CHAPTER 24- soft tissue injuries

Which of the following is a severe burn in a 2-year-old child? A. any full-thickness burn, regardless of its location on the body B. superficial burn that covers 25% of the BSA C. any burn that involves the arms, legs, or posterior part of the body D. partial-thickness burn that covers 10% of the BSA

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

Which of the following is a severe burn in a 35-year-old patient? A. circumferential partial-thickness burn to the chest B. full-thickness burn to 5% of the body surface area (BSA) C. partial-thickness burn to 20% of the BSA D. superficial burn covering 50% of the BSA

A. circumferential partial-thickness burn to the chest

All of the following body structures are lined with mucous membranes, EXCEPT for the: A. lips. B. mouth. C. nose. D. anus.

A. lips.

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

is usually less severe because the human mouth is cleaner. C.

A 56-year-old male has an incomplete avulsion to his right forearm. After controlling any bleeding from the wound, you should: A. replace the avulsed flap to its original position and cover it with a sterile dressing. B. carefully probe the wound to determine if the bleeding is venous or arterial. C. carefully remove the avulsed flap and wrap it in a moist, sterile trauma dressing. D. thoroughly irrigate the wound with sterile water and cover it with a sterile dressing.

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

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? A. 27% B. 36% C. 30% D. 18%

C. 30%

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

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

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

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

In which of the following patients should you remove an impaled object? A. a pulseless and apneic patient with a knife impaled in the back B. a conscious and alert patient with a fishhook impaled in the eye C. a semiconscious patient with an ice pick impaled in the chest D. an apneic patient with a shard of glass impaled in the abdomen

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

A burn that is characterized by redness and pain is classified as a: A. first-degree burn. B. second-degree burn C. partial-thickness burn D. third-degree burn.

A. first-degree burn.

Functions of the skin include all of the following, EXCEPT: A. the production of key antibodies. B. sending information to the brain. C. regulation of body temperature. D. maintenance of water balance.

A. the production of key antibodies.

A partial-thickness burn involves the outer layer of skin and a portion of the: A. dermal layer. B. muscle fascia. C. epidermis. D. fatty layer.

A. dermal layer.

A hematoma develops when: A. large blood vessels beneath the skin are damaged. B. severe swelling compromises arterial circulation. C. cells and small vessels in the dermis are damaged. D. small amounts of blood leak into the epidermis.

A. large blood vessels beneath the skin are damaged.

An abdominal evisceration: A. occurs when organs protrude through an open wound. B. often causes severe hypothermia because of heat loss. C. is most commonly the result of blunt force trauma. D. should be covered with bulky dry, sterile dressings.

A. occurs when organs protrude through an open wound.

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: A. open his airway and assess his breathing status. B. apply high-flow oxygen and assess his injuries. C. assess his pulse for rate, regularity, and quality. D. perform an immediate head-to-toe assessment.

A. open his airway and assess his breathing status.

In addition to severe bleeding, the MOST life-threatening complication associated with an open neck injury is: A. a spinal fracture. B. an air embolism. C. an ischemic stroke. D. nerve fiber damage.

B. an air embolism.

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: A. damage to the radial nerve. B. compartment syndrome. C. internal hemorrhage. D. a severe closed fracture.

B. compartment syndrome.

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. A. 2% B. 1% C. 4% D. 6%

B. 1%

Which of the following statements regarding the dermis is correct? A. The dermis produces a substance that provides color to the skin. B. The dermis contains hair follicles, sweat glands, and nerve endings. C. The cells of the dermis are worn away and are constantly replaced. D. The dermis lies above the germinal layer and provides protection.

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

Which of the following processes occurs during the inflammation phase of the healing process? A. The veins and arteries at the injury site constrict and platelets aggregate, which stops bleeding and causes a temporary increase in the size of the wound. B. The immune system releases histamines, which cause vasodilation and increased capillary permeability, resulting in local redness and swelling. C. White blood cells are forced away from the injury site, thus allowing an increase in the flow of red blood cells, resulting in increased blood flow. D. The blood vessels in and around the injury site constrict, which forces bacteria and other microorganisms away, thus preventing significant infection.

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

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: A. remove the steel rod, control the bleeding, apply an automated external defibrillator (AED), begin CPR, and transport to a trauma center. B. control the bleeding, begin cardiopulmonary resuscitation (CPR), stabilize the steel rod, immobilize his spine, and transport immediately. C. stabilize the steel rod, control the bleeding, begin CPR, and rapidly transport to a trauma center. D. control the bleeding, carefully remove the steel rod, begin CPR, and transport as soon as possible.

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

A laceration: A. rarely penetrates through the subcutaneous tissue to the muscle. B. is a jagged cut caused by a sharp object or blunt force trauma. C. is an injury that separates various layers of soft tissue. D. is a sharp, smooth cut that is made by a surgical scalpel.

