Quiz 8 - Burns & Face and Neck Trauma

Question 1

The onset of ___________ soon after exposure to radiation is a predictor of poor outcomes.

A. vomiting

B. tachycardia

C. hair loss

D. confusion

Answer 1

A. vomiting

Question 2

During an explosion, a 42-year-old construction worker sustained a large laceration to the lateral aspect of his neck when he was struck by a piece of flying debris. The patient is conscious, but complains of difficulty hearing. In addition to protecting his spine, you should be MOST concerned with:

A. administering high-flow oxygen via nonrebreathing mask as soon as possible.

B. applying a bulky dressing to the laceration and securing it firmly with a bandage.

C. covering the laceration with an occlusive dressing and controlling the bleeding.

D. carefully examining his ear to determine if his tympanic membrane is ruptured

Answer 2

C. covering the laceration with an occlusive dressing and controlling the bleeding.

Question 3

The progression of a chemical burn is MOSTLY dependent on:

A. whether the corrosive substance is a strong acid or alkali.

B. the surface area of the body exposed to a corrosive chemical.

C. the length of time the corrosive chemical remains on the skin.

D. the patient’s general health and the thickness of his or her skin

Answer 3

C. the length of time the corrosive chemical remains on the skin.

Question 4

The two MOST common causes of death from an electrical injury are:

A. full-thickness burns and respiratory arrest.

B. asphyxia and cardiopulmonary arrest.

C. myoglobinuria and diaphragmatic paralysis.

D. nervous system damage and massive sepsis.

Answer 4

B. asphyxia and cardiopulmonary arrest.

Question 5

If an acutely burned patient is in shock in the prehospital setting:

A. it is likely that he or she is experiencing burn shock.

B. administer a 250-mL bolus of normal saline and reassess.

C. you should look for another injury as the source of shock.

D. avoid IV fluids unless the systolic BP is below 80 mm Hg.

Answer 5

C. you should look for another injury as the source of shock.

Question 6

When considering analgesia for a burn patient who is in severe pain, you must remember that:

A. due to the risk of causing hemodynamic compromise, analgesia should be avoided in the field.

B. benzodiazepines are preferred over narcotics because they are less likely to cause hypotension.

C. burns increase the metabolic rate, which may necessitate higher than normal doses of analgesics.

D. one half of the usual dose of narcotic analgesics should be given in order to avoid drug toxicity.

Answer 6

C. burns increase the metabolic rate, which may necessitate higher than normal doses of analgesics.

Question 7

The secondary assessment of a severely burned patient is intended to:

A. locate and treat minor injuries after all serious injuries have been treated.

B. identify other injuries that may have a higher priority for treatment.

C. provide for a rapid means of assessing the patient for occult injuries.

D. focus on areas of the body that have sustained the most serious burns.

Answer 7

B. identify other injuries that may have a higher priority for treatment.

Question 8

Bradycardia that occurs shortly after you have dressed and bandaged an open neck wound is MOST likely the result of:

A. parasympathetic nervous system stimulation due to excessive pressure on the carotid artery.

B. decreased venous return from the brain and an increase in intracranial pressure.

C. decreased vagal tone secondary to direct injury to the vagus nerve.

D. an acute pulmonary embolism due to the entrainment of air into one of the jugular veins.

Answer 8

A. parasympathetic nervous system stimulation due to excessive pressure on the carotid artery.

Question 9

General care for an eye injury involves:

A. covering both eyes to minimize further injury.

B. irrigating the eye with sterile saline solution.

C. applying a cold compress to the eyeball.

D. applying direct pressure to the globe

Answer 9

A. covering both eyes to minimize further injury.

Question 10

Supraglottic damage following a burn is MOST often caused by:

A. the inhalation of superheated gases.

B. direct flame exposure to the oropharynx.

C. the inhalation of hot particulate steam.

D. exposure to carbon monoxide or cyanide.

Answer 10

A. the inhalation of superheated gases.

Question 11

What type of thermal burn is MOST commonly associated with inhalation injury?

A. Scald burns

B. Steam burns

C. Flame burns

D. Arc burns

Answer 11

B. Steam burns

Question 12

Damage to the kidneys following an electrical injury:
answer.

A. is the result of electricity passing through the kidneys.

B. is caused by excess serum potassium levels.

C. occurs when damaged muscle produces myoglobin.

D. can be prevented with boluses of lactated Ringer’s

Answer 12

C. occurs when damaged muscle produces myoglobin.

Question 13

Victims standing near an object that is struck by lightning:

A. most commonly experience blast-type injuries.

B. often have burns characterized by a feathering pattern.

C. experience full-thickness burns that require debridement.

D. typically experience intractable ventricular fibrillation.

Answer 13

B. often have burns characterized by a feathering pattern.

Question 14

The appropriate treatment for MOST chemical burns is:

A. flushing with copious amounts of water.

B. neutralization with an alkaline substance.

C. application of a moist, sterile dressing.

D. application of a dry, sterile dressing.

Answer 14

A. flushing with copious amounts of water.

Question 15

Which of the following statements regarding prehospital vascular access and fluid therapy in the severely burned patient is correct?

A. An IV line in a lower extremity is preferable to one in a burned upper extremity.

B. Intraosseous cannulation is absolutely contraindicated in severely burned patients.

C. At least one large-bore IV should be started while en route to the hospital.

D. Most burn patients will require at least 4 L of IV fluid immediately.

Answer 15

C. At least one large-bore IV should be started while en route to the hospital.

Question 16

What two major nerves provide sensory and motor control to the face?

A. Facial and trigeminal

B. Facial and maxillary

C. Maxillary and mandibular

D. Ophthalmic and vagus

Answer 16

A. Facial and trigeminal

Question 17

What portion of the eye may become icteric in patients with hepatitis?

