Quiz29

In order to avoid exacerbating a patient's injury, it is especially important to use extreme caution when providing positive-pressure ventilation to patients with a: Select one: a. pneumothorax. b. cardiac tamponade. c. flail chest. d. myocardial contusion.

a. pneumothorax.

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 providing supplemental oxygen, you should: Select one: a. prepare for immediate transport. b. determine if he has cardiac problems. c. apply bulky dressings to the sternum. d. apply an AED and assess his BP.

a. prepare for immediate transport.

Immediately life-threatening chest injuries must be found and managed during the . Select one: a. primary assessment b. patient history c. scene size-up d. secondary assessment

a. primary assessment

A patient who presents with profound cyanosis following a chest injury: Select one: a. requires prompt ventilation and oxygenation. b. has most likely experienced a ruptured aorta. c. should be placed in Trendelenburg position. d. is most likely experiencing severe blood loss.

a. requires prompt ventilation and oxygenation.

Which of the following organs or structures does NOT reside within the mediastinum? Select one: a. Trachea b. Venacavae c. Lungs d. Esophagus

c. Lungs

The thoracic cavity is separated from the abdominal cavity by the: Select one: a. diaphragm. b. anterior rib cage. c. costovertebral angle. d. intercostal margin.

a. diaphragm.

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: Select one: a. immediately request ALS support. b. insert an oropharyngeal airway. c. obtain a set of baseline vital signs. d. perform a focused secondary exam.

a. immediately request ALS support.

If a patient with a chest injury is only able to inhale small amounts of air per breath, he or she: Select one: a. must increase his or her respiratory rate to maintain adequate minute volume. b. often breathes at a slower rate because of lung damage caused by the injury. c. will eliminate more carbon dioxide than if he or she were breathing deeply. d. will maintain adequate minute volume if his or her respiratory rate stays the same.

a. must increase his or her respiratory rate to maintain adequate minute volume.

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: Select one: a. administer oxygen and transport to the hospital. b. circumferentially tape a dressing around his chest. c. immediately perform a rapid head-to-toe exam. d. recognize that he needs a needle decompression.

a. administer oxygen and transport to the hospital.

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? Select one: a. Diminished breath sounds b. Engorged jugular veins c. A rapid, irregular pulse d. Widening pulse pressure

b. Engorged jugular veins

A spinal cord injury at the level of C7 would MOST likely result in: Select one: a. paralysis of all the respiratory muscles. b. paralysis of the intercostal muscles. c. paralysis of the diaphragm. d. immediate cardiac arrest.

b. paralysis of the intercostal muscles.

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: Select one: a. begin rapid transport at once. b. partially remove the dressing. c. call for a paramedic ambulance. d. begin ventilatory assistance.

b. partially remove the dressing.

Patients with chest injuries will often present with . Select one: a. Cheyne-Stokes respirations b. tachypnea c. agonal respirations d. Kussmaul respirations

b. tachypnea

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: Select one: a. suspect a severe hemopneumothorax. b. perform a secondary assessment. c. aggressively manage his airway. d. request a paramedic ambulance.

c. aggressively manage his airway.

The _______________ nerves control the diaphragm. Select one: a. costal b. vagus c. phrenic d. intercostal

c. phrenic

Elevation of the rib cage during inhalation occurs when: Select one: a. intrathoracic pressure decreases. b. the diaphragm descends. c. the intercostal muscles contract. d. abdominal contents descend.

c. the intercostal muscles contract.

Pleural fluid is contained between the: Select one: a. visceral pleura and the lung. b. parietal pleura and the chest wall. c. visceral and parietal pleurae. d. parietal pleura and the heart.

c. visceral and parietal pleurae.

An open pneumothorax occurs when: Select one: a. extreme pleural pressure causes the lung to rupture. b. air enters the pleural space from a perforated lung. c. a fractured rib perforates the tissue of the lung. d. air enters the pleural space from outside the body.

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

During your assessment of a patient with blunt chest trauma, you note that the patient has shallow breathing and paradoxical movement of the left chest wall. You should: Select one: a. request a paramedic to decompress the chest. b. apply high-flow oxygen via nonrebreathing mask. c. make note of it and continue your assessment. d. assist ventilations with a bag-valve mask.

d. assist ventilations with a bag-valve mask.

Closed chest injuries are typically caused by . Select one: a. high-velocity weapons b. flying debris c. penetrating trauma d. blunt trauma

d. blunt trauma