Soft-Tissue Injuries & Burns (Multiple Choice)

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? -18% -27% -36% -45%

27%

A 5-year-old female pulled a pot of boiling water from the stove. She has superficial and partial-thickness burns to her head, face, and anterior trunk. What percentage of her body surface area has been burned? -18% -27% -30% -36%

30%

Which of the following is considered a severe burn? -Any full-thickness burn -20% partial-thickness burn -10% full-thickness burn with abrasions -5% full-thickness burn with a fracture

5% full-thickness burn with a fracture

You are responding to a fight at a restaurant and find a man, conscious and alert. His face is mottled with blisters and abrasions, and he has blood on his shirt. He tells you he was trying to stop the fight when he was hit in the face with scalding hot coffee and fell backwards over a chair. According to the rule of nines, what percentage of the patient's skin surface is burned? -18% -12% -9% -4.5%

9%

In order for electricity to flow through the body and cause damage: -An insulator must exist between the electrical source and the patient -A complete circuit must exist between the electrical source and the ground -The part of the body that is in contact with the electrical source must be dry -The person must make direct physical contact with the source of electricity

A complete circuit must exist between the electrical source and the ground

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: -Perform a focused physical exam of his abdomen -Administer oxygen and prepare for rapid transport -Place him in a sitting position and give him oxygen -Conclude that he is experiencing intracranial bleeding

Administer oxygen and prepare for rapid transport

The MOST appropriate way to dress and bandage an open abdominal wound with a loop of bowel protruding from it is to: -Cover the wound with a dry, sterile dressing and apply firm pressure -Apply a moist, sterile dressing to the wound and apply firm pressure -Apply a moist, sterile dressing to the wound and secure it with an occlusive dressing -Carefully replace the protruding bowel into the abdomen and cover the wound

Apply a moist, sterile dressing to the wound and secure it with an occlusive dressing

A 17-year-old male was shot in the right anterior chest during an altercation. As your partner is applying oxygen, you perform a rapid 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 -Place a sterile dressing over the wound and apply direct pressure -Direct your partner to assist the patient's ventilations with a BVM -Control the bleeding from the wound and prepare to transport at once

Apply an occlusive dressing to the wound and continue your assessment

You are treating an 8-year-old who fell while riding his bike on a gravel road. The wound on his arm is seeping blood, is about 7 inches long, and there is a lot of dirt and gravel in it. How should you treat this injury? -Flush the area with sterile saline -Apply sterile dressing -Manually brush/pick the foreign material out -Apply occlusive dressing

Apply sterile dressing

When treating a partial-thickness burn, you should: -Immerse the affected part in warm water -Rupture any blisters to prevent an infection -Cover the burn with a moist, sterile dressing -Avoid the use of creams, lotions, or antiseptics

Avoid the use of creams, lotions, or antiseptics

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: -Carefully remove the knife, control any bleeding, begin CPR, and transport -Stabilize the knife in place, provide rescue breathing, and transport at once -Remove the knife and control any bleeding, apply the AED, and analyze his rhythm -Begin CPR, control any external bleeding, and transport rapidly to a trauma center

Carefully remove the knife, control any bleeding, begin CPR, and transport

In contrast to animal bites, the bite of a human: -Is usually less severe because the human mouth is cleaner -Typically results in a minor infection that is slow-spreading -Carries with it a wide variety of virulent bacteria and viruses -Is associated with a much higher incidence of rabies infection

Carries with it a wide variety of virulent bacteria and viruses

Common signs and symptoms of an airway burn include all of the following, EXCEPT: -Hoarseness -Chest pressure -Singed nasal hair -Soot around the mouth

Chest pressure

Which of the following is the final stage of wound healing? -Formation of new capillaries -Inflammation -Collagen produced -Cessation of blood loss

Collagen produced

The germinal layer of the epidermis contains pigment granules that are responsible for skin: -Color -Texture -Moisture -Temperature

Color

You are assessing a 28-year-old with a rigid cast extending the length of his left leg. The patient is complaining of pain on passive movement and he is showing signs of impaired circulation. What do you suspect? -Crush Syndrome -Compartment Syndrome -Ecchymosis -Avulsion

Compartment Syndrome

A 30-year-old male experienced a crushing injury when his forearm 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: -Internal hemorrhage -Compartment syndrome -A severe closed fracture -Damage to the radial nerve

