978-0134024554 Chapter 27 Part 1

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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

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

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

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

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

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

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

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

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

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