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1. When assessing a pt what finding would differentiate between a tension pneumothorax and cardiac tamponade?
A. Hypotension
B. Shortness of Breath
C. Chest pain
D. Muffled heart tones
2. The most important, immediate step in the management of an open pneumothorax is:
A. Endotracheal Intubation
B. Needle throracostomy & administration of pain medication
C. Placement of an occlusive dressing over the wound taped on three sides
D. Initiation of 2 large bore IV’s with LR
A 30 year old man has attempted suicide by shooting himself in the left upper chest. On arrival of EMS, the patient is alert, complaining of SOB and is pale and diaphoretic. His vital signs are BP (palpable) 80, HR 140, RR 32.
3. No breath sounds are auscultated on the left side. The patient has increased respiratory distress and he becomes agitated and hypotensive. What critical intervention should the care giver perform?
A. Give pain medication
B. Perform needle thoracostomy
C. Place the patient on a pulse oximeter
D. Obtain 2 large bore IV’s
4. The classic signs and symptoms of a tension pneumothorax may include all except:
A. Equal breath sounds bilaterally
B. Tracheal deviation away from the affected side
C. Distended neck veins
D. Cyanosis and diaphoresis
5. The goal of flail segment management is:
A. Fluid resuscitation
B. Strapping the patient to a backboard
C. Adequate ventilation and oxygenation
D. Applying skin traction to the injured chest wall
A 19 year old man was riding his bicycle and hit a hole in the road at a high rate of speed. He struck his chest on the ground. On arrival of EMS, the patient is alert and complaining of chest pain. His vital signs are stable, but his pulse is irregular.
6. Because of the mechanism of injury, the initial assessment of this patient should include assessment for the presence of:
A. Chest wall ecchymosis
B. Periorbital ecchymosis
C. Scrotal ecchymosis
D. Abdominal ecchymosis
7. An important intervention in the care of this 19 year old patient would be :
A. Monitoring and treating cardiac dysrhythmia
B. Performing and documenting a GCS
C. Preparing the patient for rapid transport
D. Administering high flow O2
An 18 year old woman was an unrestrained back seat passenger in an automobile involved in a collision. The patient was thrown against the backseat. On the arrival of EMS, she is was awake, restless and complaining of chest pain. Her vital signs are BP 110/70, HR 90 and regular and RR 32. Her breath sounds are diminished on the left with decreased excursion and bruising on that side. Her abdomen is also distended.
8. All of the following signs and symptoms indicate a possible pulmonary contusion in this patient except:
A. Bowel sonds auscultated in chest
B. Shortness of breath
C. Restlessness and agitation
D. The presence of chest pain
9. Because of the mechanism of injury and bruising on the young female's chest, a pulmonary contusion is suspected. What is the initial management of this patient?
A. Give fluid bolus
B. Prepare the pt for elective intubation
C. Limit fluids unless the pt develops hypovolemia from associated injury
D. Administer 3 L O2 by NRB mask
A 16 year old man is brought to the ED after having been thrown 25 feet from his car. He is complaining of severe chest pain and SOB. During the primary assessment, bowel sounds can be heard over the left anterior chest.
10. What injury is suspected?
A. Pneumothorax
B. Hemothorax
C. Aortic dissection
D. Ruptured diaphragm
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