Deck 43: Smoke Inhalation, Thermal Injuries, and Carbon Monoxide Intoxication

Question 1

A patient has been brought to the emergency department after inhaling superheated steam. Pulmonary injuries unique to this situation include:
1) atelectasis.
2) pulmonary edema.
3) thick secretions.
4) pharyngeal edema.

A) 3
B) 1, 2
C) 2, 3, 4
D) 1, 2, 3

Answer 1

1, 2

Question 2

A patient with carbon monoxide poisoning has a COHb level of 20%. If the patient is given 100% oxygen, what will the approximate COHb level be in 1 hour?

A) 15%
B) 10%
C) 5%
D) 2.5%

Answer 2

10%

Question 3

Which of the following conditions occurs in 20% to 30% of hospitalized fire victims with facial burns?

A) Acute respiratory distress syndrome (ARDS)
B) Upper airway obstruction
C) Pneumonia
D) Pulmonary embolism

Answer 3

Upper airway obstruction

Question 4

Which of the following radiographic findings would be associated with the intermediate stage of recovery from a serious smoke inhalation injury?

A) Pulmonary edema/ARDS
B) Patchy or segmental infiltrates
C) Empyema
D) Normal/full recovery

Question 5

In an industrial accident, an adult incurred burns over his head and neck, both arms, and his anterior trunk. What percent of his BSA was burned?

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

Question 6

According to the Parkland Formula, what is the recommended volume of fluid that should be infused over a 24-hour period for each percent of body surface burned?

A) 1 mL/kg of body weight
B) 4 mL/kg of body weight
C) 6 mL/kg of body weight
D) 10 mL/kg of body weight

Question 7

A 65-year-old patient has third-degree skin burns over 30% of his body and a smoke inhalation injury. How does the combination of skin burns and smoke inhalation affect his prognosis?

A) It quadruples the mortality rate.
B) It more than triples the mortality rate.
C) It almost doubles the mortality rate.
D) There is no mortality change between having one or two concurrent problems.

Question 8

What COHb level is associated with a throbbing headache, nausea, vomiting, and impaired judgment?

A) 1% to 10%
B) 10% to 20%
C) 20% to 30%
D) 30% to 50%

Question 9

What level of carbon monoxide toxicity is associated with coma, convulsions, and Cheyne-Stokes respiration?

A) 10% to 20% COHb
B) 20% to 30% COHb
C) 30% to 50% COHb
D) 50% to 60% COHb

Question 10

The long-term effects of a smoke inhalation injury are:

A) obstructive lung disorders.
B) restrictive lung disorders.
C) obstructive and restrictive lung disorders.
D) neither obstructive nor restrictive lung disorders, since there is normally complete recovery.

Question 11

Clinical signs of an upper airway thermal injury include:
1) facial burns.
2) atelectasis.
3) mucosal edema.
4) epithelial sloughing.

A) 3
B) 1, 4
C) 1, 3, 4
D) 1, 2, 3, 4

Question 12

Clinical signs associated with acute upper airway obstruction due to thermal injury include:
1) pleural friction rub.
2) inspiratory stridor.
3) pulmonary edema.
4) painful swallowing.

A) 1, 3
B) 2, 4
C) 2, 3, 4
D) 1, 2, 3, 4

Question 13

All of the following classes of medications are commonly used in the care of patients with smoke inhalation injury EXCEPT:

A) parasympatholytics.
B) mucolytics.
C) sympathomimetics.
D) monoclonal antibody.

Question 14

Which portion of the pulmonary system will be affected by the inhalation of low-water solubility gases such as hydrogen chloride and phosgene?

A) Distal airways and alveoli
B) Pulmonary vascular bed
C) Upper airway
D) Pulmonary lymphatic system

Question 15

Late-stage complications of extensive body surface burns include:
1) sepsis.
2) upper airway obstruction.
3) pneumonia.
4) pulmonary embolism.

A) 1, 2
B) 3, 4
C) 2, 3
D) 1, 3, 4

Question 16

A 10-year-old patient has inhaled hot gases, and an inspection of her mouth shows edema and blisters. What should the respiratory therapist recommend?

A) Perform a bronchoscopy to evaluate the trachea.
B) Perform endotracheal intubation.
C) Monitor her SpO2 once per shift.
D) Administer an aerosol treatment with racemic epinephrine.

Question 17

All of the following will be typically found in the air of an enclosed house fire EXCEPT:

A) steam.
B) carbon monoxide.
C) hydrogen cyanide.
D) hydrogen chloride.

Question 18

Which of the following would be recommended for the treatment of cyanide poisoning?

A) Aztreonam
B) Albuterol sulfate
C) Amyl nitrate
D) Aclidinium bromide