Chapter 26

A 5-year-old female pulled a pot of boiling water from the stove. She has superficial and partial-thickness burns to her head and anterior trunk. What percentage of her body surface area has been burned?

30%

Which of the following statements regarding electrical burns is correct?

Entrance wounds are small relative to the amount of internal tissue damage.

Which of the following statements regarding the rule of nines is correct?

The anterior trunk of an adult is equal to 18% of the BSA.

In contrast to animal bites, the bite of a human:

carries with it a wide variety of virulent bacteria and viruses.

All of the following body structures are lined with mucous membranes, EXCEPT for the:

lips

An abdominal evisceration:

occurs when organs protrude through an open wound.

The hallmark sign of compartment syndrome is:

pain out of proportion to the injury.

A utility worker was trimming branches and was electrocuted when he accidentally cut a high-power line. He fell approximately 20′ and is lying unconscious on the ground; the power line is lying across his chest. You should:

rapidly assess the patient after ensuring that the power line is not live.

According to the rule of palm method for estimating the extent of a patient's burns, the palm of the patient's hand is equal to _____ of his or her total BSA.

1%

A 21-year-old male was working in an auto repair shop and sustained radiator burns to the anterior aspect of both arms and to his anterior chest. According to the rule of nines, this patient has burns that cover _____ of his BSA.

18%

Which of the following statements regarding crush syndrome is correct?

Compromised arterial blood flow leads to crush syndrome and can occur when an area of the body is trapped for longer than 4 hours.

A 33-year-old male sustained an abdominal evisceration to the left lower quadrant of his abdomen after he was cut with a large knife. After appropriately managing his ABCs and assessing him for other life-threatening injuries, how you should care for his wound?

Cover it with moist, sterile gauze and secure with an occlusive dressing.

Which of the following statements regarding penetrating injuries is correct?

External bleeding may be minimal but internal injuries can be extensive.

Which of the following statements regarding severe burns is correct?

Severe burns are typically a combination of all degrees of burn.

During an altercation in a bar, two patrons got into a fist fight. The first patient, a 44-year-old female, was struck in the mouth and refuses EMS care. The second patient, a 39-year-old female, has a small laceration to her left knuckle and also refuses EMS care. Which of the following statements regarding this scenario is MOST correct?

The 39-year-old female is at high risk for an infection.

Which of the following statements regarding the dermis is correct?

The dermis contains hair follicles, sweat glands, and nerve endings.

Which of the following processes occurs during the inflammation phase of the healing process?

The immune system releases histamines, which cause vasodilation and increased capillary permeability, resulting in local redness and swelling.

In order for electricity to flow through the body and cause damage:

a complete circuit must exist between the electrical source and the ground.

Which of the following open soft-tissue injuries is limited to the superficial layer of the skin and results in the least amount of blood loss?

abrasion

A 39-year-old male was struck in the head by a baseball during a game. He is confused, has a large hematoma in the center of his forehead, and cannot remember the events preceding the injury. After manually stabilizing his head and assessing his airway, you should:

administer high-flow oxygen.

During your assessment of a 22-year-old male who was assaulted, you note widespread contusions and abrasions to his face, chest, and abdomen. His pulse is rapid and weak, and his skin is cool and clammy. You should:

administer oxygen and prepare for rapid transport.

In addition to severe bleeding, the MOST life-threatening complication associated with an open neck injury is:

an air embolism.

Which of the following is a severe burn in a 2-year-old child?

any full-thickness burn, regardless of its location on the body

A 17-year-old male was shot in the right anterior chest during an altercation with a gang member. As your partner is applying 100% oxygen, you perform a rapid secondary assessment and find an open chest wound with a small amount of blood bubbling from it. You should:

apply an occlusive dressing to the wound and continue your assessment.

You have applied a dressing and roller-gauze bandage to a laceration on the arm of a young female. During transport, she begins to complain of numbness and tingling in her hand. You should:

assess distal circulation and readjust the bandage as needed.

When treating a partial-thickness burn, you should:

avoid the use of creams, lotions, or antiseptics.

An injury that separates various layers of soft tissue, resulting in complete detachment or a flap of skin, is called a(n):

avulsion.