Compartment syndrome

A compression injury that is severe enough to cut off blood flow below the injury is called: -A contusion -A hematoma -A local thrombus -Compartment syndrome

Compartment syndrome

Which of the following statements regarding crush syndrome is correct? -With crush syndrome, massive blood vessel damage occurs following severe, soft-tissue, such as amputation of an extremity -Provided that a patient w/ a crush injury is freed from entrapment within 6 hours, the amount of tissue damaged is generally minimal -Tissue damage that occurs in crush syndrome is severe, but kidney injury is unlikely b/c toxins are quickly eliminated from the body -Compromised arterial blood flow leads to crush syndrome & can occur when an area of the body is trapped for longer than 4 hours

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

The primary reason for applying a sterile dressing to an open injury is to: -Prevent contamination -Control external bleeding -Reduce the risk of infection -Minimize any internal bleeding

Control external bleeding

A construction worker fell approximately 30 feet and landed in a pile of steel rods. Your assessment reveals that he is pulseless and apneic and has a 10-inch steel rod impaled in his left leg. You should: -Control the bleeding, begin CPR, stabilize the steel rod, immobilize his spine, and transport immediately -Remove the steel rod, control the bleeding, apply an AED, begin CPR, and transport to a trauma center -Stabilize the steel rod, control the bleeding, begin CPR, and rapidly transport to a trauma center -Control the bleeding, carefully remove the steel rod, begin CPR, and transport as soon as possible

Control the bleeding, begin 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 -Crush injury -Abrasion -Hematoma

Contusion

A young male was struck in the forearm with a baseball and complains of pain to the area. Slight swelling and ecchymosis are present, but no external bleeding. Which type of injury does this describe? -Abrasion -Contusion -Hematoma -Avulsion

Contusion

Which type of soft-tissue injury is LEAST likely to result in infection? -Contusions on the left lateral chest -Abdominal laceration -Abrasions to the face -Burns to the face

Contusions on the left lateral chest

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 the exposed bowel and keep his legs in a straight position -Irrigate it with sterile water and cover it with a dry dressing -Carefully replace the exposed bowel into the abdomen and transport -Cover it with moist, sterile gauze and secure with an occlusive dressing

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

Burns are classified according to: -Depth and extent -Location and pain -Degree and location -Extent and location

Depth and extent

The severity of a thermal injury directly correlates with temperature, concentration, and what other factor? -Current -Chemical reaction -Duration of exposure -Source of thermal energy

Duration of exposure

Which of the following statements regarding electrical burns is correct? -Entrance wounds are small relative to the amount of internal tissue damage -The size of the entry and exit wounds is a reliable indicator of internal damage -Respiratory or cardiac arrest following an electrical burn is very uncommon -The exit wound caused by electrical burns is smaller than the entrance wound

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

What layer of the skin forms a watertight, protective seal for the body? -Dermis -Subcutaneous layer -Epidermis -Muscular layer

Epidermis

You are assessing a patient who has been in a high-impact T-bone collision. She is bleeding from the abdomen and you can see part of her large intestine outside her body. What is this injury called? -Impalement -Avulsion -Ecchymosis -Evisceration

Evisceration

Which of the following statements regarding penetrating injuries is correct? -External bleeding may be minimal but internal injuries can be extensive -The degree of internal injury can often be estimated by the external injury -It is important to distinguish between entrance and exit wounds in the field -The depth of a penetrating injury should be thoroughly assessed by the EMT

External bleeding may be minimal but internal injuries can be extensive

True or False A hematoma is an open injury that occurs whenever a large blood vessel is damaged and bleeds rapidly.

False

True or False When possible, ALS providers should administer IV fluid within 3 minutes after the crushing object is lifted off the body.

False

When using the rule of nines, which of the following do you need to include in your calculations? -Only full-thickness burns -Superficial, full-, and partial-thickness burns -Full- and partial-thickness burns -Superficial and full-thickness burns

Full- and partial-thickness burns

Functions of dressings and bandages include all of the following, EXCEPT: -Immobilization of the injury -Prevention of contamination -Protection from further injury -Control of external hemorrhage

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 -Hypothermia -Nerve damage -Vessel damage

Infection

A factory worker was splashed in the eyes with a strong acid chemical. He complains of intense pain and blurred vision. Your ambulance does not carry bottles of sterile saline or water. You should: -Irrigate both eyes continuously for 20 minutes with plain water -Flush both eyes with an alcohol-based solution and transport -Neutralize the acid chemical in his eye w/ an alkaline chemical -Mix baking soda with water and irrigate his eyes with the solution

