OEC Chapter 23 Test

A skier collides chest first with a tree at a high rate of speed. Based on this mechanism of injury​ alone, the OECT should be suspicious of all of the following injuries​ EXCEPT:

A. A lacerated liver or ruptured spleen. B. A triple A. (answer B is correct) C. ​Hemo, pneumo, or hemopneumothorax. D. Pericardial tamponade.

All of the following statements about thoracic trauma are true​ EXCEPT:

A. Ongoing assessment is vital for patients with either major or minor traumatic chest injuries. B. 10-​30% of all chest trauma requires surgical intervention. C. Skiers outnumber snowboarders almost​ 2:1 for incidences of traumatic chest injuries. (answer C is correct) D. Patients with chest trauma may initially appear very stable.

All of the following are true about the anatomy and physiology of the chest​ EXCEPT:

A. The thoracic cage encompasses the​ heart, lungs, and mediastinum. B. The mediastinum consists of the​ heart, aorta, vena​ cava, trachea,​ esophagus, thymus​ gland, and nerves. C. The thorax is enclosed by the bony rib​ cage, sternum, thoracic​ spine, and diaphragm. D. The thorax includes the area from the mandible to the costal margin. (Answer D is Correct)

A patient has sustained an injury to his mediastinum. Based on the anatomy of his​ chest, which of the following structures may have been​ injured?

A.The esophagus B. A bronchus C. The lungs (answer C is correct) D. The diaphragm

An OEC candidate asks you to explain a pneumothorax. Your response should be that it occurs​ when:

Air accumulates between the inner chest wall and the outside of the​ lung, causing the lung to collapse.

You have applied a nonporous dressing to a puncture wound on a​ patient's chest. An OEC candidate asks you why the dressing was taped only on three sides. Your best response is that taping the dressing on three​ sides:

Allows trapped air to escape upon exhalation.

A​ 39-year-old man has been stabbed once in the anterior chest. When notifying the patrol aid room by​ radio, you inform them that the patient has suffered what possible type of​ injury?

An open chest injury

You are following the L.A.P. method to examine the chest of a​ 38-year-old trauma patient. To assess for thoracic cage​ instability, you would apply moderate downward pressure on the sternum while asking the patient to take a deep​ breath, and then you​ would:

Apply moderate inward pressure on the lateral walls of the rib cage and ask the patient to take a deep breath.

You are listening to two patrollers discuss the accident to which they just responded. Which of the following injuries would lead you to believe that one of the patients had suffered from traumatic​ asphyxia?

Bluish discoloration of the neck and face

Injuries at which level of the spinal cord can affect the phrenic nerves and therefore​ respiration?

C3-C5

The diaphragm plays a major role in respiration. During​ inhalation, the​ diaphragm:

Contracts and creates a negative pressure in the​ thorax, which draws air into the lungs.

During​ inhalation, the​ diaphragm:

Contracts and descends into the abdomen.

You are at the scene of a shooting. Your assessment reveals a​ 23-year-old man who has been shot twice. The first wound is to the left lower quadrant of the abdomen and is bleeding. The second wound is to the left lateral chest and makes a sucking sound every time the patient takes a breath. The initial action of an OEC Technician should be which of the following​ actions?

Cover the chest wound with a gloved hand.

When assessing a​ patient, which of the following signs or symptoms is most indicative that the patient is suffering from a tension​ pneumothorax?

Decreased breath sounds in the right lung

​Beck's triad consists of which three significant clinical​ findings?

Distended neck​ veins, muffled heart​ sounds, and pulsus paradox

Which of the following actions occurs when the diaphragm and the intercostal muscles​ relax?

Exhalation

You are managing a patient with a large flail segment in the right lateral chest. The immediate threat to this​ patient's life​ is:

Hypoxia

You treated a 19 year old with a puncture wound to the chest by covering the wound with an impermeable dressing.​ Now, as you perform your ongoing​ assessment, you note that the patient is tachypneic and is complaining of difficulty breathing. Breath sounds on the side of the injury are also diminished. Which of the following actions should you take​ immediately?

