiratory distress, reduced tidal volume, and cyanosis. Her blood pressure is 80/50 mm Hg and her pulse is 130 beats/min and thready. You should: A. apply 100% oxygen and immediately transport. B. place her supine and elevate her lower extremities. C. perform a rapid head-to-toe physical assessment. D. provide some form of positive-pressure ventilation.

D. provide some form of positive-pressure ventilation.