AHN 447 Exam 3 Questions Answered Correctly Latest Version 2025-2026
What are the clinical manifestations of a pulmonary contusion? - Answers MAY BE
ASYMPTOMATIC AT FIRST
decreased breath sounds or crackles and wheezes over the affected area
bruising over the injury
dry cough
tachycardia
tachypnea
dullness to percussion
bloody sputum
initial CXR normal--CXR with opacities after several days
*can lead to respiratory failure
What is the pathophysiology of a pulmonary contusion? - Answers occurs most often by rapid
deceleration during car crashes
Hemorrhage and edema occur in and between the alveoli, reducing both lung movement and the
area available for gas exchange.
,Localized inflammation can cause further damage.
The pt becomes hypoxemia and dyspneic (SOB).
What position should you place the pt in who has a pulmonary contusion? - Answers Place the
pt in moderate-Fowler's position.
When side-lying, the "good lung down" position may be helpful.
What are rib fractures most often caused by? - Answers direct blunt trauma to the chest wall
(The force applied to the ribs fractures them and drives the bone ends into the chest)
What is the pt at risk for with a rib fracture? - Answers DEEP CHEST INJURY (pulmonary
contusion, pneumothorax, hemothorax)
What is flail chest? - Answers Flail chest is the result of fractures of at least 2 neighboring ribs
in 2 or more places causing PARADOXICAL CHEST WALL MOVEMENT (inward movement of the
thorax during inspiration, outward movement during expiration)
It usually involves one side of the chest and results from blunt chest trauma.
What clinical manifestations are most often seen with a flail chest? - Answers paradoxical chest
movement
SOB
cyanosis
tachycardia
hypOtension
,pain
*work of breathing is increased from the paradoxical movement of the involved segment of the
chest wall
What interventions should you implement as the RN of a pt with flail chest? - Answers Monitor
the pt's VS and F&E balance (to intervene if shock or hypovolemia occurs)
If he/she has a lung contusion, provide O2 prn and give IV fluids as prescribed
Assess for and relieve pain with prescribed analgesics
Provide psychosocial support
What is a pneumothorax? - Answers air in the pleural space causing a loss of negative pressure
in the chest cavity, which can lead to a COLLAPSED LUNG
most often caused by blunt trauma
The pneumothorax can be open or close.
Open= [pleural cavity is exposed to outside air, as through an open wound in the chest wall
Closed= when a pt with COPD has a spontaneous pneumothorax
What is hemothorax? - Answers bleeding into the chest cavity
A simple hemothorax is a blood loss of less than 1,000 mL into the chest cavity
, A massive hemothorax is a blood loss of more than 1,000 mL
What is a tension pneumothorax? - Answers a life-threatening complication of pneumothorax in
which air continues to ENTER the pleural space during iNSPIRATION but does NOT EXIT during
EXPIRATION
This leads to air collecting under pressure, completely collapsing the lung and compressing
blood vessels, which limits blood return.
This process leads to decreased filling of the heart and reduced cardiac output .
What are the clinical manifestations of pneumothorax (any type)? - Answers reduced or absent
breath sounds of the affected side on auscultation
hyperresonance on percussion
prominence of the involved side of the chest, which moves poorly with respirations
open pneumo= tracheal deviation TOWARDS pneumothorax
closed pneumo= tracheal deviation AWAY FROM pneumothorax
--Tension pneumothorax (additional assessment findings):
extreme respiratory distress and cyanosis
distended neck veins
hemodynamic instability
What are the clinical manifestations of a pulmonary contusion? - Answers MAY BE
ASYMPTOMATIC AT FIRST
decreased breath sounds or crackles and wheezes over the affected area
bruising over the injury
dry cough
tachycardia
tachypnea
dullness to percussion
bloody sputum
initial CXR normal--CXR with opacities after several days
*can lead to respiratory failure
What is the pathophysiology of a pulmonary contusion? - Answers occurs most often by rapid
deceleration during car crashes
Hemorrhage and edema occur in and between the alveoli, reducing both lung movement and the
area available for gas exchange.
,Localized inflammation can cause further damage.
The pt becomes hypoxemia and dyspneic (SOB).
What position should you place the pt in who has a pulmonary contusion? - Answers Place the
pt in moderate-Fowler's position.
When side-lying, the "good lung down" position may be helpful.
What are rib fractures most often caused by? - Answers direct blunt trauma to the chest wall
(The force applied to the ribs fractures them and drives the bone ends into the chest)
What is the pt at risk for with a rib fracture? - Answers DEEP CHEST INJURY (pulmonary
contusion, pneumothorax, hemothorax)
What is flail chest? - Answers Flail chest is the result of fractures of at least 2 neighboring ribs
in 2 or more places causing PARADOXICAL CHEST WALL MOVEMENT (inward movement of the
thorax during inspiration, outward movement during expiration)
It usually involves one side of the chest and results from blunt chest trauma.
What clinical manifestations are most often seen with a flail chest? - Answers paradoxical chest
movement
SOB
cyanosis
tachycardia
hypOtension
,pain
*work of breathing is increased from the paradoxical movement of the involved segment of the
chest wall
What interventions should you implement as the RN of a pt with flail chest? - Answers Monitor
the pt's VS and F&E balance (to intervene if shock or hypovolemia occurs)
If he/she has a lung contusion, provide O2 prn and give IV fluids as prescribed
Assess for and relieve pain with prescribed analgesics
Provide psychosocial support
What is a pneumothorax? - Answers air in the pleural space causing a loss of negative pressure
in the chest cavity, which can lead to a COLLAPSED LUNG
most often caused by blunt trauma
The pneumothorax can be open or close.
Open= [pleural cavity is exposed to outside air, as through an open wound in the chest wall
Closed= when a pt with COPD has a spontaneous pneumothorax
What is hemothorax? - Answers bleeding into the chest cavity
A simple hemothorax is a blood loss of less than 1,000 mL into the chest cavity
, A massive hemothorax is a blood loss of more than 1,000 mL
What is a tension pneumothorax? - Answers a life-threatening complication of pneumothorax in
which air continues to ENTER the pleural space during iNSPIRATION but does NOT EXIT during
EXPIRATION
This leads to air collecting under pressure, completely collapsing the lung and compressing
blood vessels, which limits blood return.
This process leads to decreased filling of the heart and reduced cardiac output .
What are the clinical manifestations of pneumothorax (any type)? - Answers reduced or absent
breath sounds of the affected side on auscultation
hyperresonance on percussion
prominence of the involved side of the chest, which moves poorly with respirations
open pneumo= tracheal deviation TOWARDS pneumothorax
closed pneumo= tracheal deviation AWAY FROM pneumothorax
--Tension pneumothorax (additional assessment findings):
extreme respiratory distress and cyanosis
distended neck veins
hemodynamic instability