Lift a corner of the dressing from the wound for a few​ seconds; then reapply and check his breath sounds.

Your patient was involved in a serious motor vehicle collision. Which of the following assessment findings best helps to determine that the patient has a flail chest​ segment?

Paradoxical chest wall movement

Your​ 35-year-old patient has received major chest trauma. He complains of shortness of breath and pain. Your assessment reveals distended neck veins and pulsus paradoxus. Based on these signs and​ symptoms, you believe the patient to be suffering​ from:

Pericardial tamponade

You suspect that a trauma patient is suffering from a hemothorax to the left lung. Which of the following assessment findings would reinforce your​ suspicion?

Respiratory distress and the signs and symptoms of shock

You have placed an occlusive dressing on a puncture wound on the right side of the chest of a​ 33-year-old woman. During your ongoing assessment your primary concern is monitoring the injury​ for:

Tension pneumothorax

You are treating a​ 26-year-old man with a pneumothorax. The​ patient's breathing has been​ inadequate, and you have been assisting his ventilations with a bag valve mask. The​ patient's condition seems to be worsening. Because you understand the pathology involved in a​ pneumothorax, you are most concerned​ that:

The pressure from the BVM is causing more air to enter the pleural space and is causing a tension pneumothorax.

The heart and lungs are located in​ the:

Thoracic cavity

The diaphragm separates​ the:

Thoracic cavity from the abdominal cavity

Which of the following phrases best describes a flail chest​ segment?

Two or more adjacent ribs that have been broken in two or more places.

You are assisting at an accident scene and are asked to apply a dressing over a sucking chest wound on the​ patient's left anterior chest wall. Which of the following items would you​ use?

Vaseline gauze

You are following the L.A.P. method to examine the chest of a​ 38-year-old trauma patient. To assess for thoracic cage​ instability, you would apply moderate downward pressure on the sternum while asking the patient to take a deep​ breath, and then you​ would:

apply moderate inward pressure on the lateral walls of the rib cage and ask the patient to take a deep breath.

You are treating a​ 26-year-old man who fell about 20 feet while rock climbing. He is complaining of right sided chest discomfort and dyspnea. You note that his respiratory rate is 28 and shallow. Based on this​ assessment, the best emergency care would​ be:

performing a rapid body survey and assisting ventilations with BVM and​ high-flow oxygen.

You are treating a​ 26-year-old man with a pneumothorax. The​ patient's breathing has been​ inadequate, and you have been assisting his ventilations with a bag valve mask. The​ patient's condition seems to be worsening. Because you understand the physiology involved in a​ pneumothorax, you are most concerned​ that:

the pressure from the BVM is causing more air to enter the pleural space and is causing a tension pneumothorax.

An OEC candidate indicates that she understands the difference between a pneumothorax and a tension pneumothorax when she makes which of the following​ statements?

​"A tension pneumothorax can cause cardiac output to​ decrease; a pneumothorax does​ not."

Which of the following statements indicates that the speaker understands chest​ trauma?

​"Internal chest injuries are more difficult to assess and manage than are the more obvious external chest​ injuries."

You are instructing a class in Outdoor Emergency Care when a student asks you to explain the L.A.P. method of examining the thorax. Your best reply to this question would be which of the following​ statements?

​"The L.A.P. method directs you to​ look, auscultate, and palpate the​ chest."

You are treating a​ 16-year-old male who was skiing out of control and ran off the trail and into the woods. When you​ arrive, he is alert and complaining of pain in his right lower chest. Upon examination you note that he has impaled himself with a tree branch. He tells you he will feel better if you just remove the branch. Based on your training as an OEC​ technician, you would respond by making which of the following​ statements?

​"We need to leave the branch in place until we get you to a​ hospital."

The thorax is enclosed by​ the:

​Ribs, sternum, thoracic​ spine, and diaphragm.