Deck 5: Burns

Question 1

You are dispatched to a structure fire at which there is a report of a burned person. Your patient is a 32-year-old man with blisters on his anterior chest and circumferential superficial burns to both lower extremities. Using the "rule of nines," the percentage of burn is:

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

Answer 1

45.

Question 2

The type of electricity supplied to homes is ________ current. Contact with this type of current may result in ________.

A) indirect; rhabdomyolysis
B) direct; rhabdomyolysis
C) direct; muscle tetany
D) alternating; muscle immobolization

Answer 2

alternating; muscle immobolization

Question 3

The three primary factors that determine the severity of radiation are:

A) distance, shielding, and symptoms.
B) duration, shielding, and dose.
C) duration, distance, and shielding.
D) dose, symptoms, and shielding.

Answer 3

duration, distance, and shielding.

Question 4

Which tissue layer(s) is (are) affected by partial thickness burns?
1) Epidermis
2) Dermis
3) Subcutaneous
4) Muscle

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

Question 5

An area of burned tissue that is not painful is MOST likely a ________ burn injury.

A) second-degree
B) full thickness
C) superficial
D) partial thickness

Question 6

Which of the following agents is the best choice for analgesia in a patient with 9 percent partial thickness burns involving the right lower extremity?

A) Naproxen sodium
B) Ketorolac
C) Acetaminophen
D) Fentanyl

Question 7

Your patient has circumferential full thickness burns of the thorax. He is intubated, and you have noticed an increase in resistance as you bag him. His skin is very tight and inflexible as you try to ventilate. Which of the following is required to improve this patient's ventilatory status?

A) IV sedation
B) Needle thoracostomy
C) Escharotomy
D) Fasciotomy

Question 8

Which of the following may occur from watching arc welding without proper protection?

A) Hyphema
B) Retinal detachment
C) Ultraviolet keratitis
D) Radial keratotomy

Question 9

Which of the following has contributed most significantly to the decline in U.S. burn mortality?

A) Public service announcements on radio, television, and billboards
B) Paramedic involvement in public education
C) Visits to elementary schools by firefighters
D) Improved building codes and construction and sprinkler and smoke detector use

Question 10

Which of the following accounts for the most severe thermal burns of the airway?

A) Inhalation of toxic gases
B) Inhalation of radioactive particles in smoke
C) Inhalation of superheated steam
D) Inhalation of superheated air

Question 11

Which of the following body areas warrant special attention when burned?

A) Legs
B) Arms
C) Abdomen
D) Feet

Question 12

You have been dispatched to a call for a burn patient. Upon arriving, you find a 23-year-old woman who was sunbathing and fell asleep. She is alert and oriented and in moderate pain. She has blisters covering her extremities, abdomen, face, and chest. This patient's burns fall into which one of the following categories?

A) Superficial
B) Critical
C) Minor
D) Moderate

Question 13

Which classification of burn is characterized mainly by blisters?

A) Full thickness
B) Superficial
C) Partial thickness
D) Minor

Question 14

According to Jackson's theory of thermal wounds, which of the following zones has suffered the greatest damage?

A) Coagulation
B) Hyperemia
C) Stasis
D) Disintegration

Question 15

Which of the following patient factors increases the criticality of the patient's burn injuries?

A) Taking antidepressants
B) Male gender
C) Prior history of burns
D) Being in the geriatric age group

Question 16

Based on total body surface area and burn depth, you have determined that an 88-year-old woman has a moderate burn. Considering the age of the patient, this burn is classified as:

A) critical.
B) significant.
C) fatal.
D) moderate.

Question 17

Which of the following stages of burn injury is best described as including a pain response, an outpouring of catecholamines, tachycardia, tachypnea, mild hypertension, and anxiety?

A) Resolution
B) Emergent
C) Fluid shift
D) Hypermetabolic

Question 18

Which type of radiation particle can travel through 6 to 10 feet of air, penetrate a few layers of clothing, and cause external and internal injuries?

A) Gamma
B) Alpha
C) Neutron
D) Beta

Question 19

You are caring for a patient with 30 percent full and partial thickness burns. He is an 80 kg man. According to the Parkland formula, he should receive ________ liters of fluid over 24 hours, with ________ liters infused in the first 8 hours.

A) 9.6; 4.8
B) 5; 3
C) 8.2; 2
D) 4.5; 1.25

Question 20

Contact with strong alkalis results in burns involving ________ necrosis of the tissue.

A) coagulation
B) liquefaction
C) thermal
D) ischemic

Question 21

Which of the following burns would be classified as moderate?

A) Superficial < 50 percent BSA
B) Full thickness < 2 percent BSA
C) Partial thickness < 30 percent BSA
D) Partial thickness > 30 percent BSA

Question 22

Which of the following chemicals must be brushed off the skin, then covered with oil?

A) Phenol
B) Sodium metal
C) Oleoresin capsicum
D) Dry lime

Question 23

Your patient is a 23-year-old woman who was rescued from a burning house. She was asleep in a back bedroom when the fire started, and there was no smoke alarm. She has a pulse oximetry reading of 99 percent after receiving oxygen by nonrebreather mask. What is the most appropriate interpretation of this finding?