A. Iris

B. Cornea

C. Conjunctiva

D. Sclera

Answer 17

D. Sclera

Question 18

Following blunt trauma to the face, a 30-year-old man presents with epistaxis, double vision, and an inability to look upward. You should be MOST suspicious of:

A. fracture of the cribriform plate.

B. traumatic conjunctivitis.

C. traumatic retinal detachment.

D. an orbital blowout fracture.

Answer 18

D. an orbital blowout fracture.

Question 19

The MOST acute complication associated with large body surface area burns is:

A. hypovolemia.

B. myoglobinemia.

C. hypothermia.

D. infection.

Answer 19

C. hypothermia.

Question 20

When assessing a burn patient, it is MOST important to:

A. apprise medical control of the situation as soon as possible.

B. accurately calculate the extent of body surface area burned.

C. rapidly determine if the patient will require an escharotomy.

D. be alert for occult trauma that could affect patient outcome.

Answer 20

D. be alert for occult trauma that could affect patient outcome.

Question 21

The severity of a thermal burn correlates directly with:

A. the duration of exposure, the physical size of the patient, and the presence of concomitant traumatic injuries.

B. the presence of any underlying medical problems, the duration of exposure, and the temperature of the heat source.

C. the temperature of the heat source, the amount of heat energy possessed by the object or substance, and the duration of exposure.

D. the body’s ability to effectively dissipate significant heat energy and the patient’s general state of health.

Answer 21

C. the temperature of the heat source, the amount of heat energy possessed by the object or substance, and the duration of exposure.

Question 22

If a patient is unable to follow your finger above the midline following blunt trauma to the face, you should be MOST suspicious for a(n):

A. Le Fort II fracture.

B. nasal bone fracture.

C. basilar skull fracture.

D. orbital skull fracture

Answer 22

D. orbital skull fracture

Question 23

According to the rule of nines, an adult man with partial- and full-thickness burns to his head, face, and anterior chest has burns to ____% of his total body surface area.

A. 27

B. 18

C. 45

D. 36

Answer 23

B. 18

Question 24

A young man was assaulted and has extensive maxillofacial injuries. Your primary assessment reveals that he is semiconscious, has shallow breathing, and has blood draining from the corner of his mouth. Initial management for this patient involves:

A. inserting an oropharyngeal airway, preoxygenating him with a bag-mask device for 2 minutes, and then intubating his trachea.

B. manually stabilizing his head in a neutral position, suctioning his oropharynx, and assisting ventilations with a bag-mask device and 100% oxygen.

C. applying a cervical collar, performing a blind finger sweep to clear his airway, and providing ventilatory assistance with a bag-mask device.

D. fully immobilizing his spine, inserting a nasopharyngeal airway, and hyperventilating him with a bag-mask device at a rate of 20 breaths/min.

Answer 24

B. manually stabilizing his head in a neutral position, suctioning his oropharynx, and assisting ventilations with a bag-mask device and 100% oxygen.

Question 25

If you are unable to orotracheally intubate a patient due to massive maxillofacial trauma and severe oropharyngeal and nasopharyngeal bleeding, you would MOST likely have to perform:

A. pharmacologically assisted intubation.

B. a needle or surgical cricothyrotomy.

C. digital (tactile) intubation.

D. nasotracheal intubation.

Answer 25

B. a needle or surgical cricothyrotomy.

Question 26

With regard to a thermal burn injury, the zone of coagulation:

A. may undergo necrosis within 24 to 48 hours after the burn.

B. surrounds the central part of the burn and is often inflamed.

C. is the central part of the burn and suffers the most damage.

D. is the area least affected by the burn and will likely recover

Answer 26

C. is the central part of the burn and suffers the most damage.

Question 27

The purpose of estimating a patient’s total body surface area burns in the prehospital setting is to

A. determine whether the patient should be transported via a helicopter.

B. obtain an accurate calculation of how severe the patient’s burns are.

C. ascertain how much IV fluid the patient should receive during transport.

D. help the paramedic determine the most appropriate destination hospital.

Answer 27

D. help the paramedic determine the most appropriate destination hospital.

Question 28

Burn shock is caused by:

A. a massive infection that occurs when microorganisms breach burned skin.

B. fluid loss across damaged skin and volume shifts within the rest of the body.

C. acute dehydration, and it commonly manifests within 30 minutes after the burn.

D. renal failure secondary to excess myoglobin production from burned muscle.

Answer 28

B. fluid loss across damaged skin and volume shifts within the rest of the body.

Question 29

You respond to an industrial plant for a 42-year-old man with a chemical burn. Upon arrival at the scene, you find the patient to be ambulatory. He tells you that he was moving some bags of dry lime when one of the bags broke and spilled lime all over him. After donning the appropriate personal protective equipment, you should:

A. remove his clothing, brush as much of the lime off of him as possible, and flush the affected areas with copious amounts of water.

B. avoid brushing any of the lime from his skin, as doing so may cause additional injury, and flush his entire body with water for 30 minutes.

C. remove all of his clothing, apply baking powder to neutralize the lime, and begin flushing his body with copious amounts of sterile saline.

D. remove his clothing, carefully brush the lime away from his skin, but avoid flushing with water, as doing so will likely increase burn severity.

Answer 29

A. remove his clothing, brush as much of the lime off of him as possible, and flush the affected areas with copious amounts of water.

Question 30

Many of the physiologic changes caused by acute radiation syndrome:

A. occur over time and will not be apparent in the prehospital setting.

B. manifest with lethal cardiac dysrhythmias and sudden cardiac arrest.

C. can be reversed if chemotherapy is administered within 24 hours.

D. are a direct result of beta particles and are usually life threatening.

Answer 30

A. occur over time and will not be apparent in the prehospital setting.