1. A young male was struck across the chest with a baseball bat. He has a large bruise over the sternum and an irregular pulse rate of 120 beats/min. In managing the patient, the EMT-B should be MOST concerned with:
A.bleeding into the pericardial sac.
B.a collapsed lung and severe hypoxia.
C.failure of the myocardium to pump effectively.
D.the probability of ventricular tachycardia or fibrillation.


2. What occurs during the process of inhalation?
A.The intercostal muscles and diaphragm relax.
B.The diaphragm and intercostal muscles contract.
C.The contents of the abdomen are pushed up.
D.The pressure within the chest increases.


3. Signs and symptoms of chest injury include all of the following, EXCEPT:
A.hemoptysis
B.hematemesis
C.increased pain with breathing
D.unequal rise and fall of the chest


4. After experiencing a blunt injury to the chest, a patient complains of a sharp pain upon inhalation. This sharp pain is referred to as:
A.pleural effusion.
B.pleurisy.
C.dyspnea.
D.friction.


5. The accumulation of air in the pleural space of the chest cavity is called:
A.hemothorax.
B.a sucking chest wound.
C.pneumothorax.
D.hemopneumothorax.


6. Following a high-speed motor vehicle crash, where an unrestrained 29-year-old man struck the steering wheel, you note a large bruise over the left side of the chest. The patient has a blood pressure of 70/40 mm Hg, a weak pulse rate of 130 beats/min, and labored respirations of 28 breaths/min. Auscultation over the left side of the chest reveals absent breath sounds, and the patient is coughing up blood. You should suspect:
A.pneumothorax.
B.hemothorax.
C.tension pneumothorax.
D.a sucking chest wound.


7. A gunshot victim is showing signs and symptoms of an open pneumothorax. After ensuring a patent airway and providing oxygen, you should immediately:
A.transport the patient on the affected side.
B.elevate the patient's legs and rapidly transport.
C.prevent air from being sucked in through the wound.
D.monitor the patient for a developing tension pneumothorax.


8. A tension pneumothorax may develop if:
A.all four sides of the dressing covering a chest wound are sealed.
B.the patient is not receiving enough oxygen.
C.the patient has an extremely high blood pressure.
D.the patient has fractured ribs.


9. If three or more ribs are fractured in two or more places, this condition is called:
A.crepitus.
B.hemothorax.
C.flail chest.
D.frail chest.


10. When managing a patient with a flail chest, it is important that the EMT-B keep in mind the fact that:
A.assisted ventilations with a BVM device will always be needed.
B.the patient will be in considerable pain as a result of the fracture.
C.the dressing used to stabilize the injury must be tightly secured.
D.this injury suggests the possibility of other serious internal injury.


11. Proper care for a patient with a flail chest includes:
A.having the patient lie in the prone position.
B.placing a sandbag on top of the flail segment.
C.stabilizing the flail segment by securing a pillow to the patient's chest.
D.stabilizing the flail segment by applying a PASG.


12. While working at a loading dock, a 45-year-old man has been pinned at the chest between the dock and a truck that was backing up. He is severely cyanotic to the face and neck and has engorged jugular veins. Management of this patient includes:
A.stabilizing the chest wall with sandbags.
B.providing ventilatory support with 100% oxygen.
C.transporting the patient in the semisitting position.
D.applying and fully inflating the PASG.


13. The accumulation of fluid or blood in the sac that surrounds the heart is called:
A.hemothorax.
B.cardiac edema.
C.pericardium.
D.pericardial tamponade.


14. After sustaining penetrating trauma to the chest, you assess your 26-year-old patient's blood pressure, which is 110/80 mm Hg. Which of the following blood pressures, taken 5 minutes later would indicate a pericardial tamponade?
A.100/90 mm Hg
B.116/74 mm Hg
C.128/60 mm Hg
D.140/90 mm Hg


15. When the chest strikes the steering wheel during a motor vehicle crash, , the resulting injury that immediately kills almost one third of patients is a/an:
A.pneumothorax.
B.hemothorax.
C.aortic rupture.
D.ruptured myocardium.



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