Ch26. Review questions

A. carefully remove the knife, control any bleeding, begin CPR, and transport As a rule, impaled objects should be stabilized in place. However, if they interfere with the pt's breathing or your ability to perform CPR, they should be removed. You cannot perform CPR on pt if a knife is impaled in the center of the chest. Carefully remove the knife, control any bleeding, begin CPR, and transport at once. The AED is not indicated for pt with traumatic cardiac arrest; their arrest is usually caused by massive blood loss, not primary cardiac dysrhythmia.

**A 22-year-old male was attacked by a rival gang and has a large knife impaled in the center of his chest. Your assessment reveals that he is apneic and pulseless. You should: A. carefully remove the knife, control any bleeding, begin CPR, and transport B. stabilize the knife in place, provide rescue breathing, and transport at once. C. remove the knife and control any bleeding, apply the AED, and analyze his rhythm D. begin CPR, control any external bleeding, and transport rapidly to a trauma center.

D. 5% full-thickness burn with a fracture Severe burns include the following; - full thickness burns involving the hands, feet, face, airway, or genitalia - full thickness burns covering more than 10% of the body's total surface area (BSA); - partial-thickness burns covering more than 30% of the BSA - burns involving the respiratory tract (eg. smoke inhalation) - burns complicated by fractures; - burns on pt younger than 5 years or older than 55 years that would otherwise be classified as "moderate" burns on younger adults

**Which of the following is considered a severe burn? A. any full-thickness burn B. 20% partial-thickness burn C. 10% full-thickness burn with abrasions D. 5% full-thickness burn with a fracture

A. prevent air from entering the wound immediate treatment for a sucking chest would (open pneumothorax) involves covering the wound with an occlusive dressing. This will prevent air from being drawn into the chest cavity. After covering the wound, assess for an exit wound, apply high-flow oxygen (if not already done), and transport promptly.

**a 45-year-old convenience stor clerk was shot in the right anterior chest during a robbery. Your assessment reveals that the would has blood bubbling from it every time the patient breathes. Your MOST immediate action should be to: A. prevent air from entering the wound B. cover the would with a bulky dressing C. assess the pt's back for an exit would D. transport the pt promptly to the closest trauma cetner

B. Using the pediatric rules of nines, the anterior chest accounts for 9% of the BSA (the entire anterior trunk, which includes the chest and abdomen, account for 18% of the BSA), and each arm accounts for 9% of the BSA. Therefore, this child has experienced 27% BSA burns.

A 5-year-old boy was burned when he pulled a barbecue grill over on himself. he has partial-and full-thickness burns to his anterior chest and circumferentially on both arms. what percentage of his body surface area has been burned? A. 18% B. 27% C. 36% D. 45%

D. compartment syndrome Compartment syndrome can occur when a part of the body has been compressed for a prolonged period of time-usually greater than 4 hours. The injured tissue begins to swell, which can impede arterial blood flow and venous return. As a result, the part of the body distal to the compression site becomes hypoxic and metabolic waste products (ie, lactic acid) begin to accumulate.

A compression injury that is severe enough to cut off blood flow below the injury is called: A. a contusion B. a hematoma C. a local thrombus D. compartment syndrome

B. contusion A contusion (bruise) is caused by direct blunt force trauma. the epidermis remains intact, but small blood vessels in the dermis are injured. The depth of the injury varies, depending on the amount of energy absorbed. Pain and swelling occur as fluid and blood leak into the damaged area. The buildup of blood produces a characteristic blue and black discoloration called ecchymosis.

A young male was struck in the forearm with a baseball and complains of pain to the area. Slgith swelling and ecchymosis are present, but no external bleeding. Which type of injury does this describe? A. abrasion B. contusion C. hematoma D. avulsion

C. 9%

According to the rule of nines, what percentage of the patient's skin surface is burned? A. 4.5% B. 7.5% C. 9% D. 18%

Rest Ice Compression Elevations Splinting

How should you treat a closed injury?