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

With regard to the pediatric rule of nines, the: A. arms are proportionately larger than an adult's. B. legs are proportionately smaller than an adult's. C. thorax is proportionately larger than an adult's. D. head is proportionately smaller than an adult's.

B. legs are proportionately smaller than an adult's.

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? A. incision B. avulsion C. abrasion D. laceration

C. 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: A. perform a neurologic exam. B. apply ice to the hematoma. C. administer high-flow oxygen. D. palpate his radial pulses.

C. administer high-flow oxygen.

When caring for a patient whose arm is covered with a dry chemical, you should: A. deactivate the chemical with a 5% vinegar solution. B. use forceful streams of water to remove the chemical. C. brush away the chemical before flushing with water. D. quickly irrigate the arm with large amounts of water.

C. brush away the chemical before flushing with water.

What layer of the skin forms a watertight, protective seal for the body? A. subcutaneous layer B. muscular layer C. epidermis D. dermis

C. epidermis

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: A. advise the child that he will need rabies shots. B. administer oxygen via a nonrebreathing mask. C. report the incident to the appropriate authorities. D. ask the child's father to try to locate the dog.

C. 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: A. assessing the bruises that overlie major organs in the chest and abdomen. B. performing a detailed secondary assessment to locate all of her injuries. C. the fact that her clinical signs could indicate that she is bleeding internally. D. obtaining a complete set of vital signs to rule out the possibility of shock.

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

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: A. carefully manipulate her arm until the symptoms subside. B. remove the bandage and dressing and apply another one. C. assess distal circulation and readjust the bandage as needed. D. remove the gauze bandage and replace it with an elastic one.

C. assess distal circulation and readjust the bandage as needed.

Which of the following areas of the body has the thinnest skin? A. soles of the feet B. scalp C. ears D. back

C. ears

When a person is exposed to a cold environment: A. sweat is produced and is warmed when the vessels constrict. B. blood vessels dilate and divert blood to the core of the body. C. peripheral vessels constrict and divert blood away from the skin. D. the skin becomes flushed secondary to peripheral vasodilation.

C. peripheral vessels constrict and divert blood away from the skin.

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? A. The patient struck in the mouth should be immobilized. B. The 44-year-old female is at high risk for an infection. C. You should contact the police and have the patients arrested. D. The 39-year-old female is at high risk for an infection

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

Which of the following statements regarding the rule of nines is correct? A. The anterior arm in the adult is equal to 9% of the total BSA. B. A child's head is equal to 14% of his or her total BSA. C. The posterior of a child's leg is equal to 13.5% of the BSA. D. The anterior trunk of an adult is equal to 18% of the BSA.

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

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: A. perform a focused physical exam of his abdomen. B. conclude that he is experiencing intracranial bleeding. C. place him in a sitting position and give him oxygen. D. administer oxygen and prepare for rapid transport.

D. administer oxygen and prepare for rapid transport.

In addition to external bleeding, the MOST significant risk that an open soft-tissue injury exposes a patient to is: A. vessel damage. B. nerve damage. C. hypothermia. D. infection

D. infection

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: A. handgun. B. .22-caliber pistol. C. .357 magnum. D. shotgun.

D. shotgun.

The sebaceous glands produce sebum, a material that: A. discharges sweat onto the skin's surface. B. pulls the hair erect when you are cold. C. facilitates shedding of the epidermis. D. waterproofs the skin and keeps it supple.

D. waterproofs the skin and keeps it supple.

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

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

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: A. direct your partner to assist the patient's ventilations with a bag-mask device. B. control the bleeding from the wound and prepare to transport at once. C. place a sterile dressing over the wound and apply direct pressure. D. apply an occlusive dressing to the wound and continue your assessment.

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

Burns are classified according to: A. location and pain. B. degree and location. C. extent and location. D. depth and extent.

D. depth and extent.

The hallmark sign of compartment syndrome is: A. a lack of pain despite the severity of the injury. B. a bounding pulse distal to the injury. C. extreme redness to the injury site. D. pain out of proportion to the injury.

D. pain out of proportion to the injury.

Burns to pediatric patients are generally considered more serious than burns to adults because: A. most burns in children are the result of child abuse. B. pediatric patients are more prone to hyperthermia. C. pediatric patients have a proportionately larger volume of blood. D. pediatric patients have more surface area relative to total body mass.

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

Patients with full-thickness (third-degree) burns generally do not complain of pain because: A. subcutaneous vessels are usually clotted. B. he or she is generally not conscious. C. blister formation protects the burn. D. the nerve endings have been destroyed.

D. the nerve endings have been destroyed.

Functions of the skin include all of the following, EXCEPT: A. regulation of body temperature. B. maintenance of water balance. C. sending information to the brain. D. the production of key antibodies

D. the production of key antibodies