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Physiological Adaptation · Multiple choice · Recognize cues

After a crush injury to the chest, part of the client's chest wall moves inward during inspiration. What does the nurse suspect?

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Correct answer: D

Flail chest occurs when multiple adjacent ribs break in more than one place, causing paradoxical chest wall movement and impaired ventilation.

Source: ACS. ATLS Student Course Manual, 11th ed.

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This question is one of 162 Physiological Adaptation items in NCLEXSim. On the NCLEX-RN, this category makes up 11–17% of the exam.

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Study tip
  • Study emergencies as a sequence: what you see, what it means, what you do first (DKA, sepsis, stroke, PE, anaphylaxis, tension pneumothorax).
  • Review fluid and electrolyte imbalances by their ECG and neuromuscular signs (peaked T waves, Chvostek and Trousseau signs).

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