A nurse is caring for a client who has flail chest. The nurse should identify the following information should the nurse include about adechest?

Coughing

Motor vehicle accidents

Falls

Assault

Answer and Explanation

The Correct Answer is B

A. Coughing: While coughing can be a symptom of respiratory distress or lung injury, it is not typically a direct cause of flail chest. Flail chest is characterized by multiple rib fractures leading to a segment of the chest wall moving independently, which can result from blunt trauma like a motor vehicle accident.
B. Motor vehicle accidents: Flail chest commonly results from significant trauma, such as that from a motor vehicle accident. The blunt force of the impact during an accident can cause multiple rib fractures, which can result in the characteristic paradoxical chest movement seen in flail chest.
C. Falls: Although falls can result in rib fractures, they are less likely to cause the severe trauma and multiple rib fractures required to result in flail chest. While serious falls could contribute to a flail chest in certain scenarios, motor vehicle accidents are more common for this type of injury.
D. Assault: While an assault can cause chest injuries, including rib fractures, it is less commonly associated with flail chest compared to the more significant force from motor vehicle accidents. The mechanism of injury in assaults may not involve the level of blunt trauma that leads to multiple rib fractures and flail chest.

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Correct Answer is B

Explanation

A. "There are no audible sounds in an open pneumothorax": An open pneumothorax typically involves audible sounds as air moves through the chest wound during inhalation and exhalation. It is not a silent condition.
B. "Air moves in and out of a wound in the chest wall": In an open pneumothorax, air can freely enter and exit through the wound, leading to a "sucking" wound. This causes a loss of pressure in the pleural space, potentially leading to collapsed lung tissue.
C. "Air cannot pass freely into the thoracic cavity through a chest wound": This statement is incorrect for an open pneumothorax. In fact, air passes freely through the chest wound in this condition, which distinguishes it from a closed pneumothorax.
D. "The air is trapped when it enters the cavity": This describes a tension pneumothorax, where air is trapped in the pleural space and cannot escape, causing pressure buildup. In an open pneumothorax, the air moves in and out of the wound.

A. A decrease in intracellular fluid volume B. An increase in hydrostatic pressure C. An increase in serum sodium D. An increase in vascular fluid volume

Correct Answer is D

Explanation

A. A decrease in intracellular fluid volume: A reduction in intracellular fluid volume often results from hypertonic conditions in the extracellular space, which can draw water out of cells. This shift can actually increase serum osmolality rather than decrease it.
B. An increase in hydrostatic pressure: Increased hydrostatic pressure promotes fluid movement from the vascular space into the interstitial tissues, contributing to edema. However, this does not significantly impact the concentration of solutes in the serum and therefore does not directly cause a decrease in osmolality.
C. An increase in serum sodium: Sodium is the main contributor to serum osmolality, so an increase in serum sodium raises osmolality. This is the opposite of what occurs in heart failure, where sodium levels are often diluted due to fluid retention.
D. An increase in vascular fluid volume: In heart failure, the kidneys retain fluid in response to decreased cardiac output, expanding the vascular volume. This excess water dilutes the concentration of solutes in the blood, such as sodium, leading to a decrease in serum osmolality.

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A nurse is caring for a client who has flail chest. The nurse should identify the following information should the nurse include about adechest?

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Naxlex Comprehensive Predictor Exams

Which of the following is true regarding the physiology of an open pneumothorax?

Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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