Integ 2

Question 1

1. A superficial partial thickness burn is expected to heal if there is no infection in:

a. 7-21 days
b. 2-5 days
c. 21-35 days
d. 72-90 days

Question 2

2. Renal failure is more common with:

a. Chemical burn
b. Thermal
c. Radiation
d. Electrical

Question 3

3. This type of burn involves only the outer epidermis, which may be red with slight edema, and healing occurs without any evidence of scarring?

a. Full-thickness burn
b. Superficial burn
c. Subdermal burn
d. Deep partial-thickness burn
e. Superficial partial-thickness burn

Question 4

4. An 8-year-old boy sustained a deep partial thickness burn to his heel. When teaching the patient, a stretching program the greatest emphasis should be placed in the direction of:
   a. Inversion
   b. Eversion
   c. Plantarflexion
   d. Dorsiflexion

Question 5

5. A patient 72 hours status post stroke is referred to therapy. As part of the patient care program, the therapist makes positioning recommendations to the nursing staff. How often should the turning occur?

a. Every 30 mins
b. Every 2 hours
c. Every 4 hours
d. Every 6 hours

Question 6

6. A patient with chronic venous insufficiency at the lower extremities is most likely to exhibit:

a. Normal superficial veins, no edema, ulceration, & patches of gangrene around the toes
b. No edema, faint dorsalis pedis pulse, & cold, hairless extremities
c. Dilation of superficial veins & edema made worse during sitting or elevation of the LE
d. Dilation of superficial veins, edema, & stasis ulceration

Question 7

7. Black, brown or tan devitalized tissue that adheres to the wound bed?
   a. Eschar
   b. Slough
   c. Granulation
   d. Epithelium

Question 8

8. Signs of maturation of a burn scar:

I. Complete fading of erythema
II. Softening and thinning out of the scars
III. Increase in wrinkling & flexibility of the scars
IV. Will not blanch to touch

a. I and III
b. II and IV
c. I, II and III
d. I, II, III and IV

Question 9

9. The rule of nines assigns percentage to an adult’s posterior leg?

a. 4.5 b. 6 c. 9 d. 14

Question 10

10. There is a complete destruction of epidermis, dermis, subcutaneous tissues and it also involves muscle and bone?

a. Superficial burn
b. Superficial partial thickness burn
c. Deep partial thickness burn
d. Full thickness burn
e. Subdermal burn

Question 11

11. Common site of pressure sore in an adult patient:

a. Sacrum
b. Spine of scapula
c. Occiput
d. Heel

Question 12

12. The most important prevention of foot ulcers in patients with DM:

a. Regular drug intake
b. Warm & cold compressed
c. Tight footwear
d. Patient education
e. All of these

Question 13

13. The following are contributory factors to pressure ulcers:

I. Prolonged pressure
II. Shear forces
III. Nutritional deficiency
IV. Friction
V. Maceration

a. I, II, and III
b. I, III and V
c. I, II, III and IV
d. I, II, III, IV and V

Question 14

14. You have been consulted to treat a patient with a 4 cm stage III decubitus ulcer over the right heel. You note a green/yellow, pungent exudates at the wound site & opt to use electrical stimulation. Your choice of polarity & electrode placement would be:

a. The cathode is placed proximal to the wound
b. The cathode is placed on the wound
c. The cathode is placed distal to the wound
d. The anode is placed on the wound

Question 15

15. The leading cause of death from burn is:

a. Pulmonary complications
b. Infections
c. Circulatory problems
d. Shock
e. Cardiac complications

Question 16

16. You are assessing a patient with a pressure ulcer. The ulcer demonstrates a partial thickness skin loss that involves the epidermis &/or dermis. In addition, the ulcer is superficial & presents clinically as an abrasion, a blister, or shallow crater. Using the National Pressure Ulcer Advisory Panel (NPUAP) Pressure Ulcer Stages, how would you grade this ulcer?

