Aemt 28 ch

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Which of the following physiologic responses occurs initially following a burn injury?

Vasoconstriction and decreased blood flow to the burned area

In addition to improving systemic perfusion following an electrical burn injury, you should administer IV crystalloid fluid boluses in order to:

maintain adequate urine output.

A 62-year-old female with a history of type 2 diabetes has sustained partial-thickness burns to 27% of her body surface area (BSA). This burn should be classified as a:

major burn.

After ensuring your and your partner's safety, the next step in caring for a patient with any burn is to:

move the patient to a place of safety.

The mouth, nose, and other body orifices are lined with _______, which secrete a watery substance and provide a protective barrier against harmful agents.

mucus membranes

A burn occurs when the soft tissue of the skin:

receives more energy than it can absorb without injury.

Lymphangitis is characterized by:

red streaks adjacent to the wound.

The degradation of dead muscle tissue is called:

rhabdomyolysis.

Static tension lines are present on the:

scalp.

The skin sends messages to the brain to regulate various functions via:

sensory nerves.

All patients with closed soft-tissue injuries should be assessed for:

serious hidden injuries.

Which of the following is not a function of the skin?

Destruction of sebum

Which of the following is the most significant acute complication associated with a laceration to the forearm?

External bleeding

Which of the following statements regarding electrical burns is correct?

Internal injury caused by an electrical burn is usually more severe than the external burns indicate.

How much IV fluid (per bolus) should you administer to a 65-kg patient with extensive burns and severe shock?

1,300 mL

When caring for a patient with multiple abrasions, you should:

be alert for underlying injuries.

Which of the following is the most acute and serious complication associated with a break in the integrity of the skin?

Loss of fluids

Appropriate management for a patient with a serious closed injury and signs of shock includes all of the following, except:

15- to 20-inch elevation of the lower extremities.

Compartment syndrome is caused by:

tissue compression and damage due to fluid trapped in a confined space.

Which of the following weapons would most likely result in the largest surface area of tissue damage?

12-gauge shotgun

Patients with electrical burns should be given enough isotonic crystalloid to maintain a urine output of _______ mL/kg per hour.

1

A 4-year-old boy pulled a pot of boiling water from the stovetop. He has superficial and partial-thickness burns to his head, left anterior trunk, and entire left arm. On the basis of the "rule of nines," what percentage of this child's body surface area (BSA) has been burned?

30%

A 60-year-old male has sustained partial- and full-thickness burns to his anterior chest, head, and both anterior arms. On the basis of the "rule of nines," what percentage of his body surface area (BSA) has been burned?

36%

During a lengthy transport of a 120-lb, 29-year-old female with partial- and full-thickness burns to 45% of her BSA, medical control orders you to begin IV fluid replacement based on the Consensus formula. What volume of IV crystalloid should you administer per hour?

620 mL

Which of the following patients has experienced a major burn?

A 65-year-old with 18% partial-thickness burns to both upper extremities

Why does the skin become flushed or red when a person is exposed to a hot environment?

Blood vessels dilate and heat radiates to the skin surface.

Which of the following statements regarding the dermal layer of the skin is correct?

Blood vessels in the dermis do not penetrate into the epidermis.

In which of the following circumstances should you remove an impaled object?

Metal shard in the cheek and inadequate respiratory effort

Which of the following types of burns is characterized by intense pain and destruction of a portion of the dermis?

Partial-thickness burn

Which of the following would be classified as a moderate burn in an infant or a child?

Partial-thickness burns covering 15% of the BSA

Which of the following statements regarding severe burns is correct?

Significant hypovolemia may not occur for several hours following the burn injury.

Which of the following has the most impact on the severity of radiation injury or type of health effect?

The amount and duration of exposure

A 22-year-old male, who was trapped in a confined space during a structural fire, is conscious and alert and refuses EMS treatment and transport. He is breathing without difficulty, but has singed nasal hair and facial redness. Which of the following statements regarding this patient is correct?

The patient may die several hours later due to pulmonary complications.

When assessing a conscious patient who experienced an electrical injury, you note irregularity in his pulse. This is most indicative of:

a cardiac dysrhythmia.

You are assessing a 4-year-old male who was electrocuted when he stuck a pin into an electrical socket. He is conscious and alert and complains of pain to his left hand, where you find a small entrance wound. When treating this child, you should:

anticipate extensive internal injuries.

A 28-year-old female was the unrestrained driver of a car that struck the rear end of another car while traveling at 35 mph. She is conscious and alert and complains of pain to the anterior chest. During your assessment, you note a large ecchymotic area over the superior aspect of the anterior chest. As your partner assumes manual stabilization of her head, you should:

apply 100% oxygen via a nonrebreathing mask.

You arrive at the scene of a residential fire where the occupant, a 48-year-old male, has sustained partial- and full-thickness burns to his lower extremities and lower torso. Firefighters removed the patient's smoldering clothing and stopped the burning process prior to your arrival. The patient is conscious, but restless, and complains of intense pain to the burned areas. After taking the standard precautions, you should:

apply supplemental oxygen and monitor his airway.

