Chest Abd

Question 1

for an inj to be an open injury what must be present:

Answer 1

must have any break in skin above the injured site

Question 2

proper management of a tibia/tibial fracture:

Answer 2

immobilization of distal femur to the foot

Question 3

organ that, if fractured, would cause the most collateral damage

spleen (incorrect)
liver
pancreas
kidney

Answer 3

pancreas

Question 4

pelvic ring fracture, bilateral closed femur fracture, how much bl predicted to have been lost:

2L is incorrect
3L

Answer 4

3L

Question 5

ptnt sitting in pool of bl, deep wound to stomach. best position for suspected evisceration:

recovery position (incorrect)
supine w/knees flexed
high fowlers (incorrect)

Answer 5

supine w/knees flexed

Question 6

thoracic fracture asw paradoxical movement:

flail chest
rib fracture
sternal dislocation

Answer 6

flail chest

Question 7

device most appropriate for closed mid shaft femur fracture:

long board splints (incorrect)
pneumatic leg splint
traction splint

Answer 7

traction splint

Question 8

10 mnth ptnt with severe burns on lower extremities. what % of surface area has burns:
18% (incorrect)
27%

Answer 8

27%

Question 9

assessment findings for a hemothorax:

Question 10

most expected assess w/a dislocated joint:

swelling (incorrect)
absent distal pulses (incorrect)
crepitus
fixed in place

Answer 10

fixed in place

Question 11

ptnt w/fractured extremity, complains of parathesia what is the best reason why:

damage to sensory nerves
damage to motor nerves
damage to bl vessels (incorrect)
damage to periosteum

Question 12

best way to stop flail segment paradoxical movement:

place ptnt onto flail segment
ventilate
tape a bulky dressing over the flail

Answer 12

ventilate the ptnt

Question 13

massive hemothorax would not make enough pressure to make JVD - so that can be ruled out if there IS distended neck veins.

Question 14

injury to the spleen can cause what symptoms:

Answer 14

Kehr’s sign is the occurrence of acute pain in the tip of the shoulder due to the presence of blood or other irritants in the peritoneal cavity when a person is lying down and the legs are elevated. Kehr’s sign in the left shoulder is considered a classic symptom of a ruptured spleen

Question 15

pneumothorax vs hemothorax

and what symptoms help discern?

how would you perform an assessment to tell the diff? (using chest percussion).

Answer 15

Pneumothorax and hemothorax are conditions that affect the pleural space surrounding the lungs. When air leaks into this space, it’s called a pneumothorax; whereas when blood fills this space, it’s called a hemothorax.

Both conditions put pressure on the lungs and cause chest pain, labored breathing, and a rapid heart rate; both with symptoms such as dyspnea, hypoxia, decreased breath sounds, and chest pain. A key clinical finding that separates these two is that a pneumothorax will have hyper-resonance to percussion (air in the space - listen for hollow drum like sounds), but a hemothorax will have a hypo-resonance to percussion (absent or decreased breath sounds with stethoscope)

a CT scan is needed to fully diagnose.

Question 16

likely injury for a ptnt with increasing BP and dropping heart rate.

Answer 16

head injury

The Cushing reflex results from the body’s response to increased intracranial pressure. Intracranial pressure is a blood pressure measurement in the brain.

The Cushing reflex is one of the body’s ways to try to keep pressure from getting too high in the skull. It signals receptors in the heart to slow the heart rate down to lower the intracranial pressure.

Question 17

best way to stop paradoxical movement as seen with a flail segment on an (U) ptnt:

Answer 17

ventilate the ptnt

Question 18

Ventricular tachycardia causes hypotension (low blood pressure) because when a person is experiences ventricular tachycardia, their left ventricle …

Answer 18

does not adequately fill with blood

Question 19

A transient ischemic attack (TIA) occurs when: a small clot in a cerebral artery causes temporary symptoms

Question 20

most indicative of a cardiovascular problem

Answer 20

JVD

Question 21

ptnt with low pitched rattling sounds at bases of the lungs most likely is

Answer 21

aspiration pneumonia

Question 22

acute MI occurs when:

heart muscle weakens and dysfunctions

coronary artery dilation decreases bl flow to heart (incorrect)

left ventricle is damaged and cannot pump bl

myocardial tissue dies secondary to an absence of o2

Question 23

angina occurs when:

Answer 23

myocardial o2 demand exceeds supply

Question 24

bl ejected from the rt ventricle:

flows into the pulm arteries

enters teh systemic circulation

was received directly fro m the aorta

has a high concentration of o2 (incorrect)

Answer 24

flows into the pulm arteries

Question 25

cardiogenic shock following AMI:

Answer 25

caused by decreased pumping force of teh heart muscle

Question 26

hypertensive emerg symptoms:

Answer 26

bounding pulse, headache, dizzy

Question 27

An acute myocardial infarction (AMI) occurs when: myocardial tissue dies secondary to an absence of oxygen

Question 28

signs of air embo:
(air or gas trapped in bl vessel)

can be caused when divers hold their breath when ascending or ascend too quickly

can also be caused by IVs, catheters, during surg procedures, trauma to lung , blast explosions (blast lung)

also air/gas in vessels can travel to the brain or lungs and cause heart attack, stroke, or resp failure

Answer 28

diff breathing
resp failure
chest pain
heart failure
muscle/joint pain
stroke
cyanosis/blue skin
mental status changes/loc
low bp

Question 29

**
hemothorax signs/symptoms

Answer 29

diminished lung sounds
flat neck veins
dull to percussion

Question 30

tension pneumothorax symptoms:

Answer 30

ABSENT lung sounds
distended neck veins
hyperresonant to percussion