Chapter 26 Soft-Tissue Injuries

62.A 4-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?

36%

52.Which of the following is considered to be a critical burn?

Circumferential partial-thickness burns to the chest

19.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.

60.A teenage boy who was involved in a bicycle accident has a puncture wound in which the bicycle kickstand is impaled in 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.

30.An abdominal evisceration

occurs when organs protrude through an open wound.

8.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.

28.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.

64.You are dispatched to an industrial plant for a 47-year-old male who was exposed to an unknown chemical. Upon arrival, you find the patient standing outside the plant. He is conscious and alert and is covered with dry lime-colored powder. After taking the appropriate self-protective measures, you should

brush the dry chemical from his skin and clothing.

2.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.

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

chest pressure.

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

color.

25.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

compartment syndrome.

31.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.

45.When assessing a patient with a closed soft tissue injury, it is MOST important to

remain alert for more severe underlying injuries.

4.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.

7.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.

10.During your assessment of a patient who was shot in the abdomen, you notice a large entrance wound with multiple small puncture wounds surrounding it. This wound pattern is MOST consistent with a

shotgun.

33.Burns are classified according to

depth and extent.

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

dermal layer.

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

first-degree burn.

67.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

initiate CPR and attach the AED.

58.With regard to the pediatric rule of nines, the

legs are proportionately smaller than an adult's.

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

lips.

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

superficial burn.

29.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.

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

the nerve endings have been destroyed.

56.According to the palmar method for estimating the extent of a patient's burns, the palm of the patient's hand is equal to ___% of the body surface area.

1

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%

35.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?

30%

12.In which of the following patients should you remove an impaled object?

A pulseless and apneic patient with a knife impaled in the back

17.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

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

Ears

59.Which of the following statements regarding electrical burns is MOST correct?

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

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

Epidermis

66.A 50-year-old male with a history of diabetes sustained partial-thickness burns to approximately 15% of his body surface area (BSA) while attempting to light a barbeque pit. He is conscious and alert and in no respiratory distress. What factor makes this patient's burn a critical burn?

His history of diabetes

24.Which of the following is a sign of compartment syndrome?

Pain upon passive movement of the injury site

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

Partial-thickness burn to 20% of the BSA

53.Which of the following is considered a critical burn in a 60-year-old patient?

Partial-thickness burns to 20% of the body surface area

34.Which of the following statements regarding severe burns is correct?

Severe burns are typically a combination of various degrees of burns.

68.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.

57.Which of the following statements regarding the rule of nines is MOST correct?

The anterior trunk of an adult is equal to 18% of the body surface area.

41.Which of the following statements regarding the dermis is MOST correct?

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

18.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.

3.A 39-year-old male was struck in the head by a baseball during a game. He is confused and has slurred speech. He 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.

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

an air embolism.

63.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 trauma 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.

65.You are assessing a 30-year-old male with an amputation just above the left wrist. He is conscious and alert and has a patent airway. Dark red blood is freely flowing from the injury. You should

apply direct pressure to the injury site.

20.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.

38.When treating a partial-thickness burn, you should

avoid the use of creams, lotions, or antiseptics.

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

brush away the chemical before flushing with water.

32.In contrast to animal bites, the bite of a human

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

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

contusion.

44.Compartment syndrome would MOST likely develop following a

crush injury

39.Functions of dressings and bandages include all of the following, EXCEPT

immobilization of the injury.

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

infection.

46.A laceration

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

55.Critical burns in an infant or child include

partial-thickness burns to more than 20% of the body surface area.

9.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.

43.When a person is exposed to a cold environment

peripheral vessels constrict and divert blood away from the skin.

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

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

37.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

the potential for airway swelling.

22.Functions of the skin include all of the following, EXCEPT

the production of key antibodies.

13.The sebaceous glands produce sebum, a material that

waterproofs the skin and keeps it supple.

27.Which of the following statements regarding penetrating injuries is correct?

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

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

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

23.A hematoma develops when

large blood vessels beneath the skin are damaged.

47.When caring for an amputated body part, the EMT-B should

keep it cool without allowing it to freeze.

54.When assessing the severity of a patient's burn(s), you should routinely consider all of the following factors, EXCEPT

known drug allergies.