A young male tripped on a garden hose, fell, and struck his head on a concrete sidewalk. He is unresponsive and has a large hematoma to his forehead. His respirations are slow and shallow. You should:

assist his ventilations with 100% oxygen.

You and your partner are caring for a 30-year-old female who sustained extensive partial- and full-thickness burns when she was near a gas heater that exploded. Your primary assessment reveals that the patient is semiconscious with profoundly labored and stridorous respirations. Immediate management of this patient should include:

assisting her breathing with a bag-mask device and oxygen.

You are dispatched to an industrial plant for a worker who was exposed to an unknown chemical. Upon arrival, you find the patient sitting outside of the plant. He has a white, dry powder covering his right arm. Care for this patient's exposure includes:

brushing the chemical from the patient's arm and then irrigating with water.

You respond to a domestic dispute, where a middle-aged male was stabbed in the chest by his wife. Your assessment reveals that the patient is pulseless and apneic. The knife is impaled in the center of his chest. You should:

carefully remove the knife, control the bleeding, and perform CPR.

Heat that is generated by an electrical injury can cause coagulation and vascular occlusion, resulting in:

compartment syndrome.

When a person is exposed to cold temperatures, blood vessels in the skin:

constrict and divert blood away from the skin.

Immediate treatment for a patient with an open soft-tissue injury includes:

control of active bleeding.

A 34-year-old male was involved in a motor-vehicle crash. During the crash, his vehicle caught fire. Bystanders removed the patient from his vehicle prior to your arrival. The patient is conscious with adequate breathing. He has partial-thickness burns to his face and neck, and an open femur fracture with severe bleeding. Immediate management for this patient should include:

controlling the bleeding from his leg.

When caring for an open wound that has small pieces of glass and other debris inside of it, you should:

cover the wound with a sterile dressing.

All of the following are characteristic of a closed soft tissue injury, except:

deformity of a short bone.

The layer of skin that lies below the germinal layer and contains nerves, sebaceous glands, and blood vessels is called the:

dermis.

The layer of the skin that plays a key role in the cooling of the body is the:

dermis.

Following an electrical burn, estimating the extent of the BSA involved is:

difficult because the degree and depth may be greater internally than externally.

Upon arriving at the scene of a motorcycle crash, you find the patient, a young male, lying supine approximately 10 feet from his bike. An emergency medical responder is manually stabilizing the patient's head. You note an obvious open injury to the patient's left lower leg with severe bleeding. Your most appropriate initial action should be to:

direct your partner to control the bleeding as you assess the patient's airway.

The hallmark sign of compartment syndrome is:

disproportionate pain.

Upon arriving at the scene of a motor-vehicle crash involving a telephone pole, you note that the driver appears unconscious and is bleeding heavily from the mouth. There is a power line across the hood and roof of the car. You should:

ensure that the power line is not electrically active.

Small muscles within the dermis that pull the hair into an erect position when you are cold or frightened are called the:

erector pili.

Common signs and symptoms of radiation sickness include:

hair loss and skin burns.

Cardiac arrest following a crush injury is most often the result of:

hyperkalemia.

When assessing a patient with multiple gunshot wounds, you should:

identify the number and location of all wounds.

The three basic pathways by which radiation enters the body are:

inhalation, ingestion, and direct exposure.

A full-thickness burn is typically characterized by all of the following, except:

intense pain.

The "rule of palms" for estimating the extent of the body surface area (BSA) burned is especially useful with:

irregularly shaped burns.

When managing an adult patient with an inhalation injury, inspiratory stridor, and an altered mental status, you should:

prepare for early definitive airway management.

During an explosion, a metal worker sustained a large laceration to the left side of his neck by flying debris. He is conscious, but restless; the wound is moderately bleeding. Appropriate care for this patient's injury includes:

preventing air from entering the wound and applying a pressure dressing.

When managing a critically burned patient, it is important to:

rapidly estimate the burn's severity and then cover with dry, sterile dressings.

A 55-year-old male sustained partial-thickness burns to his face and neck when he opened the hot radiator cap on his car. He is conscious and alert, but complains of dyspnea and difficulty swallowing. His oxygen saturation is 96% on room air. You should be most concerned about the:

status of his airway.

Common prehospital treatment for patients with severe burns includes all of the following, except:

tetanus prophylaxis.

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

there must be a complete circuit between the electrical source and the ground.

Death immediately following a burn is most commonly the result of:

toxic chemical inhalation.

High-voltage burn injuries occur most frequently in:

utility workers.

A 40-year-old patient has sustained circumferential burns to the chest. The most serious complication associated with this type of burn injury is:

ventilatory insufficiency.

All of the following signs are indicative of upper airway burns due to an inhalation injury, except:

wheezing or rhonchi.


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