SOLVED

31) Your patient was the unrestrained driver of a motor vehicle without airbags. The vehicle struck a large utility pole at about 45 miles per hour. Your patient has a contusion over his chest and upper abdomen consistent with the shape of the steering wheel. You should suspect which of the following types of injury in this patient? A) Compression B) Compression and acceleration C) Compression and deceleration D) Deceleration 32) The location of the neurovascular bundles containing the intercostal arteries is best described as the bundle that runs along the: A) Intercostal space equally distant from both associated ribs B) Posterior surface of the associated rib C) Superior margin of the associated rib D) Inferior margin of the associated rib 33) Your patient is a 24-year-old male who was struck just below the left scapula with a 3-inch-diameter metal pipe. He is awake but having difficulty breathing. His pulse is 112 at the radial artery, and his respiratory rate is 28 per minute and shallow. His breath sounds are present bilaterally but diminished on the left. He has a blood pressure of 108/68. The patient is coughing up some bloody sputum. He has no other complaints, and a rapid trauma survey reveals no additional life-threatening injuries. Which of the following represents the best sequence of intervention for this patient? A) Begin transport immediately, positive pressure ventilation, a large-bore IV of isotonic solution to maintain a systolic blood pressure of 120 mmHg or greater B) High-concentration oxygen by nonrebreathing mask, begin transport, a 16-gauge IV at a keep-open rate C) Positive-pressure ventilation, a large-bore IV of normal saline solution at a keep-open rate, transport D) High-concentration oxygen by nonrebreathing mask, begin transport, two 14-gauge IVs of 50 percent dextrose solution wide open 34) Which of the following best describes the incidence of pericardial tamponade? A) It occurs in 10 to 15 percent of all trauma patients. B) It occurs in less than 2 percent of all patients with serious chest trauma. C) It occurs in 10 to 15 percent of patients with serious chest trauma. D) It occurs in 2 percent of all trauma patients. 35) The angle of Louis serves as a landmark for performing needle thoracostomy at which of the following locations? A) Second intercostal space anteriorly B) Second intercostal space laterally C) Fourth intercostal space anteriorly D) Fourth intercostal space laterally 36) The central area in the thorax that contains the heart, great vessels, trachea, and esophagus is the: A) Mediastinum B) Pulmonary hilum C) Hemothorax D) Carina 37) You have just inserted a large-bore catheter into the chest of a patient with a tension pneumothorax and received a return of air. Which of the following should NOT be done? A) Insert a second, or even a third, catheter if the patient is symptomatic, despite the release of air. B) Leave the catheter in place, and create a flutter valve. C) Leave the catheter in place and open to air. D) Remove the catheter. 38) Another name for an open pneumothorax is: A) Tension pneumothorax B) Sucking chest wound C) Flail chest D) Hemopneumothorax 39) Which of the following is LEAST likely to be a sign of an open pneumothorax? A) Large, open thoracic wound. B) Frothy blood around the opening C) Jugular vein distention D) Dyspnea 40) Which of the following best describes the finding of tracheal deviation in the trauma patient? A) Its absence rules out tension pneumothorax. B) It is the earliest sign of tension pneumothorax. C) It is not reliably present in patients with tension pneumothorax. D) It is a contraindication to needle thoracostomy in tension pneumothorax.