Unlock document.
This document is partially blurred.
Unlock all pages and 1 million more documents.
Get Access
Emergency Care, 13e (Limmer et al.)
Chapter 27 Chest and Abdominal Trauma
1) Which of the following BEST describes an evisceration?
A) Open wound of the abdomen from which organs protrude
B) Flap of skin that is partially or completely torn away from the underlying tissue
C) Accumulation of blood beneath the skin, resulting in swelling
D) Epidermis that is scraped away by a rough surface
Objective: 27.1
2) Which of the following patients is at greatest risk of respiratory failure and should be carefully
monitored for ventilatory status throughout treatment and transport?
A) Tension pneumothorax
B) Flail chest
C) Abdominal evisceration
D) Hemopneumothorax
Objective: 27.1
1
3) In addition to lacerations, blunt trauma resulting in a closed chest injury creates the potential
for which of the following internal injuries?
A) Abrasion
B) Contusion
C) Evisceration
D) Avulsion
Objective: 27.2
4) Which of the following is NOT an open tissue injury?
A) Contusion
B) Evisceration
C) Avulsion
D) Abrasion
Objective: 27.2
2
5) The mechanism of injury in which a patient's chest has struck an immovable object, such as a
steering wheel, may most accurately be described as a(n):
A) open trauma injury.
B) compression injury.
C) penetrating injury.
D) coup contrecoup injury.
Objective: 27.2
6) You are caring for a 27-year-old male who has a puncture wound to the right upper chest. The
patient was stabbed with a serrated steak knife by his ex-girlfriend. You have placed an occlusive
dressing to the site and began emergent transport to the closest trauma center. However, while en
route the patient begins to complain of increasing shortness of breath. You notice a decrease in
ventilatory volume and an increase in thoracic diameter. Which of the following options would
be the best step to perform next?
A) Free a corner or edge of the dressing and have the patient exhale to release pressure buildup.
And re-seal the wound
B) Begin providing BVM-assisted ventilations to the patient.
C) Call dispatch for an ALS intercept en route to the hospital.
D) Begin providing CPR to the patient.
Objective: 27.3
3
7) Which of the following is an accurate definition of a flail chest?
A) Lung that has been punctured by a fractured rib, resulting in a buildup of air
B) Section of the chest wall that is unstable, leading to breathing problems
C) Fracture of one rib in two or more consecutive places
D) Fracture of at least four ribs in two or more places
Objective: 27.3
8) What is the correct terminology for a wound in which a vacuum has been created within the
chest, drawing air into the thorax with each breath?
A) Sucking chest wound
B) Closed tension pneumothorax
C) Open chest wound
D) Gurgling chest wound
Objective: 27.3
4
9) A patient with jugular vein distention (JVD) is most likely suffering from which of the
following injuries?
A) Pneumothorax
B) Hemothorax
C) Hemopneumothorax
D) Tension pneumothorax
Objective: 27.3
10) Which of the following is true concerning lacerations?
A) They may be caused by blunt trauma.
B) They may be caused by penetrating trauma.
C) They may indicate deeper underlying tissue damage.
D) All of the above
Objective: 27.3
5
11) Which of the following is of concern with a puncture wound?
A) The object that remains impaled in the body
B) Strong possibility of contamination
C) Hidden internal bleeding with minimal external bleeding
D) All of the above
Objective: 27.3
12) The chest cavity can hold up to ________ liter(s) of blood in an adult, leading to the
possibility of massive internal hemorrhage without any external blood loss.
A) 3
B) 5
C) 0.5
D) 1
Objective: 27.3
6
13) Which of the following is a true statement regarding the skin's status in the case of a closed
chest injury?
A) Internal contusions and lacerations cannot occur.
B) The skin may be penetrated and occluded.
C) The skin is penetrated.
D) The skin is not penetrated.
Objective: 27.3
14) Some drawbacks to using sterile aluminum foil as an occlusive dressing include:
A) sterility cannot be ensured unless the materials were autoclaved.
B) a flutter valve is difficult to create.
C) foil cannot create an airtight seal.
D) skin lacerations may occur from the sharp edges.
Objective: 27.3
7
15) You're an off-duty EMT who encounters a patient sitting behind the wheel of a vehicle that
ran off the road along an isolated county road. It appears the patient was unrestrained, or not
wearing a seat belt, and struck the steering wheel with his chest. On assessment, you notice a
paradoxical motion to the patient's chest on inspiration and expiration. When you radio for
dispatch of an ambulance, which of the following pieces of information would you be sure to
include?
A) The patient may have an abdominal evisceration.
B) The patient is showing signs of abdominal bleeding.
C) The patient is showing signs of an open chest injury.
D) The patient may have a flail chest.
Objective: 27.3
16) Which of the following injuries may produce distended neck veins (JVD)?
A) Traumatic asphyxia
B) Tension pneumothorax
C) Cardiac tamponade
D) All of the above
Objective: 27.3
8
17) Which of the following is an unreliable sign for determining the presence of a tension
pneumothorax?
A) Distended neck veins
B) Signs and symptoms of shock
C) Shortness of breath
D) Trachea that shifts to the side opposite the injury
Objective: 27.3
18) Which of the following describes the proper application of an occlusive dressing for an open
chest wound?
A) Trim the dressing so that it is the exact size of the wound.
B) Use a porous material such as a 4" by 4" gauze pad.
C) Tape the dressing securely on three sides.
D) Tape the occlusive dressing on two sides only to create dual flaps for relief pressure build-up.
Objective: 27.3
9
19) The pathophysiology of ________ is one in which the pericardial sac fills with blood to the
point where the chambers of the heart no longer fill adequately, usually secondary to trauma.
A) pericardial effusion
B) hemopneumothorax
C) cardiac tamponade
D) commotio cordis
Objective: 27.3
20) Which of the following traumatic chest injuries may result in massive, often fatal internal
hemorrhage?
A) Hemopneumothorax
B) Hemothorax
C) Aortic dissection
D) Cardiac tamponade
Objective: 27.3
10