Irrigate both eyes continuously for 20 minutes with plain water

A hematoma develops when: -Small amounts of blood leak into the epidermis -Large blood vessels beneath the skin are damaged -Severe swelling compromises arterial circulation -Cells and small vessels in the dermis are damaged

Large blood vessels beneath the skin are damaged

An abdominal evisceration: -Is most commonly the result of blunt force trauma -Should be covered with bulky dry, sterile dressings -Often causes severe hypothermia because of heat loss -Occurs when organs protrude through an open wound

Occurs when organs protrude through an open wound

For which injury would you use an occlusive dressing directly on the wound? -Avulsion -Open neck injury -Impaled object -Evisceration

Open neck injury

Which of the following is a sign of compartment syndrome? -Absence of pain at the injury site -Extreme redness to the injury site -A bounding pulse distal to the injury site -Pain upon passive movement of the injury site

Pain upon passive movement of the injury site

Burns to pediatric patients are generally considered more serious than burns to adults because: -Most burns in children are the result of child abuse -Pediatric patients are more prone to hyperthermia -Pediatric patients have more surface area relative to total body mass -Pediatric patients have a proportionately larger volume of blood

Pediatric patients have more surface area relative to total body mass

A 45-year-old convenience store clerk was shot in the right anterior chest during a robbery. Your assessment reveals that the wound has blood bubbling from it every time the patient breathes. Your MOST immediate action should be to: -Prevent air from entering the wound -Cover the wound with a bulky dressing -Assess the patient's back for an exit wound -Transport the patient promptly to the closest trauma center

Prevent air from entering the wound

Which of the following statements regarding chemical burns is FALSE? -Most chemical burns are caused by strong acids or alkalis -Fumes of strong chemicals can cause burns to the respiratory tract -Prior to removing a dry chemical, flush the area with sterile water Do not attempt to neutralize an acid burn with an alkaline chemical

Prior to removing a dry chemical, flush the area with sterile water

Which of the following statements regarding severe burns is correct? -Severe burns involving the airway have a 100% mortality rate -The majority of severe burns involve full-thickness burns only -Patients with severe burns are especially prone to hyperthermia -Severe burns are typically a combination of various degrees of burns

Severe burns are typically a combination of various degrees of burns

What is your first responsibility when treating a burn patient? -Administering high-flow oxygen -Preventing loss of body heat -Stopping the burning -Identifying life-threatening injuries

Stopping the burning

Which of the following statements regarding the rule of nines is correct? -The anterior arm in the adult is equal to 9% of the total -A child's head is equal to 14% of this total BSA -The anterior trunk of an adult is equal to 18% of the BSA -The posterior of a child's leg is equal to 13.5% of the BSA

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

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: -Performing a detailed secondary assessment to locate all of her injuries -Assessing the bruises that overlie major organs in the chest and abdomen -The fact that her clinical signs could indicate that she is bleeding internally -Obtaining a complete set of vital signs to rule out the possibility of shock

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: -Subcutaneous vessels are usually clotted -They are generally not conscious -The nerve endings have been destroyed -Blister formation protects the burn

The nerve endings have been destroyed

You and your partner arrive at the scene of a house fire where firefighters 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: -Treating him for hypothermia -Preventing the risk of infection -Estimating the extent of his burns -The potential for airway swelling

The potential for airway swelling

Functions of the skin include all of the following, EXCEPT: -Maintenance of water balance -Regulation of body temperature -The production of key antibodies -Sending information to the brain

The production of key antibodies

Which of the following is true about electrical burns? -The patient can go into cardiac arrest at any time within 24 hours of contact with electricity -Seriousness of electrical burns depends on the type of current, amperage, and conductivity -They always have an entrance wound but only occasionally have an exit wound -They are always more severe than the external signs indicate

They are always more severe than the external signs indicate

True or False The goal of the inflammation phase of wound healing is the removal of foreign material, damaged cellular parts, and invading microorganisms from the wound site.

True

True or False You should never remove an avulsion skin flap, regardless of its size.

True

Which effects will the application of an ice pack have on a hematoma? Vasodilation and increased pain Vasodilation and decreased bleeding Vasoconstriction and increased swelling Vasoconstriction and decreased bleeding

Vasoconstriction and decreased bleeding