EMT Chapter 26 Soft-Tissue Injuries

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. A. 18% B. 27% C. 36% D. 45%

A. 18%

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. abrasion. B. contusion. C. hematoma. D. crush injury.

A. Abrasion

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

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

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

Which of the following processes occurs during the inflammation phase of the healing process? A. The immune system releases histamines, which cause vasodilation and increased capillary permeability, resulting in local redness and swelling. B. 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. C. The blood vessels in and around the injury site constrict, which forces bacteria and other microorganisms away, thus preventing significant infection. D. 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.

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

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

A. an air embolism.

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: A. begin CPR and apply the AED. B. begin CPR and transport at once. C. assess for entry and exit wounds. D. fully immobilize his spinal column.

A. begin CPR and apply the AED.

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

A. lips.

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. perform an immediate head-to-toe assessment. C. assess his pulse for rate, regularity, and quality. D. apply high-flow oxygen and assess his injuries.

A. open his airway and assess his breathing status.

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 unresponsive on the ground; the power line is lying across his chest. You should: A. rapidly assess the patient after ensuring that the power line is not live. B. apply insulated gloves and assume manual control of his c-spine. C. quickly but carefully move the patient away from the power line. D. manually stabilize his head as your partner assesses for breathing.

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

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

B. Any full-thickness burn, regardless of its location on the body

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

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

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

B. Epidermis

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

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

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

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.

An injury that separates various layers of soft tissue, resulting in complete detachment or a flap of skin, is called a(n): A. incision. B. avulsion. C. laceration. D. amputation.

B. avulsion.

The skin regulates temperature in a cold environment by: A. secreting sweat through sweat glands. B. constricting the blood vessels. C. dilating the blood vessels. D. increasing the amount of heat that is radiated from the body's surface.

B. constricting the blood vessels.

A closed soft-tissue injury characterized by swelling and ecchymosis is called a(n): A. abrasion. B. contusion. C. hematoma. D. crush injury.

B. contusion.

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

B. first-degree burn.

The skin covering the _____ is quite thick. A. lips B. scalp C. ears D. eyelids

B. scalp

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. shotgun. C. .22-caliber pistol. D. .357 magnum.

B. shotgun.

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

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

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

C. Ears

_____ burns may involve the subcutaneous layers, muscle, bone, or internal organs. A. Superficial B. Partial-thickness C. Full-thickness D. Second-degree

C. Full-thickness

Which of the following is a severe burn in a 65-year-old patient? A. superficial burn to 30% of the BSA B. full-thickness burn to 1% of the BSA C. partial-thickness burn to 20% of the BSA D. second-degree burn covering 10% of the BSA

C. Partial-thickness burn to 20% of the BSA

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

C. administer high-flow oxygen.

An open neck injury may result in _____ if enough air is sucked into a blood vessel. A. hypovolemic shock B. tracheal deviation C. an air embolism D. subcutaneous emphysema

C. an air embolism

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

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

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. remove the bandage and dressing and apply another one. B. carefully manipulate her arm until the symptoms subside. 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.

A(n) _____ occurs when a great amount of force is applied to the body for a long period of time. A. contusion B. hematoma C. crushing injury D. avulsion

C. crushing injury

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

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

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

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

During the normal wound-healing process, bleeding may occur from even a minor injury because: A. there is a substantial decrease in the number of platelets in and around the wound, which increases the risk of bleeding. B. histamines released by the immune system constrict the blood vessels, which increases the pressure within them. C. new capillaries that stem from intact capillaries are delicate and take time to become as stable as the preexisting capillaries. D. bacteria and other microorganisms invade the wound site and damage the capillaries, which makes them more prone to bleeding.

C. new capillaries that stem from intact capillaries are delicate and take time to become as stable as the preexisting capillaries.

When assessing a patient with a closed soft-tissue injury, it is MOST important to: A. manipulate the injury site for signs of a fracture. B. assess circulation distal to the site of the injury. C. remain alert for more severe underlying injuries. D. recognize that the integrity of the skin is broken.

C. remain alert for more severe underlying injuries.

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

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

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

C. the nerve endings have been destroyed.

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. Irrigate it with sterile water and cover it with a dry dressing. B. Cover the exposed bowel and keep his legs in a straight position. C. Carefully replace the exposed bowel into the abdomen and transport. 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 is of LEAST importance when initially assessing the severity of a burn? A. area(s) burned B. age of the patient C. past medical history D. known drug allergies

D. Known drug allergies

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. quickly irrigate the arm with large amounts of water. C. use forceful streams of water to remove the chemical. D. brush away the chemical before flushing with water.

D. brush away the chemical before flushing with water.

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

D. dermal layer.

Burns to pediatric patients are generally considered more serious than burns to adults because: A. pediatric patients are more prone to hyperthermia. B. most burns in children are the result of child abuse. 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.

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. the skin becomes flushed secondary to peripheral vasodilation. D. peripheral vessels constrict and divert blood away from the skin.

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

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

D. report the incident to the appropriate authorities.

You respond to a house fire with the local fire department. They bring a 48-year-old woman out of the house. She is unconscious but her airway is open. Her breathing is shallow at 30 breaths/min. Her pulse is 110 beats/min, strong and regular. Her blood pressure is 108/72 mm Hg. She has been burned over 40% of her body. The burned area appears to be dry and leathery. It looks charred and has pieces of fabric embedded in the flesh. You know that this type of burn is considered a: A. first-degree burn. B. second-degree burn. C. partial-thickness burn. D. third-degree burn.

D. third-degree burn.

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

D. waterproofs the skin and keeps it supple.