a. Stage I
b. Stage II
c. Stage III
d. Stage IV

Question 17

17. A patient with a complete thoracic SCI is sitting in a wheelchair on a custom-made cushion. Pressure relief activities should be performed:

a. When the patient shows signs of pressure sores
b. If the patient does not have an appropriate cushion
c. Every 15 to 20 minutes
d. Every 1 to 2 hours

Question 18

18. Characterized by white, gray, or black (charred) appearance; dry surface, edema, eschar (scab or dry crust); little pain (nerve endings are destroyed)?
    a. Superficial burn
    b. Superficial partial thickness burn
    c. Deep partial thickness burn
    d. Full thickness burn
    e. Subdermal burn

Question 19

19. The rationale of using HVPG current in the management of infected Grade 2 sacral ulcers in a 65-year-old C4 quadriplegic is:

a. Attraction of fibroblasts
b. Destruction of bacteria
c. Destruction of scar tissues
d. Alter ion concentration

Question 20

20. This type of graft contains epidermis and the whole dermis from donor site?

a. Autograft
b. Xenograft
c. Split thickness graft
d. Full thickness graft

Question 21

21. Your home care patient has already developed a grade III sacral pressure ulcer in spite of having a foam pressure relief mattress. The relatives are planning to buy another one. A good choice to buy which would be fairly cost effective and with a fair pressure relief would be a mattress with this material:

a. Viscoelastic foam
b. Gel
c. Floatation (air or water)
d. Foam

Question 22

22. Best dressing for dry wounds?
    a. Hydrocolloid
    b. Hydrogel
    c. Calcium alginate
    d. Wet-to-dry

Question 23

23. Debridement for burns may be done through:

a. Surgery
b. Whirlpool
c. Enzymes
d. All of the above

Question 24

24. This type of graft is laboratory grown from patient’s own skin?

a. Allograft
b. Biosynthetic grafts
c. Cultured skin
d. Autograft

Question 25

25. Less than 10% with third degree burns and 15- 30% with second degree. What is the classification/severity of burn?

a. Minor
b. Moderate
c. Major
d. Critical

Question 26

26. A child with a burn on the anterior trunk & leg, has what percentage of a burn according to the rule of nines?

a. 18
b. 23
c. 36
d. 32

Question 27

27. This zone of burn injury has minimal cell damage and should recover within few days?

a. Coagulation
b. Stasis
c. Hyperemia
d. Ischemia

Question 28

28. Common positioning for hand burn when using a resting hand splint:

I. wrist extension (15°)
II. MP flexion (70°)
III. PIP and DIP extension
IV. thumb adduction
V. thumb abduction

a. I, II and III
b. II, III and V
c. I, II, III and IV
d. I, II, III and V

Question 29

29. In post-grafting for burn injury: discontinue exercise for ___ to allow grafts to heal.

a. 12-24 hours
b. 3-5 days
c. 1-10 days
d. 2-3 weeks

Question 30

30. If the legs are grafted, ambulation is discontinued for ____ , until the physician says otherwise.

a. 1-10 days
b. 10-20 days
c. 15-25 days
d. 20-30 days

Question 31

31. These procedures are helpful in the treatment of sacral decubitus ulcers:

I. Electrical stimulation
II. Prone positioning
III. Pressure bandaging
IV. UV therapy

a. I and III
b. II and IV
c. I, II and III
d. I, II, and IV

Question 32

32. Clinical features of an arterial ulcer:

I. Preceded by signs of arterial insufficiency; pulses poor or absent.
II. Pain: none to aching pain in dependent position.
III. Color: pale on elevation; dusky rubor on dependency.
IV. Skin changes: pigmentation, stasis dermatitis may be present
V. Presence of gangrene

a. I, II and III
b. I, III and V
c. I, II, III and IV
d. I, III, IV and V

Question 33

33. Lesions caused by unrelieved pressure resulting in ischemic hypoxia and damage to underlying tissue?

a. Arterial ulcer
b. Venous ulcer
c. Pressure ulcer
d. Decubitus ulcer

Question 34

34. Clean red wounds:

a. healthy granulating wounds (in need of protection); absence of necrotic tissue
b. include slough (necrotic or dead tissue), fibrous tissue
c. covered with eschar (dried necrotic tissue)
d. ulcer that is slow to heal; is not painful