It is not. pt has minor burns because pt has face burn which is about 9% of the total BSA. Severe burns refer to any full-thickness burn or partial thickness burns covering more than 20% of the body's total surface area. Moderate burns refer to partial-thickness burn covering 10%-20% of the body's total surface area. Minor burns refers to partial-thickness burn covering less than 10% of the body's total surface area

Is this a severe burn? Why or why not?

B. Thermal burn

Pt tells you that he was hit in the face with scalding hot coffee. What kind of burn is this? A. Inhalation burn B. Thermal burn C. Radiation burn D. Chemical burn

B. Partial-thickness

Pt's face is mottled with blisters and abrasions, and he has blood on his shirt. What is the classification of this burn? A. Superficial B. Partial-thickness C. Full-thickness D. Thermal

B. control external bleeding Although prevention of contamination is an important reason for applying a sterile dressing to an open injury, the primary reason is to control the external bleeding associated with it.

The primary reason for applying a sterile dressing to an open injury is to: A. prevent contamination B. control external bleeding C. reduce the risk of infection D. minimize any internal bleeding

D. Keep the airway open

The priority in treating a pt with a burned face and jagged laceration measuring approximately 2 inches on his abdomen is to: A. Clean any open wounds B. Take vital signs C. Stop the burning process D. Keep the airway open

Direct, even pressure and elevation Pressure dressings and/or splints Tourniquets

What are the steps to take to control bleeding?

D. Stop the bleeding

What is the priority of treating the open wound on the patient's abdomen? A. Clean it B. Flush with sterile saline C. Probe it D. Stop the bleeding

It is a quick way to estimate the amount of surface area that has been burned; it decides the body into sections, each representing approximately 9% of the total body surface area. The proportions differ from infants, children, and adults. Adults Face- 9%, (infants 18%/ children 12%) Back - 18% Each arm - 9% x 2 Each leg - 18% x 2 (infants 13.5%/ 16.5%) Abdomen - 18% Genital - 1 %

What is the rule of nine?

C. Contusion on the right lateral chest

Which of the patient's soft-tissue injuries is least likely to result in infection? A. Contusion on the right lateral chest B. Abdominal laceration C. Burns to the face D. Abrasions to the face

c. apply a moist, sterile dressing to the wound and secure with an occulsive dressing treatment for an abdominal evisceration include applying a moist, sterile dressing to the wound and covering the moist dressing with an occlusive dressing. Do not replace a protruding bowel back into the wound or apply firm pressure, which may force the bowel back into the wound; these action increase the risk of infection.

the MOST appropriate way to dress and bandage an open abdominal wound with a loop of bowel protruding from it is to: A. cover the wound with a dry, sterile dressing and apply firm pressure B. apply a moist, sterile dressing to the wound and apply firm pressure C. apply a moist, sterile dressing to the wound and secure with an occulsive dressing D. carefully replace the protruding bowel into the abdomen and cover the wound.

D. vasoconstriction and decreased bleeding applying an ice pack to a closed wound, such as a hematoma, will decrease bleeding, pain, and swelling by causing constriction of the blood vessels.

what effects will the application of an ice have on a hematoma? A. vasodilation and increased pain B. vasodilation and decreased bleeding C. vasoconstriction and increased swelling D. vasoconstriction and decreased bleeding

C. prior to removing a dry chemical you should flush the area with sterile water Dry chemicals should be brushed off the pt before irrigating the wound with sterile water or saline. Failure to do so may increase the burning process and cause further tissue damage.

which of the following statements regarding chemical burns is FALSE? A. most chemical burns are caused by strong acids or alkalis B. fumes of strong chemicals can cause burns to the respiratory tract C. prior to removing a dry chemical, you should flush the area with sterile water D. you should not attempt to neutralize an acid burn with an alkaline chemical