AH3 TEST 1 EXAM 2025 QUESTIONS
AND ANSWERS
Clinical indications for chest tube - ANS -pneumnothorax
-hemothorax
How a chest tube works - ANS -removes air and fluid from plueral cavity
-restores negative pressure
-promotes lung expansion and alevolar ventilation
subcutaneous air - ANS subcutaneous emphysema or crepitus
tidaling - ANS fluctuation of fluid in the water seal chamber
-normal
spontaneously breathing patient:
-water level rises during inspiration, falls during exhalation
-opposite for mechanically ventilated patient
-if tidaling is not present, assess for obstructing in the tubing (clot or kink)
signs of a pneumnothorax - ANS -bubbling in the water seal/air leak chamber
-first assess for a loose connection or break in the system
-check connections
-assessing for a system air leak
-chest radiograph will verify if there is a pneumnothorax
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,epidemiology of chest trauma - ANS -accounts for approximately 16,000 deaths anually
-throacic trauma is the direct cause in 20-25% of all trauma-related deaths in a contributory
cause for an additional 20-25% of deaths
-MVCs are the most prevalant cause of throacic injuries seen in emergency departments and
trauma centers
-older drivers older than 60 y/o are more susceptible to injury
-other risk factors include rate of speed, size of vehicle, seat-belt use
-at speeds greater than 25 mph, the occupants are more likely to be injured
blunt chest trauma - ANS -sudden compression of positive pressure inflicted to the chest wall
-can be difficult to determine the extent of damage, symptoms may be vague, patients may
delay seeking treatment
blunt mechanisms - ANS acceleration
deceleration
shearing
compression
acceleration - ANS moving object hitting chest or patient being thrown at an object
-fall
-bike accident
-assault
deceleration - ANS -sudden decrease in rate and speed or velocity
-MVC
shearing - ANS -strecthing forces to areas of the chest causing tears, ruptures, or dissections
compression - ANS -direct blow to the chest such as a crash injury
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, -construction or heavy machinery
blunt chest injury results in one or more pathologic states - ANS -hypoxemia from disruption
of airway, injury to lung tissue, rib cage, and respiratory musculature: pneumnothorax
-massive hemorrhage
-hypovolemia from fluid loss, cardiac rupture, or hemothorax
-cardiac failure from caridac tamponade. cardiac contusion, or increased intrathoracic pressure
-can lead to impaired ventilation and perfusion, leading to hypovolemia, shock, death
penetrating - ANS a foreign object penetrates the chest wall
-gunshot and stab wounds are most common
-classified by velocity
-stab wounds are low velocity weapon destroys a small area around the wound
-gunshot wounds : low, medium, or high velocity: extent of damage determined by distance,
caliber of gun, and type of bullet
-the appearance of the penetrating wound can be deceptive: extent of damage can be wide
spread
assessment for blunt and penetrating - ANS rapid, complete assessment of injury is critical
-how injury occurred and time elapsed since injury
Initial assessment: life threatening injuries - ANS -inspection of airway, thorax, neck veins,
breathing pattern, tracheal shift
-respiratory effort: stridor, nasal flairing, use of accessory muscles, drooling
-breath sounds, symmectrical chest expansion
-may also accompany head and abdominal injuries
-continued assessing to detect early signs of clinical deterioration
diagnostic testing - ANS CXR, CT scan, FAST, CBC, APT, PT, INR, ABG, ECG
Copyright ©2025 BRIGHTSTARS ALL RIGHTS RESERVED 3
AND ANSWERS
Clinical indications for chest tube - ANS -pneumnothorax
-hemothorax
How a chest tube works - ANS -removes air and fluid from plueral cavity
-restores negative pressure
-promotes lung expansion and alevolar ventilation
subcutaneous air - ANS subcutaneous emphysema or crepitus
tidaling - ANS fluctuation of fluid in the water seal chamber
-normal
spontaneously breathing patient:
-water level rises during inspiration, falls during exhalation
-opposite for mechanically ventilated patient
-if tidaling is not present, assess for obstructing in the tubing (clot or kink)
signs of a pneumnothorax - ANS -bubbling in the water seal/air leak chamber
-first assess for a loose connection or break in the system
-check connections
-assessing for a system air leak
-chest radiograph will verify if there is a pneumnothorax
Copyright ©2025 BRIGHTSTARS ALL RIGHTS RESERVED 1
,epidemiology of chest trauma - ANS -accounts for approximately 16,000 deaths anually
-throacic trauma is the direct cause in 20-25% of all trauma-related deaths in a contributory
cause for an additional 20-25% of deaths
-MVCs are the most prevalant cause of throacic injuries seen in emergency departments and
trauma centers
-older drivers older than 60 y/o are more susceptible to injury
-other risk factors include rate of speed, size of vehicle, seat-belt use
-at speeds greater than 25 mph, the occupants are more likely to be injured
blunt chest trauma - ANS -sudden compression of positive pressure inflicted to the chest wall
-can be difficult to determine the extent of damage, symptoms may be vague, patients may
delay seeking treatment
blunt mechanisms - ANS acceleration
deceleration
shearing
compression
acceleration - ANS moving object hitting chest or patient being thrown at an object
-fall
-bike accident
-assault
deceleration - ANS -sudden decrease in rate and speed or velocity
-MVC
shearing - ANS -strecthing forces to areas of the chest causing tears, ruptures, or dissections
compression - ANS -direct blow to the chest such as a crash injury
Copyright ©2025 BRIGHTSTARS ALL RIGHTS RESERVED 2
, -construction or heavy machinery
blunt chest injury results in one or more pathologic states - ANS -hypoxemia from disruption
of airway, injury to lung tissue, rib cage, and respiratory musculature: pneumnothorax
-massive hemorrhage
-hypovolemia from fluid loss, cardiac rupture, or hemothorax
-cardiac failure from caridac tamponade. cardiac contusion, or increased intrathoracic pressure
-can lead to impaired ventilation and perfusion, leading to hypovolemia, shock, death
penetrating - ANS a foreign object penetrates the chest wall
-gunshot and stab wounds are most common
-classified by velocity
-stab wounds are low velocity weapon destroys a small area around the wound
-gunshot wounds : low, medium, or high velocity: extent of damage determined by distance,
caliber of gun, and type of bullet
-the appearance of the penetrating wound can be deceptive: extent of damage can be wide
spread
assessment for blunt and penetrating - ANS rapid, complete assessment of injury is critical
-how injury occurred and time elapsed since injury
Initial assessment: life threatening injuries - ANS -inspection of airway, thorax, neck veins,
breathing pattern, tracheal shift
-respiratory effort: stridor, nasal flairing, use of accessory muscles, drooling
-breath sounds, symmectrical chest expansion
-may also accompany head and abdominal injuries
-continued assessing to detect early signs of clinical deterioration
diagnostic testing - ANS CXR, CT scan, FAST, CBC, APT, PT, INR, ABG, ECG
Copyright ©2025 BRIGHTSTARS ALL RIGHTS RESERVED 3
