Ch. 35

Question 1

Your patient who has been involved in a flash fire tells you he was working on a small engine when volatile chemicals ignited and burned him. He has dry red skin without blistering. Considering their depth, you would classify his burns as:

A) full-thickness.
B) superficial.
C) minor.
D) partial-thickness.

Answer 1

B) superficial.

Page Ref: 810-811
Objective: 35.1 Define key terms introduced in this chapter; 35.7 Discuss the epidemiology and significance of burns and soft-tissue injuries.

Question 2

A patient has cut his arm with a table saw. Assessment reveals dark red blood flowing steadily from the wound. As an AEMT, you should recognize this as what type of bleeding?

A) Venous
B) Lymphatic
C) Capillary
D) Arterial

Answer 2

A) Venous

Page Ref: 805
Objective: 35.1 Define key terms introduced in this chapter.

Question 3

While responding to a domestic emergency with possible injuries, the dispatcher informs you that the police on-scene report a male patient with arterial bleeding from a knife wound. Given this information, which one of the following do you expect?

A) Dark red blood flowing from the injury that is difficult to control
B) Bright red blood that is spurting with each beat of the heart
C) Bright red blood oozing from the injury site that is easy to control
D) Spurting blood that is darker red in color and difficult to control

Answer 3

B) Bright red blood that is spurting with each beat of the heart

Page Ref: 805
Objective: 35.1 Define key terms introduced in this chapter.

Question 4

When a flap of skin has been torn away without all of it being removed, this is called a(n):

A) partial avulsion.
B) complete avulsion.
C) amputation.
D) complete amputation.

Answer 4

A) partial avulsion.

Page Ref: 802
Objective: 35.2 Describe each of the following types of soft-tissue injury: abrasions, amputations, avulsions, closed injury, contusion, crush injury, hematoma, impaled body parts, incisions and lacerations, open injury, and punctures.

Question 5

Puncture wounds have a high risk of:

A) internal bleeding.
B) shock.
C) infection.
D) cavitation.

Answer 5

C) infection.

Page Ref: 803
Objective: 35.3 Describe the pathophysiology and management of complications of soft- tissue injuries and burns, including the following: bleeding, blood and fluid loss, compartment syndrome, toxic inhalation, and traumatic rhabdomyolysis.

Question 6

Care for burns should include:

A) preventing heat loss.
B) oxygen by cannula.
C) hypotonic fluid administration for glucose administration.
D) breaking blisters.

Answer 6

A) preventing heat loss.

Page Ref: 814-815
Objective: 35.3 Describe the pathophysiology and management of complications of soft- tissue injuries and burns, including the following: bleeding, blood and fluid loss, compartment syndrome, toxic inhalation, and traumatic rhabdomyolysis.

Question 7

When the skin comes into contact with acids, it forms a thick, insoluble mass at the point of contact. This process is called:

A) coagulation necrosis.
B) liquefaction necrosis.
C) the hypermetabolic phase.
D) the emergent phase.

Answer 7

A) coagulation necrosis.

Page Ref: 816
Objective: 35.4 Engage in a process of clinical reasoning to effectively prioritize the steps in management of patients with burns and soft-tissue injuries.

Question 8

When burns to an eye occur from a thermal source, then what should be used to dress the burns?

A) Saline-soaked dressings to the affected eye
B) Saline-soaked dressings to both eyes
C) Dry sterile dressings to the affected eye
D) Dry sterile dressings to both eyes

Answer 8

C) Dry sterile dressings to the affected eye

Page Ref: 815
Objective: 35.5 Demonstrate effective methods of controlling bleeding, and dressing and bandaging wounds and burns using a variety of dressing and bandaging materials.

Question 9

You are dispatched to a house fire where a 67-year-old male patient has been removed from the structure. The patient is alert and oriented, with obvious burns to the hands. His respirations are 24, pulse 110, and blood pressure 130/84. He states that the fire started in his television set and that he tried to put it out but could not. As he speaks, hoarseness is developing and blisters are starting to form on his hands. Your major concern with this patient is:

A) electrical conduction injury.
B) treatment for shock.
C) infection control.
D) inhalation injury.

Answer 9

D) inhalation injury.

Page Ref: 813
Objective: 35.7 Discuss the epidemiology and significance of burns and soft-tissue injuries.

Question 10

All of the following are burn center referral criteria EXCEPT:

A) inhalation injury.
B) full-thickness burn.
C) superficial burns over 10 percent of the body surface area.
D) burns of the hands or feet.

Answer 10

C) superficial burns over 10 percent of the body surface area.