A) Effects of smoke inhalation have been resolved by oxygen administration.
B) You cannot rely on this alone to assess oxygenation.
C) There was minimal smoke inhalation.
D) Carboxyhemoglobin is less than 1 percent.

Question 24

Cool-water immersion of a burned part effectively reduces burning only when done within which of the following time frames?

A) The first 24 hours
B) The first 10 to 15 minutes
C) The first 1 to 2 minutes
D) The first hour

Question 25

During which phase of a burn injury does extravasation of proteins, water, and electrolytes occur, resulting in edema and potential hypovolemia?

A) Emergent
B) Hyperemia
C) Hypermetabolic
D) Fluid shift

Question 26

A burn patient who has signs and symptoms of inhalation injury with associated respiratory compromise should be classified as:

A) serious.
B) moderate.
C) critical.
D) minor.

Question 27

The voltage of a bolt of lightning may be as much as ________ volts, and its temperature may reach ________ degrees Fahrenheit.

A) 5,000; 150,000
B) 150,000; 5,000
C) 50,000; 100,000
D) 100,000; 50,000

Question 28

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

A) neutralize the lime with a mild acidic solution, such as vinegar and water.
B) brush away as much of the powder as possible.
C) flush the skin with large amounts of isopropyl alcohol.
D) flush with copious amounts of tepid water.

Question 29

Which of the following is TRUE of the heat generated when electricity flows through the body?

A) Dry skin offers less resistance to electricity, generating more heat.
B) Wet skin offers less resistance to electricity, generating more heat.
C) Wet skin offers greater resistance to electricity, generating more heat.
D) Dry skin offers more resistance to electricity, generating more heat.

Question 30

Flash burns associated with electricity occur because:

A) air is a moderately good conductor of electricity, generating moderate heat.
B) air is an excellent conductor of electricity, generating moderate heat.
C) air is mildly resistant to the passage of electricity, generating only enough heat to cause superficial burns.
D) air is highly resistant to the passage of electricity, generating intense heat.

Question 31

You are assessing a 37-year-old woman who was rescued from an apartment fire. She has a harsh, stridorous, "brassy"-sounding cough productive of sooty sputum. Her eyebrows and the hair around her face are singed. Respirations = 28, heart rate = 108, and blood pressure = 124/84. You have a 30-minute transport time. Which of the following is the best intervention for this patient?

A) One hundred percent oxygen by nonrebreather mask
B) Sedation and cricothyrotomy
C) A nebulized albuterol treatment
D) Rapid sequence intubation and endotracheal intubation

Question 32

For which of the following burn patients could you use local cooling?

A) An 18-month-old child with partial and full thickness scald burns on the lower extremities, buttocks, genitalia, and lower abdomen
B) A 19-year-old woman with approximately 40 percent superficial and 45 percent partial thickness burns from sunbathing
C) A 15-year-old man with partial thickness burns of his left upper extremity, anterior chest, and neck resulting from playing with gasoline and matches
D) A 52-year-old man with a 1-inch-wide full thickness burn across the entire width of the palm of his right hand resulting from picking up a hot grate from a barbecue grill

Question 33

Patients who survive the first several days of a moderate to critical burn are MOST likely to die from which of the following complications?

A) Hypovolemia
B) Organ failure
C) Infection
D) Hypothermia

Question 34

Which of the following represents the modified body surface area percentages in the "rule of nines" for pediatric patients?

A) Posterior chest is 7 percent.
B) Upper extremities are 13.5 percent each.
C) External genitalia is 1 percent.
D) Lower extremities are 13.5 percent each.

Question 35

Which of the following best describes the pathophysiology of most burns to the human body?

A) Heat causes evaporation of water and denatures protein.
B) Radiation, including solar radiation and radiant heat, alters cell structures.
C) Chemicals cause an endothermic reaction that destroys tissue.
D) The skin, and sometimes deeper tissues, are destroyed through combustion.

Question 36

You are assessing a 17-year-old male patient with a burn on the lateral aspect of his thigh. Which of the following guidelines is most helpful when estimating the percentage of total body surface area involved?

A) The rule of palms
B) The Parkland formula
C) The rule of nines
D) The modified pediatric rule of nines

Question 37

Which of the following body structures is the best electricity conductor?

A) Bones
B) Nerves
C) Muscle
D) Skin

Question 38

Paralysis of the muscles of respiration may occur when there is body contact with electrical currents as low as ________ mA.

A) 60
B) 100
C) 20
D) 5

Question 39

Most inhalation injuries in burn patients are due to which of the following?

A) Toxic inhalation
B) Radiation burns of the airway
C) Thermal burns of the lower airway
D) Thermal burns of the upper airway

Question 40

The seriousness of burns in the pediatric population is put into perspective by realizing that burns are the ________ leading cause of death in children under age 12 years.

A) first
B) second
C) third
D) fourth