Question 35

35. Elevating a patient’s lower extremity for less than 1 minute produces a noticeable pallor of the foot, followed by delayed reactive hyperemia in a dependent position. These signs are indicative of:

a. An intact circulatory system
b. Venous insufficiency
c. Arterial insufficiency
d. Acute arterial occlusion

Question 36

36. A patient is largely confined to bed & has a stage IV sacral pressure ulcer of three months duration. The BEST choice of intervention is:

a. A 2-inch, convoluted foam mattress
b. Surgical repair
c. Nutritional supplements & pressure relief with a flotation mattress
d. Gentle wound cleansing & wet-to-dry gauze dressings

Question 37

37. A patient with a burn in the hip region should be positioned in which of the following positions:

a. Flexion and adduction
b. Extension and abduction
c. External rotation and hyperextension
d. Extension, abduction and neutral rotation

Question 38

38. A selective method of debridement using sterile instruments (scalpel, scissors, forceps, silver nitrate stick) that sequentially removes only necrotic wound tissue without anesthesia and with little or no bleeding induced in viable tissue?

a. Autolytic debridement
b. Enzymatic debridement
c. Mechanical debridement
d. Sharp debridement
e. Surgical debridement

Question 39

39. An open-cell foam dressing placed into the wound which uses controlled sub-atmospheric pressure (typically 125 mm Hg below ambient pressure)?

a. Hyperbaric oxygen therapy (HBO)
b. Vacuum-assisted closure (VAC)
c. Wound cleansing
d. Wound debridement

Question 40

40. If a patient has developed a thick eschar secondary to a full-thickness burn, the antibacterial agent MOST effective for infection control is:

a. Silver nitrate
b. Silver sulfadiazine
c. Sulfamylon
d. Nitrofurazone

Question 41

41. A patient present with a red, beefy granulating wound. The dressing that would be inappropriate to apply is:

a. Occlusive
b. Wet-to-wet
c. Hydrophilic
d. Wet-to-dry

Question 42

42. Clear, adhesive, semipermeable membrane dressings used for stage I and II pressure ulcers?

a. Transparent film
b. Calcium alginate
c. Iodosorb
d. Hydrogel

Question 43

43. This is used for heavily exudating wounds?

a. Wet-to-dry
b. Continuous dry
c. Continuous moist
d. None of these

Question 44

44. Immediately after burn injury, splint is worn:

a. 12 hours
b. 24 hours
c. 23 hours
d. Every 6 hours

Question 45

45. High voltage electrical burn?
    a. 500 volts
    b. >500 volts
    c. 500-1000 volts
    d. >1000 volts

Question 46

46. Indicated for wounds with moderate to large amount of exudates?

a. Hydrocolloids
b. Hydrogels
c. Calcium alginates
d. Gauze dressings

Question 47

47. Which of the following is the best and first treatment for a wound with black eschar over 90% of the wound bed?

a. Lidocaine
b. Dexamethasone
c. Silvadene
d. Elase

Question 48

48. A 12-year-old girl has sustained a full-thickness burn to both arms & is now beginning to develop hypertrophic scars. The most appropriate intervention to manage these scars are:

a. Ace wrapping the affected areas
b. Custom made garments
c. Surgical resection
d. Excision followed by autografts

Question 49

49. A 22-year-old female patient suffered 3rd-degree burns on the entire anterior & posterior portion of her right LE including her perineal area. Based on the Rule of nine, she would have what percentage of burn area:

a. 18%
b. 19%
c. 27%
d. 28%