Page Ref: 815
Objective: 35.7 Discuss the epidemiology and significance of burns and soft-tissue injuries.

Question 11

The epidermis:

A) contains the oil and sweat glands.
B) serves as a barrier between the body and the environment.
C) is predominantly fatty tissue.
D) is the middle layer of skin tissue.

Answer 11

B) serves as a barrier between the body and the environment.

Page Ref: 799
Objective: 35.8 Describe the structure and function of the skin.

Question 12

Which of the following burn classifications describes a first-degree burn?

A) Superficial burn
B) Full-thickness burn
C) Partial-thickness burn
D) Second-degree burn

Answer 12

A) Superficial burn

Page Ref: 810-811
Objective: 35.9 Describe the consequences of damage to the skin.

Question 13

You can differentiate a partial-thickness burn from a superficial burn by the presence of:

A) blisters.
B) pain.
C) inflammation.
D) redness.

Answer 13

A) blisters.

Page Ref: 810-811
Objective: 35.9 Describe the consequences of damage to the skin.

Question 14

The rule of nines is called such because it identifies topographical regions that, in terms of body surface area, are approximately:

A) 1 percent.
B) 4.5 percent.
C) 10 percent.
D) 9 percent.

Answer 14

D) 9 percent.

Page Ref: 811
Objective: 35.9 Describe the consequences of damage to the skin.

Question 15

A patient has been burned to the entire anterior chest, abdomen, neck and face. Using the rule of nines, approximately what percentage of the patient is burned?

A) 18
B) 36
C) 27
D) 9

Answer 15

C) 27

Page Ref: 812
Objective: 35.9 Describe the consequences of damage to the skin; 35.10 Describe special considerations in the scene size-up when responding to calls involving burned patients.

Question 16

The rule of palm is BEST used when:

A) third-degree burns are present.
B) body surface area is large.
C) body surface area is smaller.
D) superficial burns are present.

Answer 16

C) body surface area is smaller.

Page Ref: 812
Objective: 35.9 Describe the consequences of damage to the skin; 35.10 Describe special considerations in the scene size-up when responding to calls involving burned patients.

Question 17

You are dispatched to a structural fire in which a 32-year-old man has been burned in a steam blast. Upon assessment, you note blisters to the anterior chest and circumferential burns to both lower extremities. Using the rules of nines, what percentage of burn does this patient have?

A) 54 percent
B) 45 percent
C) 36 percent
D) 27 percent

Answer 17

B) 45 percent

Page Ref: 812
Objective: 35.9 Describe the consequences of damage to the skin; 35.10 Describe special considerations in the scene size-up when responding to calls involving burned patients.

Question 18

A patient walks to your location following an accident involving an afternoon barbecue where the patient tried to light the fire with gasoline. He presents with severely burned hands that are white and have areas of charred, black patches. He is complaining of pain to his upper arms and back with some blistering. This patient has:

A) partial- and full-thickness burns.
B) partial-thickness burns.
C) relative hypovolemia.
D) superficial flash burns.

Answer 18

A) partial- and full-thickness burns.

Page Ref: 811
Objective: 35.10 Describe special considerations in the scene size-up when responding to calls involving burned patients.

Question 19

Which of the following burns would be classified as a moderate burn?

A) Superficial burns <50 percent body surface area
B) Partial-thickness burns <30 percent body surface area
C) Full-thickness burns <2 percent body surface area
D) Partial-thickness burns >30 percent body surface area

Answer 19

B) Partial-thickness burns <30 percent body surface area

Page Ref: 813
Objective: 35.10 Describe special considerations in the scene size-up when responding to calls involving burned patients.

Question 20

You are dispatched to a beach where a patient has been sunburned. Upon arrival, you find a 23-year-old woman who was sunbathing and fell asleep. She is alert and oriented, in moderate pain, and has blisters covering all four extremities. She also has blisters on her abdomen, face, and chest. You should consider this patient to have ________ burns.

A) critical
B) moderate
C) superficial
D) minor

Answer 20

A) critical

Page Ref: 813
Objective: 35.10 Describe special considerations in the scene size-up when responding to calls involving burned patients.

Question 21

Your patient has come into contact with a strong acid that has created an open wound into the abdomen. You should classify this would as a:

A) superficial burn.
B) minor injury.
C) partial-thickness burn.
D) full-thickness burn.

Answer 21

D) full-thickness burn.

Page Ref: 811
Objective: 35.10 Describe special considerations in the scene size-up when responding to calls involving burned patients.

Question 22

Carbon monoxide binds with:

A) hemoglobin.
B) oxygen.
C) smoke.
D) heat.

