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NR 341 / NR341 Exam 2 | Complex
Adult Health Review | Questions &
Answers with Rationales Grade A
Verified Solutions
Exam Structure:
Subject: Nursing / Complex Adult Health, Trauma, Burns, Neurology, Critical Care
Source: NR341 EXAM 2
Format: Key Concept Questions with Correct Answers and Rationales
Thoracic Trauma
1. Flail chest
Answer: Multiple rib fractures that cause paradoxical breathing.
Rationale:
1. Flail chest occurs when a segment of the chest wall becomes
detached from the rest of the thoracic cage due to multiple rib
fractures.
2. This results in paradoxical movement: the flail segment moves
inward during inspiration and outward during expiration.
3. It impairs ventilation and can lead to respiratory distress.
2. Flail chest manifestations
Answer: Paradoxical movement of chest wall, respiratory distress. May be
associated with hemothorax, pneumothorax, pulmonary contusion.
Rationale:
1. Paradoxical movement is the hallmark sign.
2. Associated injuries are common due to the force of trauma.
3. Respiratory distress results from impaired lung expansion.
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3. Flail chest treatment
Answer: O2 as needed to maintain O2 saturation, analgesia. Stabilize flail
segment with positive pressure ventilation (intubation and mechanical
ventilation). Treat associated injuries. Surgical fixation.
Rationale:
1. Positive pressure ventilation acts as an internal splint, stabilizing the
flail segment.
2. Adequate analgesia is essential to improve ventilation.
3. Surgical fixation may be required for severe cases.
4. Hemothorax
Answer: Blood in the pleural cavity.
Rationale:
1. Hemothorax results from bleeding into the pleural space, often due to
trauma.
2. Blood accumulation compresses the lung and impairs ventilation.
5. Hemothorax symptoms
Answer: Dyspnea, diminished or absent breath sounds, dullness to
percussion, decreased Hgb, shock depending on blood volume lost.
Rationale:
1. Dullness to percussion distinguishes hemothorax from
pneumothorax (which is hyperresonant).
2. Signs of shock indicate significant blood loss.
6. Hemothorax treatment
Answer: Chest tube insertion with chest drainage system. Autotransfusion
of collected blood, treatment of hypovolemia as necessary.
Rationale:
1. Chest tube drainage removes blood and allows lung re-expansion.
2. Autotransfusion can return the patient's own blood if collected
sterilely.
3. Hypovolemia is treated with fluid resuscitation and blood products.
7. Pneumothorax
Answer: Air in the pleural cavity.
Rationale:
1. Pneumothorax occurs when air enters the pleural space, causing lung
collapse.
2. It can be spontaneous or traumatic.
NR 341 / NR341 Exam 2 | Complex
Adult Health Review | Questions &
Answers with Rationales Grade A
Verified Solutions
Exam Structure:
Subject: Nursing / Complex Adult Health, Trauma, Burns, Neurology, Critical Care
Source: NR341 EXAM 2
Format: Key Concept Questions with Correct Answers and Rationales
Thoracic Trauma
1. Flail chest
Answer: Multiple rib fractures that cause paradoxical breathing.
Rationale:
1. Flail chest occurs when a segment of the chest wall becomes
detached from the rest of the thoracic cage due to multiple rib
fractures.
2. This results in paradoxical movement: the flail segment moves
inward during inspiration and outward during expiration.
3. It impairs ventilation and can lead to respiratory distress.
2. Flail chest manifestations
Answer: Paradoxical movement of chest wall, respiratory distress. May be
associated with hemothorax, pneumothorax, pulmonary contusion.
Rationale:
1. Paradoxical movement is the hallmark sign.
2. Associated injuries are common due to the force of trauma.
3. Respiratory distress results from impaired lung expansion.
, 2|Page
3. Flail chest treatment
Answer: O2 as needed to maintain O2 saturation, analgesia. Stabilize flail
segment with positive pressure ventilation (intubation and mechanical
ventilation). Treat associated injuries. Surgical fixation.
Rationale:
1. Positive pressure ventilation acts as an internal splint, stabilizing the
flail segment.
2. Adequate analgesia is essential to improve ventilation.
3. Surgical fixation may be required for severe cases.
4. Hemothorax
Answer: Blood in the pleural cavity.
Rationale:
1. Hemothorax results from bleeding into the pleural space, often due to
trauma.
2. Blood accumulation compresses the lung and impairs ventilation.
5. Hemothorax symptoms
Answer: Dyspnea, diminished or absent breath sounds, dullness to
percussion, decreased Hgb, shock depending on blood volume lost.
Rationale:
1. Dullness to percussion distinguishes hemothorax from
pneumothorax (which is hyperresonant).
2. Signs of shock indicate significant blood loss.
6. Hemothorax treatment
Answer: Chest tube insertion with chest drainage system. Autotransfusion
of collected blood, treatment of hypovolemia as necessary.
Rationale:
1. Chest tube drainage removes blood and allows lung re-expansion.
2. Autotransfusion can return the patient's own blood if collected
sterilely.
3. Hypovolemia is treated with fluid resuscitation and blood products.
7. Pneumothorax
Answer: Air in the pleural cavity.
Rationale:
1. Pneumothorax occurs when air enters the pleural space, causing lung
collapse.
2. It can be spontaneous or traumatic.
