STUVIA 2024/2025
Chapter 28- Chest Injuries
carbon dioxide retention and acidosis - ✔✔A 34-year-old male is in late shock secondary to blunt
chest trauma. His respirations of 6 breaths/min and shallow will initially result in:
assist his ventilations with a bag-mask device. - ✔✔A 37-year-old male sustained blunt trauma to the
left anterolateral chest. He is conscious, but confused, and complains of pain during inspiration; his
respirations are shallow. Your assessment reveals crepitus to the area of impact. Breath sounds,
although weakly audible, are bilaterally equal. The pulse oximeter reads 89% on room air. You
should:
cardiac tamponade. - ✔✔A 40-year-old male experienced penetrating trauma to the left anterior
chest. During inhalation, you note that his radial pulses become barely palpable. You should suspect:
be prepared for severe hypotension once he is freed - ✔✔A construction worker is pinned in
between a truck and a loading dock. He is conscious and in respiratory distress. Further assessment
reveals upper torso and facial cyanosis and bilateral conjunctival hemorrhages. When treating this
patient, you must:
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Pericardial tamponade - ✔✔A trauma patient who presents with shock, jugular venous distention,
and bilaterally equal breath sounds has MOST likely experienced a:
the diaphragm may elevate as high as the nipple line upon exhalation - ✔✔Any injury at the nipple
line should be considered a thoracic and abdominal injury because:
unilaterally diminished or absent breath sounds. - ✔✔Common clinical findings in a patient with a
suspected myocardial contusion include all of the following EXCEPT:
hyperpnea - ✔✔Common signs of a chest injury include all of the following EXCEPT:
relieve pleural tension by lifting a corner of the dressing. - ✔✔During your rapid assessment of a
patient with a gunshot wound to the chest, you located an open wound to the right anterior chest and
sealed it with the appropriate dressing. A few minutes later, the patient's respirations are increasingly
labored and his heart rate has significantly increased. You should:
stabilize the chest wall deformity and continue your assessment. - ✔✔During your rapid assessment
of a semiconscious 44-year-old female with blunt thoracic trauma, you detect an area on the left
anterior chest that bulges during exhalation. Your partner is assisting her ventilations with a bag-mask
device and 100% oxygen. You should:
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, STUVIA 2024/2025
Tension pneumothorax - ✔✔Of the following injuries, which would MOST likely present with muffled
heart tones?
the circulatory system is intact but the amount of available oxygen is diminished. - ✔✔Patients with
multiple rib fractures may develop significant hypoxia because of a ventilation/perfusion mismatch,
which occurs when:
respiratory alkalosis. - ✔✔Regardless of the cause, hyperventilation causes:
through the posterior thorax. - ✔✔The esophagus enters the thorax via the thoracic inlet and travels:
the lungs - ✔✔The mediastinum encompasses all of the structures within the thoracic cavity
EXCEPT:
ruptured diaphragm - ✔✔The presence of a scaphoid abdomen and bowel sounds in the lower
hemithorax are MOST suggestive of a:
hemothorax. - ✔✔Unilaterally diminished or absent breath sounds, a narrowed pulse pressure, and
dullness to percussion of the hemithorax are clinical findings suggestive of a:
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blunt chest trauma - ✔✔Visceral injuries in the chest that occur from shearing forces, compression,
or rupture, are MOST commonly seen with:
transport promptly to a trauma center. - ✔✔When caring for a patient with significant thoracic trauma
and signs of shock, it is MOST important to:
Contralateral shifting of the trachea - ✔✔Which of the following signs or symptoms would you be
LEAST likely to find during your assessment of a patient with a pneumothorax?
transport immediately, start a large-bore IV en route, and request a paramedic rendezvous. - ✔✔A
22-year-old male with blunt thoracic trauma presents with severely labored respirations. His level of
consciousness is decreased and his heart rate is 140 beats/min and thready. Further assessment
reveals absent breath sounds on the entire left side of his chest and jugular venous distention. After
appropriately managing his airway and immobilizing his spine, you should:
Because they are protected by the bony girdle of the clavicle and scapula, upper rib fractures may
indicate severe internal injuries. - ✔✔A 29-year-old male was robbed and struck in the chest by an
assailant with a steel pipe. Your assessment reveals severe pain and crepitus to the right upper
chest, at and below the clavicle. What is MOST significant about the location of this patient's injury?
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