Answer 22

D) heat.

Page Ref: 814
Objective: 35.11 Describe the effects of burns on the circulatory, respiratory, renal, nervous, and musculoskeletal systems.

Question 23

Which of the following is a sign of inhalation injury?

A) Hoarseness while speaking
B) Blistering of the skin
C) Eschar
D) Rales

Answer 23

A) Hoarseness while speaking

Page Ref: 813
Objective: 35.12 Identify indications of inhalation injury in the burned patient.

Question 24

The FIRST step for treating a patient who has been contaminated with dry lime is to:

A) gently brush off the powder.
B) flush with water.
C) insert a supraglottic airway in the patient.
D) neutralize the lime.

Answer 24

A) gently brush off the powder.

Page Ref: 817
Objective: 35.13 Describe procedures for stopping the burning process when responding to a burned patient.

Question 25

You have been called for a patient who had a large bag of lime powder tear as he was unloading it from a truck. On arrival you notice that the patient is wearing shorts and has lime dust covering both lower legs. He is complaining of leg pain from the chemical powder. Which one of the following should be the AEMT's next immediate action? A) Move him to the stretcher for transport. B) Wash his legs off with plenty of water. C) Brush as much of the lime off his legs as possible. D) Cut his clothes off to better assess the extent of the burns.

Answer 25

C) Brush as much of the lime off his legs as possible. Page Ref: 817 Objective: 35.13 Describe procedures for stopping the burning process when responding to a burned patient.

Question 26

A patient working in a factory has been exposed to a corrosive chemical that splashed on his arms and legs. What is the FIRST step in stopping the burning process for this patient? A) Brush the chemical from the patient's body. B) Flush the chemical away with copious amounts of water. C) Place the patient in a supine position. D) Remove any contaminated clothing from the patient.

Answer 26

D) Remove any contaminated clothing from the patient. Page Ref: 816-817 Objective: 35.13 Describe procedures for stopping the burning process when responding to a burned patient.

Question 27

A burn area that is dry and reddened covers the back of a patient's neck and the upper back. This is a: A) partial-thickness burn covering 9 percent of the body surface area. B) partial-thickness burn covering 18 percent of the body surface area. C) superficial burn covering 18 percent of the body surface area. D) superficial burn covering 27 percent of the body surface area.

Answer 27

C) superficial burn covering 18 percent of the body surface area. Page Ref: 810-812 Objective: 35.14 Given a description or picture of a burn, classify the burn by depth and body surface area involved, for both adult and pediatric patients.

Question 28

A burn area is white, dry, and hard and covers the left shoulder of the patient from the base of the neck to the upper part of the arm. This is a: A) partial-thickness burn covering 9 percent of the body surface area. B) partial-thickness burn covering 13.5 percent of the body surface area. C) full-thickness burn covering 13.5 percent of the body surface area. D) full-thickness burn covering 18 percent of the body surface area.

Answer 28

C) full-thickness burn covering 13.5 percent of the body surface area. Page Ref: 811-812 Objective: 35.14 Given a description or picture of a burn, classify the burn by depth and body surface area involved, for both adult and pediatric patients.

Question 29

Which patient has a critical burn? A) 4 years old, full-thickness burn on right lower quadrant of abdomen B) 13 years old, partial-thickness burn on posterior right forearm C) 27 years old, partial-thickness burn on upper back D) 36 years old, full-thickness burn on lower back

Answer 29

A) 4 years old, full-thickness burn on right lower quadrant of abdomen Page Ref: 812-813 Objective: 35.15 Consider burn depth, location, body surface area involved, the patient's age, and any preexisting medical conditions in determining the severity of burn injuries.

Question 30

Which patients has a minor burn? A) 23 years old, partial-thickness burns on fingers and palm of left hand B) 33 years old, superficial burns over face, neck and anterior arms C) 43 years old, superficial burns to the face and neck with swelling of the throat D) 53 years old, circumferential burn of the right upper thigh

Answer 30

B) 33 years old, superficial burns over face, neck and anterior arms Page Ref: 812-813 Objective: 35.15 Consider burn depth, location, body surface area involved, the patient's age, and any preexisting medical conditions in determining the severity of burn injuries.

Question 31

Which patient has moderate burns? A) 6 years old, superficial burns on the shoulders and neck B) 7 years old, partial-thickness burns on the left and right anterior upper arms C) 8 years old, superficial burns on the hands D) 9 years old, superficial burns on anterior and posterior legs and arms and face and neck

Answer 31

D) 9 years old, superficial burns on anterior and posterior legs and arms and face and neck Page Ref: 812-813 Objective: 35.15 Consider burn depth, location, body surface area involved, the patient's age, and any preexisting medical conditions in determining the severity of burn injuries.

