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21) Traumatic asphyxia is a(n) ________ type of injury. A) Compression B) Deceleration C) Decompression D) Acceleration 22) Which of the following is a complication of positive-pressure ventilation in the patient with significant chest trauma? A) Pulmonary contusion B) Atelectasis C) Exacerbation of flail chest D) Reduced cardiac output 23) Which of the following most accurately characterizes simple pneumothorax? A) Untreated, it will lead to mediastinal shift and compression of the contralateral lung. B) It is a problem of ventilation/perfusion mismatch. C) It results from air entering the pleural cavity through a defect in the chest wall. D) It results from the creation of a one-way valve that continues to allow air into, but not out of, the pleural cavity. 24) Which of the following findings differentiates a simple pneumothorax from a tension pneumothorax? A) Decreased breath sounds on the affected side B) Hemodynamic compromise C) Absent breath sounds on the affected side D) An open defect in the chest wall 25) Hemothorax is primarily a problem of: A) Blood loss B) Impaired ventilation C) Ventilation/perfusion mismatch D) Increased intrathoracic pressure 26) Your patient is a 15-year-old male who was struck in the chest with a baseball. He is unresponsive, pulseless, and apneic. The monitor shows ventricular fibrillation. This condition is most accurately described as: A) Pericardial tamponade B) Blunt cardiac injury C) Commotio cordis D) Traumatic asphyxia 27) Your patient is a 21-year-old male with a single, small-caliber gunshot wound to the left anterior chest, just lateral to the sternum at the fourth intercostal space. Bleeding from the wound is minimal. The patient is initially anxious, combative, and diaphoretic. Initial vital signs include a heart rate of 100, respirations of 20, and a blood pressure of 110/80. Breath sounds are clear bilaterally and equal. En route the patient becomes quieter but still restless. The heart rate increases to 120, respirations are 24, blood pressure 106/88, and breath sounds remain clear and equal. The patient has also developed significant JVD. You are 15 minutes from a Level I trauma center and 5 minutes away from a large community hospital. You should: A) Immediately decompress the left chest and divert to the community hospital for chest tube insertion. B) Immediately decompress the left chest and continue to the trauma center for chest tube insertion. C) Continue to the Level I trauma center for pericardiocentesis. D) Divert to the community hospital for pericardiocentesis. 28) Which of the following best describes the mechanism of blunt thoracic trauma associated with blast injuries? A) Deceleration B) Acceleration C) Compression D) Compression and decompression 29) Thoracic trauma accounts for approximately ________ percent of mortality from trauma? A) 20 to 25 B) 10 to 15 C) 75 to 80 D) 45 to 50 30) Which of the following is the primary concern in the patient with a hemothorax? A) Hypovolemia B) Increased intrathoracic pressure C) Mediastinal shift D) Atelectasis

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