A patient is admitted to the emergency department with left-sided chest trauma. Which statement best identifies why the formation of a tension pneumothorax can result in a life-threatening condition for this patient?
The uninjured lung will hyperinflate because of an increased respiratory rate.
Affected lung collapses as more air is exhaled through the traumatic injury.
Trapped air causes collapse of the lung and can reduce the cardiac output.
More CO2 is retained because weakened alveoli blebs rupture.
The Correct Answer is C
A. While an increased respiratory rate may occur, it does not directly lead to hyperinflation of the uninjured lung due to tension pneumothorax.
B. In a tension pneumothorax, air enters the pleural space and does not exhale effectively; it is not about exhalation.
C. Trapped air in the pleural cavity increases pressure, collapsing the lung and pushing mediastinal structures (like the heart) to the opposite side, thereby reducing venous return and cardiac output.
D. Retained CO2 is not a direct cause of tension pneumothorax; the main issue is the pressure from trapped air affecting lung function and hemodynamics.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. An increased capillary refill time suggests reduced perfusion and may indicate decreased cardiac output, which is critical to assess in patients with atrial fibrillation as it can lead to hemodynamic instability.
B. A rumbling heart murmur may suggest valvular disease but is not specifically indicative of decreased cardiac output in this scenario.
C. Intermittent claudication typically indicates peripheral arterial disease and is not a direct sign of decreased cardiac output.
D. Jugular venous distension can indicate fluid overload or right-sided heart failure, but it is not the most direct indicator of decreased cardiac output compared to capillary refill time.
Correct Answer is B
Explanation
A. Hydronephrosis may lead to renal dysfunction but does not directly explain the altered mental status or confusion in this context.
B. Uremic encephalopathy occurs due to the accumulation of waste products, particularly urea, in the bloodstream, which can lead to neurotoxicity and confusion.
C. Metabolic alkalosis does not typically cause confusion; it is more related to acid-base disturbances and does not develop from over-secretion of bicarbonate in renal failure.
D. Hypotension due to hypophosphatemia is not a common cause of confusion, and while electrolyte imbalances can affect mental status, this option does not directly connect with renal failure.
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