A 38-year-old male was electrocuted while attempting to wire a house. Your assessment reveals that he is unresponsive, pulseless, and apneic. A coworker has shut off the power to the house. You should:

begin CPR and apply the AED.

When caring for a patient whose arm is covered with a dry chemical, you should:

brush away the chemical before flushing with water.

Common signs and symptoms of an airway burn include all of the following, EXCEPT:

chest pressure.

Which of the following is a severe burn in a 35-year-old patient?

circumferential partial-thickness burn to the chest

The germinal layer of the epidermis contains pigment granules that are responsible for skin:

color

A 30-year-old male experienced a crushing injury when his arm was trapped between the back of a truck and a loading dock. Upon your arrival, the man's arm has been freed. Your assessment reveals that his arm is obviously deformed and swollen and is cold and pale. Further assessment reveals an absent radial pulse. You should be MOST concerned that this patient has:

compartment syndrome.

A construction worker fell approximately 30′ and landed in a pile of steel rods. Your assessment reveals that he is pulseless and apneic and has a 10″ steel rod impaled in his left leg. You should:

control the bleeding, begin cardiopulmonary resuscitation (CPR), stabilize the steel rod, immobilize his spine, and transport immediately.

A closed soft-tissue injury characterized by swelling and ecchymosis is called a(n):

contusion.

Burns are classified according to:

depth and extent.

A partial-thickness burn involves the outer layer of skin and a portion of the:

dermal layer.

Which of the following areas of the body has the thinnest skin?

ears

What layer of the skin forms a watertight, protective seal for the body?

epidermis

A burn that is characterized by redness and pain is classified as a:

first-degree burn.

Functions of dressings and bandages include all of the following, EXCEPT:

immobilization of the injury.

In addition to external bleeding, the MOST significant risk that an open soft-tissue injury exposes a patient to is:

infection.

A laceration:

is a jagged cut caused by a sharp object or blunt force trauma.

Which of the following is of LEAST importance when initially assessing the severity of a burn?

known drug allergies

A hematoma develops when:

large blood vessels beneath the skin are damaged.

With regard to the pediatric rule of nines, the:

legs are proportionately smaller than an adult's.

As you approach a young male who was involved in an industrial accident, you note that his eyes are closed and that he is not moving. You can see several large contusions to his arms, a laceration to his forehead with minimal bleeding, and a closed deformity to his right leg. You should:

open his airway and assess his breathing status.

Which of the following is a severe burn in a 65-year-old patient?

partial-thickness burn to 20% of the BSA

Burns to pediatric patients are generally considered more serious than burns to adults because:

pediatric patients have more surface area relative to total body mass.

When assessing a patient with a closed soft-tissue injury, it is MOST important to:

remain alert for more severe underlying injuries.

A 56-year-old male has an incomplete avulsion to his right forearm. After controlling any bleeding from the wound, you should:

replace the avulsed flap to its original position and cover it with a sterile dressing.

An 8-year-old male was bitten by a stray dog. He has a large laceration to the back of his left hand, which your partner covered with a sterile dressing and bandage. In addition to transporting the child to the hospital, you should:

report the incident to the appropriate authorities.

You are assessing a 30-year-old woman with multiple large bruises to her chest and abdomen that she experienced during an assault. She is conscious but restless, and her skin is cool and pale. You should be MOST concerned with:

the fact that her clinical signs could indicate that she is bleeding internally.

Patients with full-thickness (third-degree) burns generally do not complain of pain because:

the nerve endings have been destroyed.

You and your partner arrive at the scene of a house fire where fire fighters have rescued a 50-year-old male from his burning house. The patient has superficial and partial-thickness burns to his face and chest. His nasal hairs are singed and he is coughing up sooty sputum. You should be MOST concerned with:

the potential for airway swelling.

Functions of the skin include all of the following, EXCEPT:

the production of key antibodies.

A teenage boy who was involved in a bicycle accident has a puncture wound where the bicycle kickstand impaled his leg. The MOST appropriate method for treating this injury is to:

unbolt the kickstand from the bike frame and stabilize it with bulky dressings.

The sebaceous glands produce sebum, a material that:

waterproofs the skin and keeps it supple.