Question 32

Radiation burns are cared for in the same way as: A) thermal burns. B) chemical burns. C) electrical burns. D) inhalation burns.

Answer 32

A) thermal burns. Page Ref: 818 Objective: 35.16 Discuss each of the following types of burns: chemical, electrical, inhalation, radiation, and thermal.

Question 33

What is the extent of injury with an electrical burn? A) The contact point B) Anywhere touched by the current C) The entry and exit points D) The epidermis and dermis

Answer 33

B) Anywhere touched by the current Page Ref: 817 Objective: 35.16 Discuss each of the following types of burns: chemical, electrical, inhalation, radiation, and thermal.

Question 34

The exit point for an electrical burn is: A) where the patient is grounded. B) through the upper extremities. C) through the skull. D) at the patient's highest ungrounded point.

Answer 34

A) where the patient is grounded. Page Ref: 817 Objective: 35.16 Discuss each of the following types of burns: chemical, electrical, inhalation, radiation, and thermal.

Question 35

A patient has been exposed to electrical shock from an ungrounded household appliance. Which statement regarding this patient is TRUE? A) The patient will have no injuries if the patient was grounded. B) The patient will only have internal injuries. C) The patient might have both contact and exit burns. D) The patient will likely only be injured superficially at the level of the epidermis.

Answer 35

C) The patient might have both contact and exit burns. Page Ref: 817 Objective: 35.17 Discuss each of the following mechanisms of burn injuries: contact, electrical, flame, flash, gas, scald, and steam.

Question 36

The injury from coagulation necrosis is limited by: A) eschar. B) acid. C) clot formation. D) muscular tissue.

Answer 36

A) eschar. Page Ref: 816 Objective: 35.17 Discuss each of the following mechanisms of burn injuries: contact, electrical, flame, flash, gas, scald, and steam.

Question 37

Radiation burns are caused by: A) electrical current. B) ionizing radiation. C) caustic chemicals. D) short-term exposure to sunlight.

Answer 37

B) ionizing radiation. Page Ref: 818 Objective: 35.17 Discuss each of the following mechanisms of burn injuries: contact, electrical, flame, flash, gas, scald, and steam.

Question 38

Which patient DOES NOT present a contamination danger? A) A patient was exposed to radiation without proper shielding. B) A patient has been burned by a sludgy, unidentified substance covering the hands and fingers. C) A patient has radioactive material on the hands and arms. D) A patient has been submerged to the waist in a sticky, smelly, corrosive material.

Answer 38

A) A patient was exposed to radiation without proper shielding. Page Ref: 818 Objective: 35.18 Describe special considerations in responding to, assessing, and managing patients with chemical and electrical burns.

Question 39

Current fluid resuscitation guidelines recommend: A) 400 mL × body surface area involved over 4 hours. B) 40 mL/kg × body surface area involved over 24 hours. C) 2-4 mL/kg × body surface area involved over 24 hours. D) administer fluid bolus as necessary to keep systolic bp at 100 mmHg.

Answer 39

C) 2-4 mL/kg × body surface area involved over 24 hours. Page Ref: 816 Objective: 35.19 Demonstrate the ability to calculate proper volumes of fluid to be infused into the burn patient using the Parkland burn formula.

Question 40

Which of the following would present itself as black-and-blue discoloration, or bruising, of the skin? A) Abrasion B) Contusion C) Avulsion D) Puncture

Answer 40

B) Contusion Page Ref: 800 Objective: 35.2 Describe each of the following types of soft-tissue injury: abrasions, amputations, avulsions, closed injury, contusion, crush injury, hematoma, impaled body parts, incisions and lacerations, open injury, and punctures.

Question 41

Which of the following occurs when edema of the extremity reaches a point at which nervous function and circulation to the remainder of the extremity are compromised as a result of being compressed? A) Capillary bleeding B) Liquefaction necrosis C) Compartment syndrome D) External bleeding

Answer 41

C) Compartment syndrome Page Ref: 801 Objective: 35.1 Define key terms introduced in this chapter.

Question 42

When assessing the patient, you immediately see that a flap of skin has been completely torn away. What type of injury has occurred? A) Abrasion B) Avulsion C) Contusion D) Puncture

Answer 42

B) Avulsion Page Ref: 802 Objective: 35.2 Describe each of the following types of soft-tissue injury: abrasions, amputations, avulsions, closed injury, contusion, crush injury, hematoma, impaled body parts, incisions and lacerations, open injury, and punctures.